Local agencies are responsible for building and maintaining much of the infrastructure and public facilities in their communities. Such capital improvements typically include a variety of civic buildings, water and sewer lines and treatment facilities, parks and recreational facilities and an extensive network of local streets and sidewalks. These public facilities and infrastructure offer another way for local officials to integrate health considerations into their decisions.

Cities and counties typically develop a multiyear capital improvement program to guide investments in infrastructure. When developing and reviewing the capital improvement program, local elected officials and agency administrators can assess the extent to which the proposed investments contribute to community goals for health. They can then give priority to public works projects that enhance health outcomes. For example:

• Local agencies can make it a priority to construct and maintain a continuous, connected network of sidewalks and bikeways linking homes, schools, shops and places of employment.
• Traffic-calming measures — such as intersection bulbs, raised crosswalks, traffic roundabouts, angled parking and bicycle lanes — can be installed to help control speeding vehicles in residential neighborhoods and near schools, thus reducing traffic accidents and exposure to auto emissions.
• Maintenance projects to restripe, resurface or repair roadways provide a cost-effective way to redesign streets to work better for all users, including drivers, transit vehicles, bicyclists and pedestrians.
• Street trees, street lighting, median and planter strips, sidewalks set back from the roadway and other landscaping improvements can be provided to create a more welcoming environment for pedestrians in residential neighborhoods and business districts.
• Transit-stop improvements, including weather-protected seating and safety lighting, can be installed to encourage transit ridership in inclement weather or during night-time hours.
• Joint-use agreements with local schools, recreation centers and sports complexes can provide recreation space that is accessible and in close proximity to all residents. Making school playgrounds available for use before and after school hours can help provide park space for park-deficient neighborhoods, offering a low-cost recreation opportunity for area residents.⁵¹
• Equitably distributing  parks, recreational facilities, trails and open spaces throughout the community can be addressed in park master plans and long-range capital improvement plans, which can include park design and trail standards and minimum acreage standards per resident.