Strategies

What Works for Health includes evidence-informed strategies to create communities where everyone can thrive.

Alternative fuels initiatives

Support alternative fuel and vehicle use via financial incentives (e.g., tax benefits, rebates, etc.), mandates (e.g., consumption targets or renewable fuel standards), research and development investments, etc.

Evidence Rating:

Expert Opinion

Bicycle & pedestrian master plans

Establish a framework to increase walking and biking trails and improve connectivity of non-auto paths and trails in a particular area

Evidence Rating:

Some Evidence

CAFO regulations

Establish local regulations for confined animal feeding operations (CAFOs) that address location, size, facility management, and pollution contributions to complement U.S. EPA regulations

Evidence Rating:

Expert Opinion

Carpool & rideshare programs

Help participants share transportation via informal arrangements between individuals, formally arranged ridesharing programs, or other ride-matching services

Evidence Rating:

Expert Opinion

Clean diesel technology fleet transition programs

Replace or retrofit diesel buses or other vehicles to operate with clean diesel technology

Evidence Rating:

Scientifically Supported

Community gardens

Establish and support land that is gardened or cultivated by community members via community land trusts, gardening education, zoning regulation changes, or service provision (e.g., water or waste disposal)

Evidence Rating:

Some Evidence

Community land trusts

Purchase the land a home is on to lease to homeowners with low and middle incomes and require homeowners to sell the home back to the trust or to another resident with low income upon moving

Evidence Rating:

Some Evidence

Community supported agriculture (CSA)

Establish partnerships between farmers and consumers in which consumers purchase a share of a farm’s products in advance

Evidence Rating:

Expert Opinion

Competitive pricing for healthy foods

Assign higher costs to non-nutritious foods than nutritious foods via incentives, subsidies, or price discounts for healthy foods and beverages or disincentives or price increases for unhealthy choices

Evidence Rating:

Scientifically Supported

Complete Streets & streetscape design initiatives

Enhance streetscapes with greater sidewalk coverage and walkway connectivity, street crossing safety features, traffic calming measures, and other design elements

Evidence Rating:

Scientifically Supported

Composting

Use aerobic, natural decomposition to divert food and yard waste from landfills and create a nutrient-rich soil amendment product on an individual or large scale

Evidence Rating:

Scientifically Supported

Conservation Reserve Enhancement Program (CREP)

Support the federal-state partnership that pays participating landowners an annual rental rate for removing environmentally sensitive land from production and introducing conservation practices on the land.

Evidence Rating:

Some Evidence

Conservation tillage practices

Encourage methods of soil cultivation that keep at least one-third of cultivated soil covered with the previous year’s crop residue (e.g., mulch till, ridge till, strip till, or no-till)

Evidence Rating:

Scientifically Supported

Electric vehicle initiatives

Replace internal combustion engine vehicles with all-electric vehicles through financial incentives, regulations, and multi-component initiatives

Evidence Rating:

Scientifically Supported

Farm to school programs

Incorporate locally grown foods into school meals and snacks, often with visits from food producers, cooking classes, nutrition and waste reduction efforts, and school gardens

Evidence Rating:

Some Evidence

Farmers markets

Support multiple vendor markets where producers sell goods such as fresh fruit and vegetables, meat, dairy items, and prepared foods directly to consumers

Evidence Rating:

Some Evidence

Food buying clubs & co-ops

Offer opportunities for group purchase and distribution of selected grocery items, generally at a reduced price

Evidence Rating:

Expert Opinion

Food hubs

Support businesses or organizations that aggregate, distribute, and market local and regional food products (e.g., fresh fruits and vegetables, meat, dairy, grains, and prepared items)

Evidence Rating:

Expert Opinion

Fruit & vegetable gleaning initiatives

Gather food left in fields after a primary harvest, food in fields where harvesting is not profitable, or excess produce from orchards, packing houses, urban agriculture sites, etc.

Evidence Rating:

Expert Opinion

Fruit & vegetable incentive programs

Offer participants with low incomes matching funds to purchase healthy foods, especially fresh fruits and vegetables; often called bonus dollars, market bucks, produce coupons, or nutrition incentives

Evidence Rating:

Scientifically Supported

Green space & parks

Increase green space through new parks or open spaces, renovation or enhancement of under-used recreation areas, rehabilitation of vacant lots, brownfields, etc.

Evidence Rating:

Some Evidence

Healthy food in convenience stores

Encourage convenience stores, corner stores, or gas station markets to carry fresh produce and other healthier food options

Evidence Rating:

Some Evidence

Healthy food initiatives in food pantries

Combine hunger relief efforts with nutrition information and healthy eating opportunities, often with on-site cooking demonstrations, recipe tastings, produce display stands, etc.

Evidence Rating:

Some Evidence

Healthy school lunch initiatives

Modify the school lunch food environment or school lunch schedules by increasing the convenience of healthy foods, providing healthy options, or ensuring students have enough time to eat

Evidence Rating:

Scientifically Supported

Household lead control education interventions

Inform parents and caregivers about lead exposure pathways from contaminated dust, soil, water, and air as well as the irreversible health consequences of lead exposure

Evidence Rating:

Evidence of Ineffectiveness

Inclusionary zoning & housing policies

Require developers to reserve a proportion of housing units for residents with low incomes via mandatory requirements or incentives, such as density bonuses

Evidence Rating:

Some Evidence

Individual incentives for public transportation

Offer incentives such as free or discounted bus, rail, or transit passes, reimbursements, partial payments, or pre-tax payroll deductions to encourage individuals’ use of existing public transit

Evidence Rating:

Some Evidence

Integrated pest management (IPM) for agriculture & outdoor use

Support a four-tiered approach to outdoor pest control that minimizes potential hazards to people, property, and the environment

Evidence Rating:

Scientifically Supported

Land banking

Acquire, hold, manage, and develop properties such as vacant lots, abandoned buildings, or foreclosures, and transition them to productive uses, often affordable housing developments

Evidence Rating:

Some Evidence

Lead contaminated soil abatement interventions

Clean, remove, replace, or cover lead contaminated soil with non-contaminated soil, mulch, sod, grass, or concrete

Evidence Rating:

Some Evidence

Lead paint abatement programs

Eliminate lead-based paint and contaminated dust by removing or encapsulating lead paint, or removing lead painted fixtures and surfaces

Evidence Rating:

Scientifically Supported

Lead pipe & plumbing material replacement interventions

Replace lead plumbing material such as pipes, service lines, fittings, solder, flux, and fixtures with non-lead plumbing material through multi-component interventions

Evidence Rating:

Some Evidence

Mixed-use development

Support a combination of land uses (e.g., residential, commercial, recreational) in development initiatives, often through zoning regulations or Smart Growth initiatives

Evidence Rating:

Scientifically Supported

Mobile produce markets

Support fresh food carts or vehicles that travel to neighborhoods on a set schedule to sell fresh fruits and vegetables

Evidence Rating:

Some Evidence

Multi-component groundwater management programs

Protect underground water resources via regular groundwater monitoring, education about risks to groundwater, water quotas and taxes, and other efforts

Evidence Rating:

Some Evidence

Multi-component workplace supports for active commuting

Provide physical infrastructure (e.g., bike parking or showers), educational or social support (e.g., walking groups), and financial incentives that support active commuting

Evidence Rating:

Some Evidence

Nutrient management plans

Support site-specific plans for crop production that match nutrient applications to crop needs, typically with agricultural best management practices

Evidence Rating:

Scientifically Supported

Open Streets

Allow community members to gather, socialize, walk, run, bike, skate, etc. on streets temporarily to closed to motorized traffic; also called Ciclovía programs

Evidence Rating:

Expert Opinion

Permeable pavement projects

Use pervious concrete, porous asphalt, permeable interlocking pavers, open-jointed blocks or cells, or other permeable pavement in individual or commercial development efforts; also called porous or pervious pavement

Evidence Rating:

Scientifically Supported

PFAS regulations

Establish regulations for per- and polyfluoroalkyl substances (PFAS) manufactured chemicals, that address production, use, and environmental contamination

Evidence Rating:

Expert Opinion

Places for physical activity

Modify local environments to support physical activity, increase access to new or existing facilities for physical activity, or build new facilities

Evidence Rating:

Scientifically Supported

Plastic bag bans

Prohibit the manufacture, use, and provision of single-use plastic bags, either partially or completely, and provide education and outreach to raise consumer awareness and support of bans

Evidence Rating:

Some Evidence

Proper drug disposal programs

Establish programs that accept expired, unwanted, or unused medicines from designated users and dispose of them responsibly

Evidence Rating:

Expert Opinion

Public transportation systems

Introduce or expand transportation options that are available to the public and run on a scheduled timetable (e.g., buses, trains, ferries, rapid transit, etc.)

Evidence Rating:

Scientifically Supported

Rain barrels

Use ready-made or home constructed barrel systems to collect and store rainwater from rooftops that would otherwise flow to storm drains and streams

Evidence Rating:

Some Evidence

Rain gardens & other bioretention systems

Establish bioretention systems (e.g., rain gardens, bioretention cells, green roofs, planter boxes, bioswales, etc.) to make city landscapes more permeable to help control stormwater

Evidence Rating:

Scientifically Supported

Safe Routes to Schools

Promote walking and biking to school through education, incentives, and environmental changes; often called SRTS

Evidence Rating:

Scientifically Supported

School fruit & vegetable gardens

Establish designated areas where students can garden with guidance, often with nutrition and food preparation lessons and opportunities for taste tasting and hands-on learning

Evidence Rating:

Scientifically Supported

School nutrition standards

Regulate the quality of food that can be sold to students through the National School Lunch Program (NSLP), à la carte options, vending machines, etc.

Evidence Rating:

Scientifically Supported

Scrap programs for old vehicles

Provide incentives to trade in old cars or light duty trucks with low fuel efficiency and high emissions and buy new vehicles with higher efficiency and lower emissions; also called scrappage or vehicle early retirement programs

Evidence Rating:

Expert Opinion

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