Every day, millions of Californians breathe unhealthy air or lack clean drinking water. Toxins are rampant in the products we purchase and consume. Sprawling new development is causing longer commutes. Countless neighborhoods lack safe parks for children to play. Our built environment is not only straining the natural environment but it is also increasingly taking a toll on public health.

So often, local land use and planning decisions have a significant and direct impact on public health. Research suggests that reversing our current pattern of sprawling new developments and focusing on smart land use and designing communities and buildings which account for public health has the potential to reduce diseases such as heart and pulmonary disease, diabetes, obesity, and asthma.

There exists a real link between the public’s health and the built environment. Place and physical spaces exposes communities to pollutants and have an effect on people’s lifestyles that contribute to cardiovascular and respiratory disease, diabetes, and asthma.

Health and Safety Laws

At the onset of the 20th century, unsanitary living conditions and overcrowding facilitated the spread of infectious disease. Due to the public health and safety threat brought by these conditions, the City of New York enacted the Tenement House Act in 1901 that regulated housing construction and maintenance. City officials also enforced public nuisance laws to separate harmful activities from populated areas.

By 1916, New York City enacted the first zoning law, which later became a federal mandate under the 1924 Standard Zoning Enabling Act that was upheld by the U.S. Supreme Court through Ambler Realty v. Village of Euclid, Ohio, where it was noted that separating land uses would promote the health and safety of the community, protecting residents from fires and disease.

These laws with other governmental policies and economic considerations were the impetus to the separation of residential, shopping, and industrial uses. Urban sprawl became apparent as standardized planning and design practices spread out low density development that came to be dependent on vehicle use. Land uses were segregated and separated housing from work, schools, and public services. Another unforeseen consequence is the emergence of communities isolated by housing type, income, and/or ethnicity.

Current Land Use Policy

Public health and safety concerns directed local governments to separate nuisances from populated areas. However, current land use policy fails to recognize the considerable impact current growth patterns have on public health. An article by the American Journal of Preventive Medicine, states that “zoning was born and grew up in a time dramatically different from today. Instead of overcrowding and the spread of fire and disease, American cities confront an array of health and economic challenges …. Population declines and stagnant economies continue to plague many cities and inner suburbs as market forces and government policies have redirected jobs and housing into outlying suburban and rural communities. Zoning’s separation of uses created vast suburban communities where routine daily trips to stores and schools must be done in automobiles. Walking … is often not a practical or safe alternative.”

Land use planning practices tend to give primacy to automobile-oriented design and standardized land use regulations. This has resulted in behavior changes that have given rise to new health concerns. For example, suburban residents spend more than 90 minutes in a vehicle each day; one child in ten walks or bikes to school; and, low-income populations remain in unhealthful concentrations of poverty that lack infrastructure, housing choice, employment, and are disproportionately impacted by pollutants.

There is little understanding about the broad impact of the built environment on health, and there have been few instances where communities are designed to promote social, economic and environmental well being. The built environment has been shaped by law and governmental decisions; a healthy environment will be created by new laws and decisions based on the collaborative efforts of governmental agencies, environmentalists, public health specialists, planners, architects, policymakers, social scientists, engineers, developers, law enforcement, economists, and community leaders/organizations.