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HIA Stories from the Field

This website is archived for historical purposes and is no longer being maintained or updated.

The Healthy Community Design Initiative, also known as the Built Environment and Health Initiative, is no longer a funded program and the information on this website is not being reviewed and updated on a regular basis.


A Small Town Assesses a Big Rail Project

photo of the town of Davidson

The Town of Davidson, North Carolina

Davidson, NC, population 11,750, is located on Lake Norman in Mecklenburg County, 21 miles north of Charlotte. In 2011, Davidson was the only small town to receive a “Health Impact Assessment to Foster Healthy Community Design” grant from the Centers for Disease Control and Prevention (CDC). The grant provided the resources to conduct Health Impact Assessments (HIAs) to address local transportation and land use issues. Now Davidson can serve as a healthy community design model for other small towns throughout North Carolina and across the nation.

Davidson Design for Life

Davidson Design for Life (DD4L) was formed in 2010 to support healthy community design in Davidson, the Charlotte-Mecklenburg region, and North Carolina. The goal was to increase physical, mental, and emotional well-being among Davidson’s residents. From the outset, DD4L involved community members and organizations in the process.

The DD4L Committee consists of staff from the Town of Davidson who came together to locate funding, training, and resources to reach these goals. The CDC grant allowed DD4L to begin conducting HIAs to evaluate the potential health effects of proposed plans, projects, or policies.

Red Line Regional Rails Project

One of Davidson’s CDC-funded HIAs evaluated the possible health impacts of converting 25 miles of existing Norfolk Southern rail lines between nearby Mooresville and Charlotte to handle more freight travel and add commuter train service. The Red Line Project proposed making Mooresville (located 7 miles from Davidson in Iredell County) a transit stop, thus offering Davidson residents commuter rail service to Charlotte.

The HIA evaluated health concerns in the study area of Mecklenburg and Iredell Counties:

  • Nearly 16,700 households within the study area have no vehicle access.
  • Approximately 12% of Mecklenburg adults and 8% of Iredell adults have asthma. Heart disease is the second leading cause of death in both counties.
  • Motor vehicle injuries are the 10th leading cause of death in North Carolina and the leading cause of death for those between 5 and 24 years of age.
  • Sixty-four percent of adults in Mecklenburg and 67% in Iredell are overweight or obese.

The HIA demonstrated that the Red Line Project’s 10 proposed transit stops could address these health issues by

  • Providing access to transportation, employment, and housing
  • Improving air quality, and lessening respiratory and cardiovascular disease by reducing vehicular traffic
  • Reducing the number of motor vehicle crashes
  • Increasing physical activity, leading to reduced obesity and lower incidence of chronic diseases like heart disease, cancer, and diabetes.

However, the HIA also found that increased freight rail and commercial truck traffic could add to air pollution, traffic congestion, and safety concerns.

Based on its thorough evaluation of all possible health impacts of the Red Line Project, the HIA made recommendations to increase the positive health effects and minimize the negative ones.

The findings and recommendations were summarized in the Red Line Regional Rail Health Impact Assessment report and shared with the Red Line Task Force, a standing committee that searches for ways to finance and advance the project.

HIA Insight

The Town of Davidson and DD4L now have greater insight into the way HIAs can evaluate and guide decisions on land use and transportation in Davidson, the region, and the state. The HIA process gave Davidson residents a voice in creating healthier lifestyle options for the community. In addition, the HIAs provided opportunities to work with local, regional, and national partners in promoting HIA and healthy community design principles.

The Town of Davidson has documented its HIA work on the Davidson Design for Life web site and produced the video, Davidson Design for Life: An Initiative to Improve the Health of a Community. The video shows how the town and DD4L developed principles for creating a healthy community. It also shares how Davidson has incorporated healthy design into its planning process and suggests ways that other communities can promote health through HIA.

The Town of Davidson continues to be a model of health for small towns. In 2014, the Board of Commissioners adopted a holistic goal to “enhance the physical, intellectual, mental, emotional, spiritual, occupational, environmental, and social well-being of our residents.”

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  • Page last reviewed: March 2, 2016 (archived document)
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