Healthy homes and communities: putting the pieces together

Context: This article reviews and updates the evidence base informing four recommendations of the Robert Wood Johnson Foundation Commission to Build a Healthier America (the commission) that address the creation of healthy, vital neighborhood and community environments.

Evidence acquisition: Reviews of published research, consultation with experts in housing, community development policy, and site visits by the commission were conducted between 2006 and 2009. The literature reviews and national statistics were updated with publications appearing through the first half of 2010.

Evidence synthesis: The physical, social, and economic environments of local communities affect residents' health and exacerbate health disparities. Public and private decision makers are increasingly recognizing the importance of investing in cross-cutting strategies to reduce exposures harmful to health and to establish conditions that support healthful daily practices. Pilot and demonstration projects that engage community members in identifying priorities and implementing interventions that improve health and quality of life show promise in terms of their overall impact and effect on health disparities.

Conclusions: Consistent with the broad policy directions outlined in the commission's recommendations, an effective population health improvement strategy requires enlisting new partners among public agencies including housing, transportation, recreation, community development, and planning, and joint efforts between private sector business and voluntary organizations. Evaluation research of community-based interventions is needed to generate strong evidence of impact in order to guide policy and secure future investments in such measures.