Communities change over time, evolving in response to demographic trends, changing economic conditions and other circumstances. Guiding this change in a positive direction is an important function of local government, particularly in older neighborhoods that have lost jobs and local businesses as their traditional economic activities have weakened or become obsolete. These neighborhoods often suffer from aging infrastructure and inadequate public and private investment as well as other social and economic challenges.

Residents in economically distressed neighborhoods often lack the economic resources, access to nutritious food, and opportunities for physical activity enjoyed by residents elsewhere, which can in turn lead to poor health outcomes.⁴⁸ Because income is one of the strongest and most consistent predictors of health, neighborhoods that offer a range of jobs and attract and retain local businesses and industries have healthier residents.⁴⁹

Cities and counties have used a variety of tools to reverse neighborhood decline and revitalize communities.

• Business improvement districts and similar public-private partnerships have been established to develop and fund programs that improve the streetscape and facades of businesses, increase public safety, provide services and cultural events to attract customers and otherwise help struggling neighborhoods generate local economic activity. This economic activity can expand residents’ opportunities for healthy eating and active living.
• Local agencies have used Community Development Block Grants, affordable housing bonds and tax credits, energy efficiency and conservation grants and other federal and state funding programs to improve public facilities, underwrite housing development and rehabilitation and reduce business operating costs, thereby attracting and retaining companies in revitalizing neighborhoods.
• In developing public-private partnerships for redevelopment, local agencies have negotiated to secure specific benefits for the community, including measures that can improve public health. Examples of community benefits that can improve the economic status of residents and thereby improve health outcomes include local hiring and work-force development programs and requirements or incentives to offer living wages and other employee benefits. Community benefits can also include physical improvements that contribute to better health, such as community gardens and constructing or rehabilitating neighborhood parks and athletic facilities.⁵⁰