The downstream effects of exclusionary, low-density residential zoning on health and health equity should make scholars and policymakers focus on reforming zoning to make housing more plentiful and affordable in healthy neighborhoods.
What’s the Issue
Research has long established important connections between housing and health. The pathways that can affect health are housing stability, housing quality and safety, neighborhood characteristics, and affordability. Recent housing research and media attention have emphasized the effect of zoning and land use regulations on some of these pathways.
In its governance of municipal space by zoning codes, the United States earmarks large shares as low-density space—meaning only single-family homes can be built there. This often has a supply and demand effect in which a limited housing supply raises the cost of housing for everyone. Thus, people who cannot afford to buy single-family homes on large lots are excluded. The brief focuses on low-density residential zoning ordinances, which make it more difficult and costly to build multifamily housing. Even in urban areas such as Los Angeles, California, and Seattle, only detached single-family homes are allowed on 75 percent and 81 percent of all residential land, respectively. These regulations have exacerbated spatial segregation by class and income, and their role in health inequities—especially in large U.S. urban areas.
The brief describes the robust connection between housing location and health. Single-family zoned areas are often the safest and healthiest neighborhoods in urban areas, with the greatest proximity to medical services and the least proximity to environmental hazards. Historical inspection and contemporary analysis reveal that low-density zoning restrictions have an exclusionary purpose. The racist and classist origins of the first comprehensive zoning code in the United States—created in New York City—have been well documented. These zoning codes do not tend to change quickly and may frequently be out of date with the local population’s preferences as they evolve. Though there is little research on the direct connections between zoning and health equity, some research is discussed on the connections between zoning, segregation, and the built environment with chronic health conditions and disparities.
Although little research exists on the direct connections between zoning and health equity, some existing literature links the effects of zoning and segregation to various common chronic health conditions and disparities. Other research emphasizes how outdated zoning policies have failed to adapt to growing threats to public health, such as physical inactivity and obesity, and highlights the role of zoning in perpetuating segregation by income and race. Although data on these regulations are not plentiful, more data of this type are being amassed now than ever before.
To break these patterns of segregation and inaccessible higher-resource areas, it is recommended that cities “upzone” to increase allowable density and permit more multifamily housing to be built, giving lower-income families access to healthier neighborhoods. Existing efforts to limit low-density zoning are underway in cities around the country; for instance, in 2019, Minneapolis eliminated single-family zoning.
These recent changes suggest that the policy pendulum is shifting in some places, but communities of color remain concerned that upzoning is more likely to push them out of their neighborhoods than benefit them through housing abundance in higher-resourced areas (to which only some wish to move). Scholars interested in health equity should find ways to study the potential health effects resulting from these changes. The author concludes that more available housing subsidies are complementary to zoning reform, as housing vouchers are easier to use when housing is more plentiful. In addition, affordable housing production is cheaper when zoning is more permissible.
Federal Policy Recommendations to Advance Health Equity from RWJF
A series of policy briefs include evidence-based recommendations to help people through the immediate health and economic crises and longer-term recommendations to ensure a fair and just opportunity to be as healthy as possible.