A Case Study on Incorporating Health and Equity into Urban Plans, Transportation, and Land Use Policies


  • Kelly Haworth, MPH Larimer County, Colorado
  • Elizabeth Young Winne, MPH, MURP Larimer County, Colorado




In 2017, the Built Environment Program at the Larimer County Department of Health and Environment (Colorado, USA) collaborated with a partner municipal agency to create a health and equity index to be a component of a revitalized sidewalk prioritization model. The Health Equity Index uses indicators that are linked to the determinants of health to spatially understand factors that contribute to an individual or household’s likelihood of being more vulnerable. The data to create the Health Equity Index is publicly sourced at block group level from the United States Census American Community Survey 5-year estimates and at census tract level from the Center for Disease Control and Prevention’s 500 Cities dataset. The score is one of three factors used to determine sidewalk improvement priorities in the City. The new model mapped prioritization and created broader geographic distribution than what was previously used. The creation of the Health Equity Index was a valuable partnership that led to multiple outcomes outside of the sidewalk prioritization process. First, its creation has established a foundation for partnership between two sectors across different government agencies. Second, the Health and Equity Index has also been used as an assessment tool for the adopted City Plan, the guiding comprehensive plan for the municipal agency. Through this process, we have learned that elements of Health Impact Assessment can be a powerful tool for understanding the health impacts of a policy or process on community, as well as for building and developing trusted cross-sector relationships.