Making the Healthy Choice the Easy Choice

Development strategies that can improve health outcomes—such as providing protected bikeways, minimizing noise pollution, and offering amenities such as community gardens—are highlighted in a new publication from the Urban Land Institute, the Building Healthy Places Toolkit: Strategies for Enhancing Health in the Built Environment.

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Development strategies that can improve health outcomes—such as providing protected bikeways, minimizing noise pollution, and offering amenities such as community gardens—are highlighted in a new publication from the Urban Land Institute (ULI), the Building Healthy Places Toolkit: Strategies for Enhancing Health in the Built Environment.

The Building Healthy Places Toolkit outlines 21 practical, evidence-based recommendations that the development community can use to promote health at the building or project scale. The recommendations, based on the latest documentation of the need for and impact of building for health, were formulated to help developers, owners, property managers, designers, and investors understand opportunities to integrate health-promoting practices into real estate development.

The release of the report is in response to declining health trends in the United States and other countries around the world, with many of the conditions linked to past land use decisions that limited options for healthy, active living environments. For instance:


  • 13 million school days are missed each year in the United States due to asthma-related illnesses;
  • The number of children with type 2 diabetes related to sedentary lifestyles has tripled since 1980;
  • By 2030, it is anticipated that one out of 11 people in the United States will be at least 100 pounds overweight; and
  • Health care costs—the cost to treat illness, not keep people well—currently represent 19 percent of the gross domestic product (GDP) of the United States; 9 percent of the GDP in Europe; and 5 percent of the GDP in China.

“In many communities around the world, the healthy choice is not the easy choice,” said ULI Global Chief Executive Officer Patrick L. Phillips. “We know that the built environment has a profound impact on health outcomes. ULI is aiming to encourage development practices that promote health and wellness, physical activity, and social interaction. Increasingly, the ability of developers and communities to deliver on health is translating into market value for projects.”

ULI’s work connecting land use and health includes documentation that communities and projects that are able to meet the market demand for health will see their value endure over time. Some indications of the growing demand for and rising value associated with healthy places are as follows:


  • Seventy-six percent of millennials think walkability is important in where they choose to live;
  • More than half of Americans (51 percent) want to live in a community that has transit; 53 percent want to be close to shops, restaurants, and offices.
  • Homes located in neighborhoods with good walkability are worth $34,000 more on average than similar homes in neighborhoods with average walkability.
  • Access to sunlight in office buildings increases worker productivity by 15 percent.

The report’s 21 recommendations are organized into the following three categories: 1) the availability of opportunities to be physically active, 2) access to healthy food and drinking water, and 3) exposure to a healthy environment with a high degree of social interaction:

On physical activity:


  • Incorporate a mix of land uses (to reduce the need to drive from place to place);
  • Design well-connected street networks at the human scale;
  • Provide sidewalks and enticing, pedestrian-oriented streetscapes;
  • Provide infrastructure to support biking;
  • Design visible, enticing stairs to encourage frequent use;
  • Install stair prompts and signage;
  • Provide high-quality spaces for multigenerational play and recreation; and
  • Build play spaces for children.

On healthy food and drinking water:


  • Accommodate a grocery store;
  • Host a farmers market;
  • Promote healthy-food retail;
  • Support on-site gardening and farming; and
  • Enhance access to drinking water.

On healthy environment and social well-being:


  • Ban smoking;
  • Use materials and products that support healthy indoor air quality;
  • Facilitate proper ventilation and airflow;
  • Maximize indoor lighting quality;
  • Minimize noise pollution;
  • Increase access to nature;
  • Facilitate social engagement; and
  • Adopt pet-friendly policies.

The 21 recommendations are accompanied by evidence-based strategies, suggested best practices, project descriptions and photos, and quotes by real estate leaders. The report illustrates the application of the recommendations to seven real estate typologies: master-planned communities, multifamily, mixed use, office, industrial, single-family, and retail. The report also includes summaries of leading health and sustainability certification systems.

The Center for Active Design was the contributing author and expert content adviser for the toolkit. The center is a nonprofit organization that promotes architecture and urban planning solutions to improve public health. “This ground-breaking toolkit illuminates the intersection between health and real estate development,” says Joanna Frank, executive director of the Center for Active Design. “By translating the latest health evidence into practical recommendations, this resource empowers developers to provide opportunities for active, healthy lifestyles, while meeting growing market demand for health-promoting places.”

The project was generously supported by the Colorado Health Foundation and a gift to the ULI Foundation from the estate of Melvin Simon. The Colorado Health Foundation has been a key partner in ULI’s health-related work. “We are at a rare and exciting moment in public life that allows us to put our heads together and design communities that put people first by creating buildings, neighborhoods, and towns that help people live healthy lives,” stated Khanh Nguyen, portfolio director, Healthy Living, Colorado Health Foundation. “Obesity is one of our biggest health challenges. In order to address this multifaceted issue, we commend ULI and its many partners on producing a toolkit that will inspire and guide both the development and health communities as they collectively design for generations to come.”

The Building Healthy Places Toolkit is part of ULI’s Building Healthy Places Initiative. The initiative, which started in 2013, is an ongoing program of work that is leveraging the power of the Institute’s global networks to shape projects and places in ways that improve the health of people and communities.

“Health happens not in your doctor’s office, but where you live. ULI has created a work that can—and I hope will—change how every building and rebuilding, every subdivision and retrofit, will be carried out in America and perhaps beyond,” said Dr. Richard Jackson, a nationally renowned pediatrician and chair of environmental health services at the University of California, Los Angeles, Fielding School of Public Health. Dr. Jackson serves on the Building Healthy Places Initiative’s advisory board, which guides the Institute’s work on land use and health.

The report identifies several opportunities to amplify the effects of the recommendations. These include forming new partnerships that support health priorities; gaining a deeper understanding of community health needs; measuring health outcomes; using language that reinforces health messages; and considering health at every stage of the real estate development process.

Projects highlighted in the report include the headquarters of GlaxoSmithKline in Philadelphia; Miasteczko Wilanow in Warsaw; Mariposa in Denver; Rancho Sahuarita in Sahuarita, Arizona; Ecopark in Hanoi, Vietnam; Via Verde in south Bronx, New York; the Hercules Campus in Playa Vista, California; SoundCloud in Berlin; and Rouse Hill Town Centre in Sydney, Australia.

For more information on ULI’s Building Healthy Places Initiative, visit www.uli.org/health.

Trish Riggs is a public relations consultant and freelancer with Keadle-Riggs Communications. Riggs was a senior vice president with the Urban Land Institute from 2005 to 2019.
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