More and more, inter-disciplinary research associates the “built environment” (i.e., land use, transportation systems and community design) with health outcomes and well-being at the population level. For example, healthful neighborhood conditions require adequate and good quality housing; access to public transit, schools, and parks; safe routes for pedestrians and bicyclists; meaningful and productive employment; unpolluted air, soil, and water; and, cooperation, trust, and civic participation.

These built environment factors are generally determined outside the institutional realm of public health, in the purview of Planning, Transportation, Housing and Economic Development agencies. While there are few mandates to consider health in “built environment” planning and policy-making, public health agencies in diverse cities such as San Francisco, Riverside, Denver, and Minneapolis, are increasingly investing in strategies to influence the “built environment” to improve population health and reduce health inequities.

In San Francisco, the Department of Public Health has responded to the need for health and planning tools and guidelines by creating the Healthy Development Measurement Tool, a comprehensive evaluation metric to consider health needs in urban development plans and projects. The Tool encompasses a community-based vision for planning and uses public health to explicitly connect physical and environmental planning to a wider set of social interests.

The fundamental value behind the HDMT is that all communities should have equal access to health resources. As such, HDMT objectives and indicators explicitly call out the need for development that serves existing and new residents and workers. Data are also disaggregated by neighborhood and are illustrated spatially in an effort to highlight disparities. SFDPH has primarily targeted use of the HDMT in communities experiencing health inequities as these communities are most likely to be impacted by new development. Where applied, the Tool might thus help to achieve a higher quality social and physical environment that protects and promotes health.