Health Evidence

The report outlines 21 evidence-based recommendations for promoting existing health literature. The 21 recommendations all have strong supporting evidence, defined as peer-reviewed publication of at least five cross-sectional or two longitudinal studies or an equivalent systematic review with significant findings. A list of practical implementation strategies and best practices, grouped according to their available evidence base, supports each of the 21 overarching recommendations.

The recommendations and strategies in the report meet the following criteria:

  • EVIDENCE-BASED RECOMMENDATIONS. The toolkit identifies 21 evidence-based recommendations, which are in boldface type and numbered throughout. These recommendations have strong supporting evidence, defined as peer-reviewed publication of at least five cross-sectional or two longitudinal studies or an equivalent systematic review with significant findings.
  • EVIDENCE-BASED STRATEGIES. These strategies support the 21 recommendations. The listed strategies have strong supporting health evidence, in at least one supporting peer-reviewed publication.
  • BEST PRACTICE STRATEGIES. The best practice strategies lack a published health-evidence base at this time but are anticipated to promote health, given theory, professional practice, and industry standards. More research is encouraged.

Full citations are included in the report. Download the PDF or purchase the report to learn more.

Taking It to the Next Level

The 21 recommendations in this report represent a tremendous opportunity to benefit health. The following implementation considerations could greatly enhance the impact of the recommendations:

  • NEW PARTNERSHIPS THAT SUPPORT HEALTH PRIORITIES. Formal and informal partnerships can help developers, property owners, and managers build bridges, increase impact, and ensure the ongoing success of a project. Nontraditional partners include foundations, schools, health care providers, and health-focused nonprofits.
  • DEEPER UNDERSTANDING OF COMMUNITY HEALTH NEEDS. Each community has particular and specific health challenges, needs, and goals. A health profile can help build an understanding of health challenges that the project can address. Health impact assessments can be used to analyze the potential health effects of a proposed project and to identify strategies for reducing harm and increasing benefits.
  • MEASUREMENT OF HEALTH OUTCOMES. We measure what we value. In partnership with other professionals, the real estate industry can help facilitate efforts to measure health outcomes and grow the body of evidence about what works for health, so that practices can be improved in the future.
  • USE OF LANGUAGE THAT REINFORCES HEALTH MESSAGES. Words matter. Language that reinforces health, wellness, and well-being can help spur behavior change. Make the healthy choice the visible choice by emphasizing healthy options, such as walking and taking transit. This report is grounded in a rigorous review of the health literature, with the understanding that the included recommendations and strategies can be referenced in marketing language.
  • CONSIDERING HEALTH AT EVERY STAGE OF REAL ESTATE DEVELOPMENT. Because many of the design recommendations and strategies in the toolkit look at the base building or project design, considering them at the outset of a project and revisiting them at each key decision-making stage of a project are essential.

Health for All

Market drivers for health-promoting development features are strong, but regardless of income, education, or ethnic background, all people should have the opportunity to live, work, learn, and play in places that allow them to live long, healthy lives.

Today, too many people do not have the opportunity to be healthy because they live in places that make choosing healthy behaviors extremely challenging: they lack access to healthy foods and places that make physical activity easy and are exposed to environmental toxins. Improvements to the physical realm and built environment should enable everyone to enjoy the best health possible.

Every day, developers, designers, and others involved in the practice of real estate make decisions about their projects—they make tradeoffs and set priorities. They anticipate market trends. They balance community needs and wishes with financial constraints. Most of the health strategies described in this report are low-cost or no-cost adjustments to business as usual, yet they have the potential to both improve health outcomes and increase the appeal of buildings and projects. Let’s make them the norm.