Healthy Neighbourhood Design

Credit: Picture BC

The built environment is the human-made, physical setting for human activities – where people live, work, learn, and play. Whether rural, urban, or suburban communities, healthy built environments are places that can be intentionally designed to support good health and help people to thrive.

Healthy neighbourhood design means employment, amenities, and services are located near or among residential areas; connected street patterns encourage active forms of transportation such as walking, cycling, and transit; and housing choices suit people of all incomes, ages, and abilities.

There are three key healthy neighbourhood design elements:

  • complete: a variety and mix of land uses are available in the community
  • compact: the community is concentrated, not spread thinly over a large area
  • connected: the layout makes it convenient and pleasant to get to destinations

What is this issue about?

Neighbourhood design and land use are effective strategies for promoting health. As individuals we make choices that affect our health, but it was estimated in a 2009 Canadian Senate Report that 60% of health outcomes can be attributed to the places we live and socio-economic determinants of health.i

Evidence shows that people have better health when they live in communities that are designed to support day-to-day healthy choices, such as being physically active, eating healthy food, and engaging in positive social interactions.

People with low incomes generally have poorer health status, more barriers to making healthy choices, and less of a voice to advocate for changes that result in better health. Living in neighbourhoods that offer opportunities to be active and provide access services is a boost to health.

Designing, building, and retrofitting communities to be healthy is about making it easy for all residents to move around, be connected with one another, feel safe, and access services that they need.

Why is healthy neighbourhood design important for health and well-being?

Enables physical activity

If routine neighbourhood destinations (shopping, work, etc.) are near to home, and if it is safe and easy to get there by active transportation, residents are more active in daily life.

  • People living in mid- to high-density neighbourhoods offering a mix of services within walking distance are 2.4 times more likely to meet their 30 minutes of recommended daily activity requirements for better health.ii
  • Parks, trails, and playgrounds are a key part of a healthy design because they encourage active transportation and exercise among all age groups. Both physical and mental health benefits are gained by those who have access to greenspace.iii
  • The number of people who get regular exercise (3 days a week) increases by 25% in neighbourhoods with parks, trails, and playgrounds.iv
  • In places with direct pathways connecting homes with multiple destinations (stores, transit stops, parks), people are more likely to engage in moderate physical activity for 30 minutes or more per day.v 

Encourages healthy eating

The location of grocery stores and other sources of healthy food in close proximity to home can positively affect our ability to make healthy choices. Easy access to unhealthy food sources can negatively impact health as over-consumption of “junk foods” raises the risk for diabetes, heart disease, and certain Residents living in a neighbourhood with at least one grocery store are 1.5 times as likely to be physically active than residents living in an area with no grocery store. Each additional grocery store within a one-kilometre distance from an individual’s residence is associated with an 11% reduction in the likelihood of being overweight.vii

Increases social capital and safety

Social capital is commonly referred to as the glue that holds the people in communities together. Communities where people are active and socialize have high levels of social capital and are associated with greater prosperity, lower crime, greater overall community cohesion, and better engagement with local government. Connected communities are also safer. Safety is linked with a higher residential density and mixed land use since such places can be vibrant with social activity in daytime and in the evenings.viii,ix

Strengthens social connections and improves access to services

Children, elderly adults, people with disabilities, and people with lower incomes particularly benefit from healthy community design and land use because it provides them with convenient access to community services and connections close to where they live without driving.

Such benefits include:

  • improved child development: the neighbourhood distribution of programs and services, including childcare, parks, recreation centres, and child- and family-friendly locations, can improve the quality of life for children and their families. University of BC research shows that children in mixed income neighbourhoods have the best access to these services and the best early learning development outcomes, which bode well for their long-term health outcomes.x
  • enhanced community connections and networks: mixed housing types build social ties and understanding among neighbours with different economic and life circumstances. Healthy design includes spaces that help people to interact and build these social connections.xi Having social ties within the community is associated with lower stress, improved overall health status, lower mortality rates,xii and longevity.xiii

Why does healthy neighbourhood design matter for local governments?

There is an unmet and growing market demand to live in complete, compact, and connected communities.xiv Such communities are necessary to meet environmental, economic, and social planning objectives.xv Resident and political support for these planning directions may be bolstered when evidence that links progressive community design and land use with positive health outcomes is provided.

Municipal plans contain the building blocks for community design and land use: street layout, land use, park locations, and buildings and public space design. Planning processes are important opportunities to build a healthy community – without adding extra cost to the process.

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i The Senate Standing Committee on Social Affairs, Science and Technology, Government of Canada. A Healthy, Productive Canada: A Determinant of Health Approach. (Ottawa: Government of Canada, June 2009)…

ii Lawrence Frank, Sarah Kavage, and Todd Litman with Smart Growth BC, Promoting Public Health Through Smart Growth (Vancouver: Smart Growth BC, 2006).

iii Frances Ming Kuo, Parks and Other Green Environments: Essential Components of a Healthy Human Habitat, Research Series 2010 (Ashburn, Virginia: National Recreation and Park Association, 2010

iv Leslie Mikkelsen, Sana Chehimi, Larry Cohen for Prevention Institute, Healthy Eating & Physical Activity: Addressing Inequities in Urban Environments (Oakland: Prevention Institute, 2007)…

v Roger Parsonage, “Creating Healthier Built Environments: Developing a tool to conduct health reviews of land use proposals” SPHA 590 Research Project, University of British Columbia, June 2009).

vi Heart and Stroke Foundation of Canada, Shaping Active, Healthy Communities. Built Environment Toolkit for Change (Toronto: Heart and Stroke Foundation of Canada, 2012)

vii Roger Parsonage, “Creating Healthier Built Environments: Developing a tool to conduct health reviews of land use proposals” SPHA 590 Research Project, University of British Columbia, June 2009).

viii Bill Hillier and first Ozlem Sabhaz, An evidence based approach to crime and urban design: Or, can we have vitality, sustainability and security all at once? (London: Bartlett School of Graduate Studies, 2008)…

ix Meghan Williams and Myrna Wright, The Impact of the Built Environment on the Health of the Population: A Review of the Review Literature (Barrie: Simcoe Muskoka District Health Unit, 2007).

x University of British Columbia “Integrated Living,” Frontier, Fall 2009: p19. (Vancouver: University of British Columbia, 2009)

xi Howard Frumkin, Lawrence Frank, Richard Jackson, Urban Sprawl and Public Health: Designing, planning, and building for healthy communities (Washington, D.C.: Island Press, 2004), cited in Simcoe Muskoka Health Unit, Healthy Community Design Policy for Official Plans (Ontario: Simcoe Muskoka Health Unit, 2010.

xii Ibid.

xiii Robert García, Erica S. Flores, and Sophia Mei-ling Chang, Healthy Children, Healthy Communities: Schools, Parks, Recreation and Sustainable Regional Planning in Fordham Urban Law Journal Volume 31, Issue 5, Article 3, 2004.… children, healthy communities%3A schools, parks, recreation and sustainable regional planning%26sourc

xiv Province of BC, “Climate Action Tool Kit: Actions for Land Use,”

xv Smart Growth More Efficient Land Use Management, Victoria Transport Policy Institute.

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