Improving health and equity through built environment approaches: Findings from a qualitative study in Los Angeles

Introduction: In Los Angeles, numerous organizations are working to enhance community health through built environment approaches.  Given the magnitude of the issue and the complex nature of policy solutions, we sought to explore whether there are untapped opportunities for collaboration and coordination among community-based organizations, residents, and public agencies working to achieve more equitable outcomes, particularly for people living in low-income communities.

Methods: We conducted 36 key informant interviews to explore the priorities and perspectives of practitioners from community-based organizations, local governments, and relevant businesses on how to advance health and equity through land use policies and practices in Los Angeles. 

Findings: Interviewees identified several opportunities to advance health and equity through built environment approaches.  First, greater public awareness of how land use planning influences health could clarify what residents can and should expect.  Second, mechanisms could be established to better ensure that public dollars are allocated more equitably.  Third, public agencies require more capacity, political will, and skills to consistently engage residents across Los Angeles.  Further, community-based “anchor organizations” represent a critical linkage between local government and residents.

Conclusions: Our research suggests that efforts to achieve more equitable outcomes through changes to the built environment should incorporate four key components: build skills for meaningful collaboration among community-based organizations, residents, and public agency staff; improve financial and structural decisions to prioritize equitable investments in land use planning and implementation; dedicate resources to support robust community engagement; and scale up innovative and successful approaches among “anchor organizations” working in low-income communities.