As decision-makers, local officials can play a critical
leadership role in efforts to improve community health, because
there are so many ways that local decisions can affect residents’
health and well-being.
A wide array of local officials — those elected to serve on the
city council or county board of supervisors, residents serving on
advisory boards and commissions as well as local agency
administrators and staff — have many opportunities to integrate
health considerations into local programs and policy decisions.
Some of the most important types of local decisions with health
implications are outlined below.
How local officials choose to plan and lay out communities —
through the general plan, zoning and other land-use regulations —
For example, if homes, stores, schools and other places people
need to go are near one another and connected by safe and
convenient walking and bicycling routes, people are more likely
to walk or bike than if these amenities are located farther from
one another. Studies show that when residents take advantage of
these opportunities to increase their everyday activity, it
reduces their risks of obesity, diabetes and other chronic health
less time in cars gives people more free time to spend with their
families and communities, which can improve emotional
Decisions on how buildings are designed, constructed and
renovated have implications for health.
Many communities have established architectural standards, green
building requirements and other local policies that affect the
health and safety of residents and tenants. For example,
incorporating “universal design” principles into residential
construction — such as simply requiring that at least one entry
to each new or renovated residence be accessible for people with
disabilities — can make a neighborhood safer for people of all
ages and abilities.
Decisions on the type and character of public facilities and
infrastructure affect the health and safety of residents.
For example, neighborhood streets that carry fast auto traffic
can be modified through traffic-calming measures to slow vehicle
speeds. “Complete streets” programs can provide safe routes for
vehicles, bicycles, pedestrians and people with disabilities (for
more about complete streets, see “An
Overview of Planning Concepts for Health and the Built
Environment.”) These programs can help seniors and those with
limited mobility cross busy streets and make it easier for
children to safely walk and bike to school. As a result, the rate
of injuries and deaths from traffic accidents typically
Decisions about the programs that are funded through the city or
county budget can affect health.
This applies to decisions beyond those typically thought of as
health related, such as funding for clinics, senior meals and
other traditional health and social services. For example,
responding to a local budget crunch by closing parks or limiting
the hours they are open can make it more difficult for residents
to be physically active, even in neighborhoods where quality
recreational facilities can be safely reached by biking or
walking. This in turn can lead to declines in levels of health