Mixed-use development
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Disparity Ratings
Potential to decrease disparities: Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Potential for mixed impact on disparities: Strategies with this rating could increase and decrease disparities between subgroups. Rating is suggested by evidence or expert opinion.
Potential to increase disparities: Strategies with this rating have the potential to increase or exacerbate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Inconclusive impact on disparities: Strategies with this rating do not have enough evidence to assess potential impact on disparities.
Strategies with this rating do not have enough evidence to assess potential impact on disparities.
Health factors shape the health of individuals and communities. Everything from our education to our environments impacts our health. Modifying these clinical, behavioral, social, economic, and environmental factors can influence how long and how well people live, now and in the future.
Community in Action
Mixed-use development supports a combination of land uses within a project rather than developing an area for a single purpose. Mixed-use development projects can be site-specific, neighborhood-based, or regional, and can be incorporated into new development, redevelopment, brownfield, and Smart Growth initiatives in urban and rural areas. Mixed-use development areas have high densities and incorporate places to work, shop, or play within residential areas. Such development is sometimes required through municipal zoning regulations or encouraged through Smart Growth initiatives and neighborhood planning efforts. Smart Growth principles encourage the development of healthy and vibrant communities through compact building design, walkable neighborhoods, diverse housing and transportation options, and a variety of land uses including open spaces and areas for social interaction1. Transit-oriented development (TOD), a component of mixed-use development, creates desirable neighborhood features, such as affordable housing, businesses, and entertainment venues, near public transit, which is then accessible to other neighborhoods with public transit stations2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased physical activity
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased active transportation
Improved health outcomes
Reduced vehicle miles traveled
What does the research say about effectiveness?
There is strong evidence that design and land use policies, including mixed-use development, increase physical activity, especially when combined with transportation system interventions such as developing public transit infrastructure and sidewalks or trails3, 4, 5. Mixed-use development initiatives that include interventions to improve bicycle or pedestrian transportation systems also increase opportunities for active transportation3.
People walk and ride bicycles more often in mixed-use development areas than in single-use development areas4, 5, 6, 7, 8. Children who live in Smart Growth neighborhoods with more green space appear to engage in more moderate-to-vigorous physical activity (MVPA), as well as more physical activity with friends and within walking distance of their homes than peers in conventional neighborhoods1, 9, 10. The greater housing density created by mixed-use developments may increase walking and transit use by older adults11. Mixed-use development and Smart Growth strategies can also successfully promote and sustain active living in rural and suburban areas12, 13.
Replacing automotive trips with biking and walking in mixed-use development areas can reduce vehicle miles traveled (VMT) and the greenhouse gas emissions that contribute to climate change7, 14, 15. There is some evidence that increasing employment opportunities located in a mixed-use development project may support fewer miles driven; however, the effect on total miles driven is small and unlikely to have an impact on overall driving or greenhouse gas emissions levels16. Additionally, while residents of mixed-use developments and transit-oriented development (TOD) may reduce VMT to get to work, residents may still increase VMT for leisure activities11. However, a study in Korea demonstrated that residents of mixed-use developments spent less time traveling for leisure activities than other residents of the same city, and were more likely to walk or use public transit, suggesting that mixed-use development may reduce VMT for all travel reasons17.
Mixed-use development is a suggested strategy to reduce transportation costs, increase economic opportunity, household wealth, and mobility, and enhance neighborhood cultural diversity18. However, a Toronto-based study suggests that adding mixed-use developments in urban areas may still only be affordable for those with higher incomes19. Combining mixed-use development with regional transportation plans and TOD efforts may increase the effectiveness of Smart Growth policies20, 21, which may benefit the health of older adults11. For example, a study of U.S. metro areas found that residents living in or near Smart Growth and TOD efforts can have better access to quality transportation options, affordable housing, employment opportunities, and safe neighborhoods; may be more likely to walk, bike, or use public transit; and may experience improved health outcomes22. A Portland-based study suggests the blend of mixed-use development, pedestrian-oriented design, and density of employment options are among the built environment features that influence households’ decisions to walk more23.
Mixed-use development typically produces net societal economic, social, and environmental benefits, especially when plans result in dense development in relatively central locations with good access to transit24. However, while some studies suggest there is a net environmental benefit to mixed-use development, the available evidence is mixed and further research is required25. Regional mixed-use development efforts can reduce the cost of public transportation infrastructure and services18, 26. One feasibility study suggests that greyfields (e.g., empty parking lots, closed or dying shopping centers) and redfields (e.g., foreclosed commercial real estate) are more successfully and cost-effectively transformed into mixed-use developments than brownfields (e.g., contaminated lands) or greenfields (e.g., open, undeveloped areas)27.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
It is unclear what impact mixed-use development has on racial segregation, disparities in economic opportunities for different income levels, and disparities in health outcomes. Available evidence suggests that, in some circumstances, implementing mixed-use development has reduced housing affordability19, 22.
A study of U.S. metro areas suggests that mixed-use development may increase social cohesion and decrease experienced segregation for residents with high and middle incomes, but decrease social cohesion and increase experienced segregation for residents with low incomes8. Yet, mixed-use development can be combined with other strategies that promote equitable development. Examples include removing exclusionary zoning regulations and permitting higher density development in more areas, rather than just in disadvantaged neighborhoods that were historically zoned for higher density and intended for residents with lower incomes. Zoning reforms that address exclusionary zoning codes can help reduce residential segregation and concentrated poverty, create inclusive community spaces, reduce the racial homeownership gap, and improve health outcomes, especially for children of color34, 35, 36.
Mixed-use development can also feature elements of transit-oriented development (TOD), which adds desirable features to neighborhoods near public transit. TOD can increase public transit use but also increases property prices, potentially contributing to gentrification of neighborhoods over the long-term; more research is needed on long-term effects and whether increased public transit use is sustained by residents with higher incomes2, 22.
What is the relevant historical background?
Mixed-use development practices, such as a business owner living above their premises, were common prior to the Industrial Revolution37. As population density increased in urban areas and the harmful effects of pollution from burning coal become known, decision makers at the local, state, and federal levels encouraged zoning to distinguish land uses and to encode racial segregation. The resulting separation of residential areas from commercial development further exacerbated the social divide by race and class; it persists today through policies and practices such as local zoning ordinances37. Homeowners have historically opposed construction of apartment buildings in suburban areas, including overt opposition to individuals of color, religious minorities, and other groups moving into what were perceived as white neighborhoods38. Explicitly racial zoning ordinances, such as Black and white-designated city blocks, were banned by the Supreme Court in 191738.
Recent studies demonstrate how historic zoning patterns have shaped communities today. Zoning appears to have significantly contributed to current inequities, including racial residential segregation, regional inequality, disparities in public resources and services, and unaffordable housing38. Zoning is used to maintain strict distinctions between residential neighborhoods zoned for single-family houses with high values and areas for commercial and industrial uses39.
Mixed-use development in its current form was first introduced in the 1960s to merge intense residential developments, also known as Traditional Neighborhood Development, with transit-oriented development (TOD), which places affordable housing, commercial, and entertainment venues near transit stations. Proponents of mixed-use development suggest it can maximize the use of existing infrastructure, minimize segregated areas, increase affordability and equity by mixing housing types, generate more housing options for smaller households with older adults, reduce dependence on cars, and create opportunities for people to live near amenities and sources of employment37.
Equity Considerations
- How do local housing agencies track the implementation of mixed-use development in your community? What data is collected to ensure that the greatest benefits are experienced by residents? How can local housing agencies reach residents who may benefit from mixed-used developments to include them in the planning process?
- How can mixed-use development and relevant zoning procedures be tailored to meet affordable housing needs in your community? How can the local job market support employment opportunities for residents?
- Can mixed-use development be used to support efforts to increase active transit (i.e., walking, biking, public transit) and reduce dependence on cars in your community? How does this fit with existing land uses, pedestrian-oriented features, and strong job markets?
- Who are the local stakeholders that can help identify opportunities for mixed-use development that meet the needs of your community?
- How have historic zoning patterns and uses in your community contributed to local challenges, such as neighborhood segregation, inequitable school funding, or disparities in economic and community development?
Implementation Examples
Mixed-use development is used across the country, often as part of Smart Growth projects. In 2015, the U.S. Environmental Protection Agency granted its National Awards for Smart Growth Achievement to Jackson, TN; Hamilton, OH; and Newark, NJ for their innovative use of mixed-use development28.
The Centers for Disease Control and Prevention (CDC) provides resources for state and local municipalities to implement elements of mixed-use development in their community design efforts to increase physical activity29.
Non-profit organizations can support site-specific, mixed-use development projects throughout a region; for example, the East Bay Asian Local Development Corporation in Oakland, CA and the greater East Bay area30. Individual organizations can also support efforts around the country, as in the Congress for New Urbanism31. The Smart Growth Network, a partnership of non-profit, business, and government organizations, also supports mixed-use development and Smart Growth projects throughout the U.S.32.
Via Verde in the Bronx, NY is an example of a mixed-use development housing project33.
Implementation Resources
‡ Resources with a focus on equity.
CDC-PA Land use - Centers for Disease Control and Prevention (CDC). Physical activity: Land use and community design.
CDC-PA Community design - Centers for Disease Control and Prevention (CDC). Priority strategy: Increasing physical activity through community design.
HPbD‡ - Healthy Places by Design (HPbD). Advances community-led action and proven, place-based strategies to ensure health and wellbeing for all.
MA EOHED-Mixed-use - Massachusetts Executive Office of Housing and Economic Development (MA EOHED). Mixed-use development/transit oriented development.
SGO-Resources - Smart Growth Online (SGO). Smart growth resources.
US EPA-Trip generation - U.S. Environmental Protection Agency (U.S. EPA). Mixed-use trip generation model.
NACCHO-Community design - National Association of County & City Health Officials (NACCHO). Healthy community design toolkit.
ICMA-Mishkovsky 2010 - Mishkovsky N, Dalbey M, Bertaina S, Read A, McGalliard T. Putting Smart Growth to work in rural communities. Washington, D.C.: International City/County Management Association (ICMA); 2010.
US DOT-PBIC - U.S. Department of Transportation (U.S. DOT), Federal Highway Administration (FHWA). Pedestrian and Bicycle Information Center (PBIC).
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural childhood obesity prevention toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation; 2014.
ULI Building healthy places‡ - Urban Land Institute (ULI) Building Healthy Places Initiative. Building healthy places toolkit: Strategies for enhancing health in the built environment.
LISC-Affordable housing‡ - Local Initiatives Support Corporation (LISC). Helping neighbors build communities: Affordable housing.
CG-BE resources - The Guide to Community Preventive Services (The Community Guide). Physical activity: Built environment (BE) approaches combining transportation system interventions with land use and environmental design: Additional materials.
PAS-Zoning 2016 - Planning Advisory Service (PAS). Planning & zoning for health in the built environment. American Planning Association (APA); 2016.
SRTSNP-Safe routes to healthy foods‡ - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods.
LHS‡ - Local Housing Solutions (LHS). To enhance local affordability and foster inclusive communities. New York University, Furman Center and Abt Associates, Inc.
Footnotes
* Journal subscription may be required for access.
1 Almanza 2012 - Almanza E, Jerrett M, Dunton G, Seto E, Pentz MA. A study of community design, greenness, and physical activity in children using satellite, GPS and accelerometer data. Health & Place. 2012;18(1):46-54.
2 Ibraeva 2020 - Ibraeva A, Almeida Correia GH, Silva C, Antunes AP. Transit-oriented development: A review of research achievements and challenges. Transportation Research Part A: Policy and Practice. 2020;132:110-130.
3 CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity.
4 Brownson 2006 - Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health. 2006;27:341-370.
5 Saelens 2008 - Saelens BE, Handy SL. Built environment correlates of walking: A review. Medicine & Science in Sports & Exercise. 2008;40(7 Suppl):S550-66.
6 CDC MMWR-Khan 2009 - Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report (MMWR). 2009;58(RR-07):1-26.
7 US EPA-Kramer 2013 - Kramer MG. Our built and natural environments: A technical review of the interactions among land use, transportation, and environmental quality. Washington, D.C.: U.S. Environmental Protection Agency (U.S. EPA); 2013.
8 NBER-Abbiasov 2022 - Abbiasov T, Heine C, Glaeser EL, et al. The 15-minute city quantified using mobility data. National Bureau of Economic Research (NBER). 2022: Working Paper 30752.
9 Dunton 2012 - Dunton GF, Intille SS, Wolch J, Pentz MA. Investigating the impact of a smart growth community on the contexts of children’s physical activity using Ecological Momentary Assessment. Health & Place. 2012;18(1):76-84.
10 Jerrett 2013 - Jerrett M, Almanza E, Davies M, et al. Smart growth community design and physical activity in children. American Journal of Preventive Medicine. 2013;45(4):386-392.
11 Bai 2021 - Bai X, Steiner RL, Zhai W. Beyond neighborhood design: Exploring the effects of smart growth on older adults’ travel behavior over time. Journal of Planning Education and Research. 2021.
12 Dalbey 2008 - Dalbey M. Implementing smart growth strategies in rural America: Development patterns that support public health goals. Journal of Public Health Management and Practice. 2008;14(3):238-243.
13 Dunham-Jones 2009 - Dunham-Jones E, Williamson J. Retrofitting suburbia: Urban design solutions for redesigning suburbs. Hoboken, NJ: Wiley; 2009.
14 Project Drawdown-Walk - Project Drawdown. Climate solutions: Walkable cities.
15 Salon 2012 - Salon D, Boarnet MG, Handy S, Spears S, Tal G. How do local actions affect VMT? A critical review of the empirical evidence. Transportation Research Part D: Transport and Environment. 2012;17(7):495-508.
16 Stevens 2017a - Stevens MR. Does compact development make people drive less? Journal of the American Planning Association. 2017;83(1):7-18.
17 Choi 2021a - Choi D, Kang M, Yoon J. Utility of mixed-use development by reducing aggregated travel time for multiple non-work activities: A case of Seoul, Korea. Cities. 2021;109:103007.
18 Litman 2017 - Litman T. Selling smart growth: Communicating the direct benefits of more accessible, multi-modal locations to households, businesses and governments. Victoria, BC: Victoria Transport Policy Institute (VTPI); 2017.
19 Moos 2018 - Moos M, Vinodrai T, Revington N, Seasons M. Planning for mixed use: Affordable for whom? Journal of the American Planning Association. 2018;84(1):7-20.
20 Moeckel 2017 - Moeckel R, Lewis R. Two decades of smart growth in Maryland (USA): Impact assessment and future directions of a national leader. Urban, Planning and Transport Research. 2017;5(1):22-37.
21 Nahlik 2014 - Nahlik MJ, Chester MV. Transit-oriented smart growth can reduce life-cycle environmental impacts and household costs in Los Angeles. Transport Policy. 2014;35:21-30.
22 Appleyard 2019 - Appleyard BS, Frost AR, Allen C. Are all transit stations equal and equitable? Calculating sustainability, livability, health, & equity performance of smart growth & transit-oriented-development (TOD). Journal of Transport & Health. 2019;14:100584.
23 Gehrke 2017 - Gehrke SR, Clifton KJ. A pathway linking smart growth neighborhoods to home-based pedestrian travel. Travel Behavior and Society. 2017;7:52-62.
24 Chatman 2016 - Chatman DG, Rayle L, Gabbe CJ, et al. Analyzing the economic benefits and costs of smart growth. 2016.
25 Gren 2019 - Gren A, Colding J, Berghauser-Pont M, Marcus L. How smart is smart growth? Examining the environmental validation behind city compaction. Ambio. 2019;48:580-589.
26 Litman 2017a - Litman T. Understanding smart growth savings: Evaluating economic savings and benefits of compact development, and how they are misrepresented by critics. Victoria, BC: Victoria Transport Policy Institute (VTPI); 2017.
27 Laitos 2013 - Laitos JG, Abel TM. Sites suitable for mixed use development in Britain and America. Kenna P, ed. International Journal of Law in the Built Environment. 2013;5(2):137-155.
28 US EPA-Smart Growth - U.S. Environmental Protection Agency (U.S. EPA). Smart Growth: Program, resources, topics, partnerships, and the 2015 National Award for Smart Growth Achievement.
29 CDC-PA Community design - Centers for Disease Control and Prevention (CDC). Priority strategy: Increasing physical activity through community design.
30 EBALDC-Healthy neighborhoods - East Bay Asian Local Development Corporation (EBALDC). Building healthy, vibrant and safe neighborhoods.
31 CNU-Building places - Congress for the New Urbanism (CNU). Building places people love.
32 SGO-Smart growth - Smart Growth Online (SGO). Smart Growth: Supporting the development of vibrant, healthy communities
33 US HUD-Via Verde - Via Verde: Innovative Design of Via Verde’s Affordable Housing Development. Washington, D.C.: Office of Policy Development and Research, U.S. Department of Housing and Urban Development (U.S. HUD).
34 TCF-Quick 2019 - Quick K, Kahlenberg RD. Attacking the Black-white opportunity gap that comes from residential segregation. Washington, D.C.: The Century Foundation; 2019.
35 Brennan 2019 - Brennan M, Peiffer E, Burrowes K. How zoning shapes our lives. Housing Matters: An Urban Institute Initiative. June 12, 2019.
36 Brookings-Freeman 2021 - Freeman L. How we rise: Build race equity into rezoning decisions. Washington, D.C.: Brookings Institution; July 13, 2021.
37 Metzinger 2017 - Metzinger JR. Considerations for mixed-use development. Associated Schools of Construction (ASC). 53rd ASC Annual International Conference Proceedings; 2017.
38 Shertzer 2022 - Shertzer A, Twinam T, Walsh RP. Zoning and segregation in urban economic history. Regional Science and Urban Economics. 2022;94:103652.
39 Shertzer 2018 - Shertzer A, Twinam T, Walsh RP. Zoning and the economic geography of cities. Journal of Urban Economics. 2018;105:20-39.
Related What Works for Health Strategies
To see citations and implementation resources for this strategy, visit:
countyhealthrankings.org/strategies-and-solutions/what-works-for-health/strategies/mixed-use-development
To see all strategies:
countyhealthrankings.org/whatworks