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Social determinants of health and land use: Reforming zoning to improve health outcomes

By Smart Growth America, April 23, 2026

Social Determinants of Health (SDOHs) are non-medical factors that affect people’s health, such as socioeconomic status and geographic location, by influencing their exposure to health risks or their ability to access healthcare.

Land use policies help determine where people live, what they can access, and the conditions they experience every day, shaping health outcomes. We looked at the five SDOH categories and evaluated how zoning and other land use policies can be reformed to improve health outcomes:

  • Social & Community Context
  • Neighborhood & Built Environment
  • Economic Stability
  • Health Care Access & Quality
  • Education Access & Quality

These categories do not exist in silos, and land-use policy can serve as a common thread across all five.

Smart Growth America developed this series of one-pagers on the SDOHs as part of our Zoning for Equitable Solutions and Thriving Communities (ZEST) Technical Assistance Program. These resources outline each category, its connection to the built environment, potential zoning solutions, and recommendations and case studies for community-based organizations working at the intersection of health and the built environment.

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