Elisabeth Haub Law School of Law
Pace University
Land Use Law Center
Supervisor: John R. Nolon, Distinguished Professor
Blog No. 30 of the Land Use, Human Health, and Equity Project
Editor: Brooke Mercaldi
Contributing Author: Abigail Dove [*]
Health Impact Assessments: A New Tool for Analyzing Land Use Plans, Zone Changes, and Development Projects

Health Impact Assessments and Land Use

Health Impact Assessments have been a tool mainly used by state and federal health agencies to review and avoid the adverse public health impacts of their plans and large-scale capital projects. Local land use officials are beginning to employ Health Impact Assessments (HIA) to review community design issues in formulating comprehensive plans and reviewing land use projects to prioritize public health.

If a community implements an HIA to review its comprehensive plan and the plan’s strategies for their public health impacts, then the zoning that is implemented in conformance with the plan will be more considerate and protective of public health. At the granular level, developers’ applications for project approval can also be reviewed through the lens of an HIA that looks at the immediately surrounding area and impacts with a cautious eye toward adverse health effects; such projects can be approved subject to conditions that mitigate their negative health impacts. As communities continue to react to COVID-19 and its variants, there is a growing interest in designing sites and public spaces (i.e., placemaking) to minimize the fears of contagion associated with denser urban living.

HIAs and the Comprehensive Plan

Oklahoma City used an HIA to “gauge the effectiveness of the major planokc components of its comprehensive plan as they relate to community health… [The HIA] was completed to evaluate the potential for various city-wide development patterns to influence opportunities related to health. It is widely understood that how a city grows affects the people and businesses who call it home. The HIA evaluates whether one of those effects is health, and if so, which aspects of health.” Oklahoma City, Oklahoma HIA.

Amending Zoning: Mitigating Health Impacts

In most states, zoning must be in conformance with the comprehensive plan. Where serious effort, data, and study are focused on the public health impacts of the goals, objectives, and, particularly, the strategies adopted in the plan, later zoning amendments should refer to and be guided by the conclusions of the HIA. One such strategy could be for the legislature of the community to require planning and zoning boards to conduct HIAs on present and proposed projects of certain sizes or impacts.

Effects on the Approval of Proposed Development Projects

In order to comply with zoning and comprehensive plan health impact assessments, developers may be required or encouraged to conform their buildings and site designs to the findings in the HIA reflected in the requirements of zoning. Oklahoma City’s HIA on its comprehensive plan, for example, establishes special development and building standards for projects built close to highways and creates a tree planting program to buffer residential areas from the polluting effects of transportation and industrial uses. The HIA findings address current conditions, 5-year targets, and 10-year targets with quantitative indicators to ensure the implementation process of the comprehensive plan is on track with the public health goals of Oklahoma City.

Conditional Approval of Development Projects to Protect Health

During the process of reviewing and approving development projects, local planning and zoning boards can encourage and sometimes require the developer to modify its building and site design to avoid identified adverse health impacts and determine whether the developer needs to implement any additional strategies to help mitigate those impacts.

Community Design and Placemaking Policies and Projects

Placemaking is a tool urban planners use, among other objectives, to ease the effects of population density by creating human scale in the built environment to motivate urban dwellers to embrace, invest, and remain in their neighborhoods. More recently, placemaking is being employed to respond to the fears wrought by the viral pandemic by making social distancing more feasible and outdoor activities more robust. Placemaking in planning practice is “more than just promoting better urban design[; it] facilitates creative patterns of use, paying particular attention to the physical, cultural, and social identities that define a place and support its ongoing evolution.” The Town of Davidson, North Carolina conducted three HIAs as part of an initiative to create healthy community design. Davidson identified four health impacts which would be solved by creating safe neighborhoods and public spaces by using placemaking techniques.

HIAs and Racial Impact Assessments are perhaps the most recent and among the more innovative responses to the four pandemics’ effects on public health to be placed in the land use toolbox. This blog attempts to create a framework for incorporating health analyses into the major land use techniques communities have traditionally used to adjust to changing circumstances. To see a wide range of agency and community policies and plans to which HIAs have been used, click here.

The previous blogs in the series are listed here:

  1. Reframing Sustainability: Introducing the Land Use, Human Health, and Equity Project
  2. Planning for Public Health: A New Beginning for Land Use Law
  3. The Role of Density in Combatting Climate Change and COVID-19
  4. Novel Coronavirus Claims Implicate Age-Old Property Rights Questions
  5. State & Local COVID-related Emergency Powers: Individual Rights
  6. COVID-Related Land Use Regulations and Judicial Deference
  7. Mediation of Eviction Disputes May Hold the Key to the Survival of Small Businesses
  8. Using Zoning to Help Eliminate Food Deserts: A Few Steps Forward
  9. Urban Heat Islands and Equity
  10. Urban Heat Island and Equity: What Can Local Governments Do?
  11. The Recovery Lease: Preventing Evictions of Commercial Tenants During the Pandemic
  12. The Role of Hazard Mitigation Planning in Promoting Public Health and Resilience
  13. Hazard Mitigation Planning: A Case Study
  14. Complete Streets: Protecting Public Health
  15. Zoning and Lease Mediation as a Way to Retain Critical Small Businesses
  16. Segregation by Law and the Racial Inequity Pandemic
  17. Combating Food Swamps to Improve Equity and Public Health
  18. The Pandemic Plan for Healthy Buildings
  19. Remediating Distressed Properties to Improve Public Health
  20. Housing, a Crucial Determinant of Health
  21. ADU Introduction
  22. NIMBY Restrictions to Poison the Prospects of Accessory Dwelling Units to Address Housing Insecurity
  23. Zoning to Fill the Missing Middle Housing Gap
  24. Old Tools to Fight Housing Insecurity: Adaptive Reuse and Infill Development
  25. Racial Impact Analyses
  26. A New Era of Equity-Based Comprehensive Planning…Finally
  27. Equity-Based Comprehensive Plans: Land Use Policies to Correct Past Disparities
  28. Reversing the Legacy of Redlining: Reducing Exposure to Toxins and Pollutants Through Land Use Law Reform
  29. Addressing the Four Pandemics – A Case Study

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