LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
LAND USE & COMMUNITY DESIGN AND HEALTH
Land Use and Community Design Determine Health
Heart diseases, cancer, diabetes, stroke, injuries and mental illness leading causes of morbidity and mortality. Many can be prevented by health-promoting built
environment policies and practices. The term “built environmenti” broadly refers to the “form and character of communities” encompassing land-use patterns,
urban design characteristics, and transportation systems. The built environment, comprising the physical and the social environments, affects both human and
natural environmental health.
The physical aspect of the built environment shapes people’s social behaviors and lifestyles. The land-use mix and layout and the urban design of neighborhoods
can determine one’s proximity to health-relevant opportunities and resources. Uncontrolled growth and reliance on cars do not only cause traffic volume and injury
fatalities, but also physical inactivity, air pollution, and carbon emissions. Proximity to unhealthy food retail, such as convenience stores and fast food restaurants,
is linked to unhealthy dietary behaviors and related chronic diseasesii. Residential proximity to environmental hazards can increase the risk of adverse health
outcomes, including adverse pregnancy outcomes, cancer, cardiovascular and respiratory illnessesiii.
The social aspect of the built environment equally affects our health. In general, this relates to safety, violence, and social disorder. Specific factors pertain to the
type, quality, and stability of social connections, including social participation, social cohesion, social capital, community resilience, and the collective efficacy of
the neighborhood (or work) environment. Social capital depends on the ability of people to form and maintain relationships and networks with their neighbors.
Characteristics of communities that foster distrust among neighbors, such as neglected properties and criminal activity, can affect both the cohesiveness of
neighbors and our health and well-beingiv.
The Logic Model
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
Compact
Development
• Encourage development densities that existing
and planned infrastructure and services can
support.
• Encourage mixed-use development.
• Support Smart Growthv principles.
• Ensure jobs-housing balance/match in mixed
use centers.
• Increased walkability and physical
activity.
• Increased social connection.
• Increased transit usage.
• Reduced greenhouse gas emissions.
• Reduced impervious surface.
• Improved urban stormwater.
• Improved air quality.
• Increased environmental and social
capitals in local communities.
• Reduced body mass index and obesity.
• Reduced morbidity and fatalities.
• Reduced mortality.
• Reduced the prevalence of depression.
• Improved health and well-being.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
• Provide opportunities to walk to amenities and
services.
• Reduced urban sprawl.
• Reduced reliance on cars.
• Reduced commuting.
• Reduced motor vehicle accidents.
• Improved quality of life.
• Increased community inclusiveness.
• Increased neighborhood safety.
• Improved a sense of communityvi and
place.
Complete
Neighborhoodvii
viii
• Build 20-minute neighborhoods at a walkable
and bikeable human scale, and meets the
needs of people of all ages and abilities.
• Provide safe and easy walking access to
goods and services needed in daily life, such
as active transportation options, grocery stores
and other personal services, quality public
schools, parks and recreational facilities, and
other civic amenities.
• Provide mixed-income housing with affordable
access to diverse opportunities.
• Retrofit or add to existing neighborhoods to
improve amenities, adjacency, and experience
where residents already live.
• Increased equitable access to housing,
transit, healthy food and lifestyle.
• Increased walkability and physical
activity.
• Increased social connection.
• Reduced vehicle miles traveled.
• Reduced greenhouse gas emissions.
• Increased “an eye on the street”.
• Reduced body mass index and obesity.
• Reduced health disparities.
• Improved health and well-being.
• Improved quality of life.
• Increased social and environmental
capitals in local communities.
• Increased community inclusiveness.
• Increased neighborhood and housing
integration.
• Improved neighborhood safety.
• Improved a sense of community and
place.
• Increased social integration.
Transit-oriented
Development
and Colocationix
of Services
• Develop mixed-use centers along reliable
transit facilities.
• Co-locate essential services along transit
facilities and near community hubs.
• Explore joint use facilities and public-private
partnerships in addition to co-locating services.
• Design for maximizing use, ridership and
multiplier effect of new transit investments.
• Increased walkability and physical
activity.
• Increased social connection.
• Increased transit usage due to increased
density.
• Reduced vehicle miles traveled.
• Reduced greenhouse gas emissions.
• Reduced body mass index and obesity.
• Improved air quality.
• Improved health and well-being.
• Improved quality of life.
• Increased social and environmental
capitals in local communities.
• Increased community inclusiveness.
• Improved a sense of community and
place.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
Neighborhood
Environment
• Encourage retail that supports healthy living on
main streetsx.
• Discourage fast food restaurants by limiting
drive-through services.
• Identify foodshed and sources of fresh,
nutritious food.
• Provide access to local healthy foods and
community gathering opportunities through
community gardens and farmers’ markets.
• Expand curb-side opportunities for deliveries
and placemaking.
• Provide and capitalize on small, informal
outdoor gathering spaces, such as parklets
and pocket parks, with flexible seating and
shade environment, etc.
• Develop safe routes to destinations with street
trees and amenities (including water fountain
to adapt urban heat island effect).
• Apply Crime Prevention through
Environmental Design (CPTED) principles to
improve community health.
• Improved access to healthy foods and
healthy eating.
• Reduced obesity and cardiovascular risk
factors.
• Increased foot traffic.
• Increased “an eye on the street” and
reduced crime.
• Increased social, cultural and
environmental capitals in local
communities.
• Increased community inclusiveness and
mobilization, and collective efficacy.
• Improved neighborhood safety.
• Improved health and well-being.
• Improved quality of life.
Urban-Rural
Connection
• Right-size land-use markets through economic
mechanisms, such as Transfer of Development
Rights.
• Create stronger continuum of shared impacts
regarding land-use change and opportunities.
• Recognize agricultural productivity and its
importance, along the urban-rural gradient.
• Support connections to the land and
responsible farming practices, identity of land
• Improved urban-rural connections.
• Improved food systems and nutrition
security.
• Improved healthy eating across
population groups.
• Improved food justice and food
stability.
• Increased environmental capital.
• Improved environmental and human
health.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
stewardship tied to sustainable agriculture, and
family farms and regional foods.
• Document food deserts and loss of agricultural
productivity as a form of environmental
injustice.
• Explore tools, such as agricultural conversation
easement and density purchase, etc., to
protect healthy and responsible farmlands.
• Work with Conservation Futures to secure
funds to acquire and preserve timberlands and
agricultural areas.xi
Placemaking and
Built Form
• Develop complete streets as healthy and safe
“places”.
• Build urban parks including linear parks for
spontaneous social interaction.
• Encourage development densities that existing
and planned infrastructure and services can
suppor
• Provide place-making opportunities through
public space design and public arts by
engaging the local community.
• Provide safe and interesting destinations and
public spaces along main streets and in mixed-
use centers to encourage social gatherings.
• Encourage placemaking strategies and tactics
to encourage social gatherings.
• Provide movable furniture in public spaces and
destinations for informal use and social
interactions.
• Increased pedestrian traffic.
• Improved traffic safety.
• Reduced social isolation and depression.
• Reduced street crime.
• Increased “an eye on the street" and
reduced crime.
• Increased social, cultural and
environmental capitals in local
communities.
• Increased place attachmentxiii.
• Improved a sense of community.
• Improved street and neighborhood
safety.
• Increased social support.
• Reduced psychological distress and
depression.
• Improved health and well-being.
• Improved quality of life.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
• Encourage the use of street plinth (ground
floor building façades) to create “a city at an
eye levelxii” offering attractive public space and
pedestrian interaction opportunities with
ground floor activities.
• Create human-scale, pleasant and walkable
neighborhoods with the use of form-based
codes.
• Encourage architectural features of the front
entrance, such as porches, to promote visibility
from a building's exterior.
• Protect against widespread privatization of
public spaces as unintended consequence of
redevelopment.
• Preserve public access and comfort for
pedestrians and visitors, regardless of income,
ability and interest.
• Work with developers to provide private open
space and walkway connectivity for public use
at all reasonable hours.
Universal Design • Apply universal design principles to create
safe and walkable neighborhoods for all ages
and abilities.xiv
• Increased generational-friendly
opportunities to support aging-in-place.
• Increased access opportunities for
people with special needs.
• Reduced injuries and deaths among
aging populations.
• Increased social capital.
• Increased a sense of place.
• Increased community diversity,
inclusiveness and social integration.
• Improved health and well-being.
• Increased life expectancy.
Biophilic City
• Bring nature to the built environment by
integrating nature into urban design.
• Increase and protect urban tree canopy.
• Increased protected tree canopy.
• Reduced urban heat island effect.
• Improved air quality.
• Increased environmental, social and
physical capitals.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
• Encourage green infrastructure, such as green
roofs and rain gardens, etc.
• Create tree-lined linear urban parks for
recreation and mobility.
• Increased walkability and physical
activity.
• Reduced body mass index.
• Increased social interaction.
• Increased levels of focus, concentration
and self-discipline.
• Increased a sense of place and
community.
• Decreased the prevalence of
depression.
• Improved health and mental well-being.
Historic and
Architectural
• Identify and make visible all histories of the
community, including those of displaced and
historically marginalized populations.
• Work with the local communities and tribes to
identify and preserve the historic, architectural,
and aesthetic character and heritage of a
community.
• Make affordable housing preservation a
priority in retention of historic buildings to
prevent displacement of renters.
• Bring old buildings up to the National Healthy
Housing Standardxv and current codes.
• Consider using the “Transfer of Development
Right” tool to preserve buildings of historic,
cultural and architectural significance.
• Consider impacts and mitigations to historic
and cultural features during SEPA reviews.
• Work with Conservation Futures to secure
funds to acquire and preserve cultural,
archaeological and historic landmark sites.
• Improved walkability.
• Increased neighborhood socializing.
• Increased access to affordable housing.
• Reduced residential and local business
displacement.
• Reduced urban sprawl.
• Increased investment to renew urban
neighborhoods.
• Increased efficient use of existing
resources.
• Increased heritage tourism.
• Reduced building-specific crime, such as
graffiti.
• Increased a sense of place, history,
culture and community.
• Increased social, cultural and physical
capitals.
• Increased social and community
resilience.
• Improved social well-being.
• Improved local economy.
• Improved cultural identity among
generational residents.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Input/ Impact
Area
Strategies/ Policies
Intermediate Outcomes
Ultimate Outcomes
Arts and Cultural
• Use public arts to promote community culture
and history, and walkability.
• Work with local artists and engage local
communities in creative placemaking and
transformative public arts project.
• Encourage local public arts in public spaces
and facilities to tell the story of the local
community.
• Support “creative class” to fuel economic
development.
• Promote arts through adaptive reuse of
underutilized buildings, etc.
• Reduced social isolation.
• Decreased stress.
• Increased self-efficacy.
• Reduced crime.
• Broadened public participation.
• Increased art-based industries,
businesses and tourism.
• Increased social, cultural and physical
capitals.
• Increased community resilience and
community healing.
• Increased a sense of identity, place,
history, culture, and belonging.
• Increased social inclusiveness and
community diversity.
• Improved mental and emotional health
outcomes.
• Improved public safety.
• Increased civic pride.
• Improved health and well-being.
• Improved quality of life.
LAND USE & COMMUNITY DESIGN HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020 -CMOS)
Research Evidence
Compact Development
Badger, Emily. 2013. “Mixed-Use Neighborhoods May Be Safer, Too.” CityLab. Accessed May 20, 2020. https://www.citylab.com/equity/2013/03/mixed-use-
neighborhoods-may-be-safer-ones-too/4962/.
Campoli, J. 2012. Made for Walking: Density and Neighborhood Form. Cambridge, MA: Lincoln Institute of Land Policy. http://www.urbandesignresources.org/wp-
content/uploads/2013/12/2150_1509_MFW_Web_Chapter.pdf.
Conserve Energy Future. “Effects of Urban Sprawl”. Accessed May 20, 2020.…