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CDC's Built Environment and Health Initiative

CDC 24/7: Saving Lives. Protecting People from Health Threats. Saving Money Through Prevention.

Environmental Health

Your environment is everything around you—the air you breathe, the water you drink, the community you live in, the places where your food is grown or prepared, your workplace, and your home. When your environment is safe and healthy, you are more likely to stay healthy. But when your environment exposes you to dangerous events or toxic substances, your health can be negatively affected.

CDC is committed to saving lives and protecting people from environmental hazards by responding to natural and man-made disasters, supporting state and city public health programs, educating communities, and providing scientific knowledge. We help maintain and improve the health of Americans by promoting a healthy environment and preventing premature death and avoidable illness caused by environmental and related factors. CDC also identifies how people might be exposed to hazardous substances in the environment and assesses exposures to determine if they are hazardous to human health. CDC invests in prevention to improve health and save money by reducing health care costs. We strive to maximize the impact of every dollar entrusted to the agency.

Built Environment and Health Initiative1

Family of four riding bicycles and wearing helmets.
A Few Notes about Funding
  • The initiative funded and supported 34 HIAs. Many communities have chosen to continue HIA activities after direct CDC support ended.
  • The initiative funded six local, county and state entities to conduct at least three HIAs a year between 2011 and 2014.
  • The initiative funded an online course that explains the value of and the steps involved in conducting an HIA. More than 5,000 health and planning professionals have taken the course.

Personal health depends on many factors, such as access to nutritious food, clean air and water, and opportunities for regular physical activity. When these are easily available in the communities where we live, work and play, they can contribute to good health.

Unfortunately, some community environments make it hard to maintain good health. In fact, public health challenges like asthma, motor vehicle-related injuries, obesity and heart disease are directly related to how communities are designed and built. CDC’s Built Environment and Health Initiative is the only source of federal expertise to help states and communities integrate health considerations into transportation and community planning decisions.

The Built Environment and Health Initiative:

  • Supports Health Impact Assessments (HIA)
    HIAs help communities reduce health costs by recommending proven public health approaches that meet their needs.
  • Equips health departments
    By helping health departments build ongoing relationships with local governments or planning commissions, the initiative supports communities in building infrastructure that maximizes good health.
  • Provides scientific expertise
    Scientific expertise helps promote important federal priorities like the National Prevention Strategy’s focus on healthy physical environments.
  • Provides training and assistance
    The initiative provides training and technical assistance on how proposed projects, policies, and state, tribal and local decisions can affect community health.
  • Tracks key environmental public health indicators
    The initiative tracks key indicators by monitoring and evaluating active transportation, and by tracking local and state community design data (through CDC’s National Environmental Public Health Tracking Portal).

1Built Environment and Health Initiative is also known as Healthy Community Design Initiative.

For Example
The program supports the Alliance for Bicycling and Walking in developing its benchmarking report. This report collects and analyzes data on bicycling and walking in every state and the 50 most populated U.S. cities. The report has become an important reference for decision-makers at all levels of government, and more than 14,000 copies have been distributed. Since 2007, when the report was first published, at least 42 jurisdictions have used it as a reference in considering policy changes and informing stakeholders.

Program Funding

Program Funding Trends: Built Environment and Health Initiative
Year Funding Level
FY 2011
FY 2012 $2,628,000

Public Health in Action:
Advancing Health Impact Assessment

New pedestrian area at Times Square in New York City.

Photo: Courtesy of the Times Square Alliance.

Doctors regularly advise patients to take steps to prevent disease. Health Impact Assessments (HIAs) provide similar advice to communities. HIAs help communities make informed choices about how community design can improve health. Here are some examples showing how the Built Environment and Health Initiative has supported communities in improving health.

Oregon Health Authority is building local and state capacity to evaluate the health effects of projects and policies and providing this information to decision-makers. It also has encouraged a wide range of stakeholders from health and non-health sectors to evaluate prospective health impacts of key community design decisions. The program supports four HIAs:

  • County transportation policy decisions (2),
  • County-level health effects of wind energy, and
  • Statewide health effects of climate change policies.

Douglas County, Nebraska
With the help of state government agencies, Douglas County’s health department is improving the health status of county residents by making HIAs a routine component of the county planning process.

Davidson, North Carolina
The town of Davidson and state-level partners are using HIA to maintain a health focus in the newly established “Davidson Design 4 Life” framework for town planning and development. A team comprised of members of the local health and planning departments is conducting HIAs on the effects of proposed changes in residential design standards and physical activity levels in Smart Growth Communities, as well as the impact of a proposed extension to the regional commuter line.