Equitable Adaptation Legal & Policy Toolkit

Built Environment Public Health Tools

The built environment is an important source of some of the social determinants of health, including housing, clean air and water, and cooler temperatures.See footnote 1 Public health departments have a keen interest in those social determinants, but often relatively little authority over them. Some of the planning tools, above, can help with integrating public health priorities into housing, transportation, and other plans, but implementation is key for ensuring equitable distribution of resources among neighborhoods and residents.

This section focuses on implementation, particularly equitable implementation of built environment tools such as tree planting, stormwater harvesting, and cool roof incentives. Cities must figure out how to not only implement climate- and health-smart policies, but also ensure that the effects are equitably distributed. Particularly with incentive-based programs such as rebates or giveaways that are given out on a first-come, first-serve basis, low-income residents often are not the first to the table and are therefore less able to take advantage of those programs. Rebates can be particularly hard to make equitable because property owners must have the money for an upfront investment, making them sometimes inaccessible for low-income residents.See footnote 2 The case studies below describe several programs that devised strategies to reverse that usual trend and get more resources into the communities with the most need.

Considerations of Built Environment Tools


  • Tree planting, cool surfaces, and other built environment interventions often have energy efficiency benefits in addition to adaptation and health benefits.See footnote 3 
  • These cost savings can help to make the case for paying the cost of the interventions themselves.


  • Many built environment tools that cool cities, improve air quality, and manage stormwater have both health and environmental benefits.
  • While health departments tend to focus on the health benefits first and environmental second, other departments may think about the same strategies in the opposite order.
  • Partners may need to be willing to speak one another’s language in order to work together effectively.


  • Built environment tools that give incentives to private property owners to make changes must be carefully implemented to ensure that frontline communities know about the incentives and are fully able to participate.
  • These built environment improvements can also, of course, worsen gentrification and increase rents/property taxes.See footnote 4 


  • Health departments have little authority over these tools in most places and will need to find willing partners to work together, and should ensure that those partners keep a health and equity lens on the work instead of just focusing on the engineering pieces of it.


  • Local governments generally have authority over their own buildings and rights of way, including streets. In order to effect change on private property, they will need instead to require action (for example, through building or zoning code changes) or incentivize action through financial or other means.
  • Not all local governments have authority over their own building and zoning codes, and action can be politically tricky; many local governments start instead with voluntary, incentive-based programs.

Lessons Learned

  • Zero-interest loans and grants can be a good way to get capital for projects to low-income residents, especially when given according to community priorities following community engagement
  • Incentive-based programs can be targeted to areas of highest need, rather than being first-come, first-serve across the jurisdiction. Data is necessary ahead of time to identify those areas clearly.



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