Strengthening Community and Home Environments
June 30, 2026
Where we live shapes our health and well-being — from risks in the broader community to hazards in the home, the environment plays a key role. Communities can create safe and welcoming spaces that support positive interactions, often referred to as changes in the built environment, which includes the physical places where people live, work, and carry out daily activities (i.e., homes, buildings, streets, transportation, and parks).
Meanwhile, a quality home environment free from health hazards is critical to protecting children from injuries and violence — as a poor home environment can not only cause physical injury but stress and negative effects on cognitive, social, emotional, and biological development. Health agencies can help families achieve safer home environments by supporting efforts to reduce exposure to toxins (i.e., lead) and promote the safe storage of firearms.
Ensuring that both neighborhood and household environments are safe and protect against injury is critical for helping people of all ages thrive. The approaches detailed in this action guide are key to strengthening these environments — developed from an abundance of research demonstrating they are at the intersection of preventing adverse childhood experiences, suicides, and overdoses. Effective implementation of each take:
- Convening and partnering with organizations that can support education efforts.
- Collecting and disseminating data on opportunities for and benefits of these prevention mechanisms.
- Raising awareness in communities and reducing barriers for families and those providing these critical services.
On This Page
Promoting Modifications to Community Environments
Improve Local Community Design
Community-driven design, or placemaking, approaches involve communities enhancing and maintaining public spaces where people can come together to interact and connect (i.e., in neighborhoods and around businesses or schools). They often include creating or reimagining green spaces, enhancing tree cover, improving lighting to increase visibility, and remediating vacant lots. These strategies can also improve opportunities for alternative transportation (public transportation or trails for pedestrians and cyclists) to access green spaces and other social environments, like recreation centers. By improving public spaces, people can safely gather, which addresses growing public health concerns about loneliness and social isolation. Efforts that engage the community enhance acceptability, use, and commitment to maintaining any of the improvements made to the built environment.
CDC grants (i.e., High Obesity Program, Racial and Ethnic Approaches to Community Health, and State Physical Activity and Nutrition) have funded built environment improvements. While focused on enhancing physical activity and nutrition to prevent obesity, these investments simultaneously create spaces that improve community safety and mental health. Organizations such as Project for Public Spaces and the National Endowment for the Arts also invest in placemaking projects.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the need to improve the built environment include state and local government agencies (i.e., community development, planning, parks and recreation, transportation, and public health), community organizations, and local businesses or schools.
Education
Key Data
Focus on sharing information about how improving the built environment can expand the use of safe public spaces, encouraging community interaction and social engagement. Collect and share local improvements to community design, demonstrating how local agencies and communities collaborated to identify and implement these improvements.
Local Stories
Source stories directly from community members who have been positively impacted by improvements in their neighborhood, highlighting how it made them feel safer, more connected, and better supported by their community.
State Assessment
Determine whether the state has funding (federal, state, or local) to support efforts around improving the built environment, and if these resources are reaching communities and neighborhoods with the highest needs. Determine whether additional state- or local-level programming could further improve community design, including:
- Helping community members identify where there is a need for cleaning up underbrush and vegetation to improve green spaces, and collaborating with them to “green” these areas by planting grass or trees, or adding fences or small gardens.
- Facilitate ongoing maintenance of green spaces by community groups or members, and regular neighborhood cleaning events.
- Assess opportunities through state and local parks departments to provide or increase staffing of parks and other green spaces.
- Increase the number of parks and open spaces available to community members.
- Increase opportunities for alternative transportation (like trail systems) that improve access to parks, open spaces, and recreation centers available to community members.
- Fix and beautify buildings and homes. If necessary, remove abandoned or run-down ones.
- Increase the amount or brightness of streetlights in neighborhoods so it is easier to see, which improves community member’s feeling of safety.
Raising Awareness and Reducing Barriers
- Support informational campaigns about the importance of improving community design to create safe and welcoming public spaces that provide prosocial spaces for community members to connect. Ask policymakers to allocate resources to improve outreach about programs that may exist in the state to enhance built environment improvements.
- Back state or local agencies in accessing federal, state, or local funding for built environment improvements.
- Support zoning or land use changes that transform vacant lots into open, green spaces or allow for the expansion of open spaces in communities, particularly in areas where there are fewer green spaces.
- Support local efforts pursuing:
- Joint use agreements to share facilities with schools to increase the availability of safe places to play.
- Community benefit agreements with housing developers to ensure community members have access to parks or open spaces as development occurs.
- Provide resources to agencies or communities to support the maintenance of grass and trees in green spaces, ensuring their ongoing health and sustainability.
- Offer programs to homeowners or property managers to support structural improvements to buildings and housing, such as installing functional windows and doors, and removing or repairing deteriorated elements (e.g., shutters, decks, walkways, etc.).
- Determine whether implementing a vacant building ordinance is feasible. This ordinance would hold property owners or managers responsible for keeping empty buildings safe and well-maintained. It is important that communities agree on which properties should be demolished.
Reduce Exposure to Harmful Community Conditions
Harmful community conditions that have been well-studied are high availability of substances — particularly alcohol — and exposure to neighborhood crime or violence. Being exposed to these harmful conditions often leads to an ongoing cycle of substance misuse and violence or has long-lasting social or emotional impacts on children and youth.
Addressing these social conditions includes policies related to reducing access to alcohol in communities, and efforts to ensure children and youth are protected against witnessing or being involved in violence as they travel to and from school. The U.S. Department of Transportation funds the Safe Streets and Roads for All grant annually to local government or tribal agencies, funding efforts to provide children with safe routes to and from school.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the need to reduce community member’s exposure to harmful community conditions include state and local government agencies (e.g., community development, social services, transportation, and public health), community organizations, faith-based organizations, and local businesses or schools.
Education
Key Data
Focus on sharing information about how reducing community members’ exposure to harmful community conditions can increase safety, break the cycle of substance misuse and violence in communities, and improve the social and emotional health of community members. Collect and share local efforts to reduce these exposures, demonstrating how local agencies and communities collaborated to identify and implement them.
Local Stories
Source stories directly from community members who have been positively impacted by an effort to reduce harmful community conditions (e.g., an alcohol policy or a new safe route to school program), highlighting how it made them feel safer, empowered to make healthier decisions, and better supported by their community.
State Assessment
Determine whether the state has funding (federal, state, or local) to support implementing programs or policies that prevent exposure to high availability of substances or neighborhood violence, and if these resources are reaching communities and neighborhoods where these efforts are most needed. Determine whether additional state- or local-level programming could further reduce these exposures, including:
- Strengthening practices and policies for establishments selling substances, which could include:
- Measuring your state or community’s alcohol outlet density, and determining the feasibility of local efforts to limit the number and location of establishments selling alcohol through licensing, density, or zoning regulations.
- Determining whether a social host liability state law or local statute exists, which assigns responsibility to adults who allow minors to drink alcohol at social gatherings.
- Increasing compliance checks in establishments to ensure they are not selling alcohol to minors.
- Restricting alcohol marketing tactics and merchandising, so youth are not specifically exposed to product marketing. This may include limiting where products can be placed in stores to prevent children from being exposed.
- Increasing the price of alcohol (including increasing excise or sales taxes) to reduce underage initiation and use in the community.
- Strengthening opportunities to ensure children and youth travel safely to school, which could include:
- Determining whether state, local, or school policies exist that establish or support safe routes to school efforts.
- Determining whether any efforts exist or could be enhanced, particularly in neighborhoods where there are high levels of violence (e.g., walking or biking school buses or trains, neighborhood watch, “eyes on the street”, community crossing guard programs, enhanced school bus availability to get to/from school).
Raising Awareness and Reducing Barriers
Support informational campaigns about any existing efforts that community members (in the case of safe route programs), establishments, or other businesses (in the case of reducing alcohol availability) should be aware of. In addition, support state or local agencies in accessing federal, state, or local funding for efforts to limit alcohol availability or enhance safe routes to school. And back regulations, zoning, or tax changes that limit the number of alcohol establishments.
Determine whether adjustments to state programs or policies would assist local communities in advancing efforts to create safe routes to school, particularly in communities with high violence. Finally, make connections across other efforts that are improving transportation systems for people of all ages to make the case that these can help 1) parents or guardians access work, 2) families access public spaces like parks and libraries, and 3) older adults access services so they can age in place. This helps leverage transportation funding to expand impact across all population groups.
Resources for Promoting Healthy Community Environments
- Improving the Built Environment Prevents ACEs and Creates Safer Communities
by ASTHO: A collection of success stories on state efforts to improve the built environment and how this work helps in the prevention of ACEs. - States Invest in Public Health and Safety Through Transportation Policy
by ASTHO: A blog that discusses the role of public health in transportation policy. - The Green Streets, Green Jobs, Green Towns (G3) Initiative and Approach
by Environmental Protection Agency: Learn more about green street design and how it can improve community health. - Built Environment Assessment Tool and Manual
by CDC: A resource to understand how to assess the built environment in communities. - Neighborhood and Built Environment
by Healthy People 2030: A guide and evidence-based resource list for improving neighborhood and built environments. - Planning for Healthy, Equitable Communities
by ChangeLab Solutions: A guide for developing partnerships between public health practitioners and urban and regional planners. - Conducting Neighborhood Cleanup Programs
by Community Toolbox: A toolkit providing resources to learn more about community cleanup programs and the impact of these programs on neighborhood environments. - Neighborhood Beautification Resources
by Keep America Beautiful: A resource hub of tools, guides, and program materials to improve neighborhood environments. - The Case for Healthy Places
by Project for Public Spaces: A report including peer-reviewed research, guidance, and recommendations detailing how to improve community environments. - Stories from Across Communities by Creative Placemaking Technical Assistance: Stories about neighborhood improvements from all over the United States.
- Greening America’s Communities: Community Stories
by the Environmental Protection Agency: Stories about communities that worked to make cleaner, safer spaces. - Using Big Data for Local Decisions
by the Bloomberg Harvard City Leadership Initiative: Research findings to inform demolitions for reducing gun violence. - Preventing Excessive Alcohol Use with Proven Strategies by CDC: Policies and strategies that states and communities can implement to reduce excessive alcohol use.
- Toolbox of Strategies
by National Center for Safe Routes to School: Tools and strategies for making routes to school safer. - Strategies for Improving Road Safety: A Public Health Resource
by UNC Highway Safety Research Center: A guide for public health practitioners on their role in improving transportation safety, and how they can bring their expertise to cross-agency project teams.
Advancing Safe Home Environments
Support Efforts to Reduce Lead Exposure
Lead is a poisonous chemical, and exposure early in life can contribute to developmental delays, learning difficulties, and behavioral problems. While the United States has made substantial progress in reducing the number of children exposed to lead, many older neighborhoods still risk exposing children — a risk that is even greater in low-income households — with the most common risks including lead-based paint in houses built before 1978 and lead service lines that carry the home’s drinking water. Removing lead from all sources in households or the surrounding environment can further reduce childhood exposure to lead.
Federal grants through the U.S. Department of Housing and Urban Development, Environmental Protection Agency, and CDC fund state or community efforts to address lead poisoning through education and outreach, monitoring and surveillance, environmental assessment, and remediation. In addition, states and communities can receive peer support from the Lead-Free Communities Initiative, a national learning and support network focused on lead elimination.
One way to extend the reach of lead poisoning prevention efforts is to use a health in all policies approach. Following this approach, health agencies can engage partners across sectors and levels of government to integrate health considerations into decision-making and leverage additional resources to support their efforts. This could include building relationships with other partners who touch lead (environment, Medicaid, housing authorities), but can move into more collaborative efforts (i.e., hosting regular meetings and sharing information) to create a larger network of entities working to reduce lead exposure.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the health risks of lead and the need to reduce lead exposure include state and local government agencies, community and faith-based organizations, housing professionals (owners, managers, or contractors), and health care providers. Other housing partners could include housing authorities, property owners or landlords, real estate professionals and insurers, general contractors, and other companies involved in water systems or construction materials.
Education
Key Data
Focus on sharing information about how eliminating childhood exposure to lead from all sources can improve children's health and development. Collect and showcase state and local efforts that have resulted in reductions of these exposures over time, as well as gaps in these efforts.
Local Stories
Source stories directly from families who have been positively impacted by home or neighborhood improvements that reduce lead exposure, highlighting how it protected their child’s development and opportunities to flourish. For example, while homes with service lines with potential lead presence were being replaced, Denver Water provided free Brita water pitchers and filters certified to remove lead to families potentially affected.
State Assessment
Determine whether the state has funding (federal, state, or local) to support efforts that prevent lead exposure, and if these resources are reaching neighborhoods and children with the highest risk of lead exposure. Determine whether funds are available to support additional programming in local communities to further reduce exposure and its impacts, including:
- Abate lead-based paint in older housing via certified contractors and provide temporary housing while the residents are displaced.
- Replace water service lines that have lead pipes.
- Remove lead from soil surrounding homes and manage further contamination of soil.
- Respond to and provide follow-up services to children with elevated blood lead levels.
Raising Awareness and Reducing Barriers
Host and support educational campaigns that highlight ways to prevent childhood lead exposure, targeting the public and those who might be at the highest risk of exposure. Ask policymakers to allocate resources to improve outreach and ensure that groups supporting at-risk families provide information in multiple languages.
In addition, inform decision-makers about how they can enhance laws and policies that help reduce exposure to lead (e.g., rental registries). And support state or local agencies in accessing federal, state, or local funding to reduce or respond to lead exposure.
Promote Secure Firearm Storage
Secure storage of firearms can prevent suicides, unintentional injuries, and theft of firearms that might be used in crime, as it prevents or delays firearm access during a crisis or by unauthorized users. It is a particularly helpful strategy for reducing these injuries or deaths among children. Secure storage efforts can focus on ensuring firearm owners:
- Contain their firearms in a lockbox, safe, or vault.
- Use a device like a cable or trigger lock.
- Temporarily and voluntarily removing firearms if someone in the household is in crisis.
Secure firearm storage efforts focus on training trusted messengers as well as providing free or reduced-cost locking devices to families. Additionally, 35 states have passed Child Access Prevention laws to ensure children do not have unsupervised access to firearms.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the need to promote secure firearm storage include state and local government agencies, community organizations, and groups trusted by firearm owners about the use of and safety practices for firearms. This might include firearm businesses (i.e., gun shops), firearm instructors, or hunting or recreation groups.
Education
Key Data
Focus on sharing information about how encouraging secure firearm storage can protect against potential injuries or deaths in households (particularly for children) among those who have access to firearms. Collect and showcase trends related to authorized access and secure storage practices in your jurisdiction, as well as gaps in efforts to increase these secure storage practices.
Local Stories
Source stories directly from families who have been positively impacted by establishing secure firearm storage practices, highlighting how it increased their family’s safety during a time of crisis, giving them time to access care while the firearm is securely stored in their home or temporarily out of their home.
State Assessment
Determine whether the state has funding (federal, state, or local) to support efforts that encourage secure firearm storage, and if these resources are reaching populations with the highest access to firearms and risk for injury or death. Identify whether additional state- or local-level programming could further enhance secure firearm storage, including:
- Education on secure firearm storage within households to protect against unauthorized access by children or those in crisis — to the public (e.g., Agree to Agree, Let’s Talk Guns Colorado), through health care providers to firearm owners (e.g., BulletPoints, AMA Learning Module), and through firearm businesses to firearm owners (e.g., Gun Shop Project, Pause to Protect).
- Education on temporary and voluntary off-site storage and its availability in the state.
- Education on the Child Access Prevention law for states where it exists, or the need for the law to prevent unauthorized access among children in states where it does not exist.
- Partnerships with local organizations to provide free or reduced-cost safes or locking devices to families with firearms in the household.
Raising Awareness and Reducing Barriers
Support informational campaigns about the importance of secure firearm storage in protecting against injuries and deaths. Ask policymakers to allocate resources to improve outreach and ensure that groups already collaborating with families who own and access firearms provide them with information about safe storage.
Inform decision-makers about how they can enhance laws that show promise in reducing injuries and deaths involving firearms. Finally, support state or local agencies in accessing federal, state, or local funding to promote secure firearm storage.
Resources for Advancing Safe Home Environments
- About Childhood Lead Poisoning Prevention
by CDC: A page about preventing childhood lead poisoning, including risk factors, causes, testing, and resources. - Federal Action Plan to Reduce Childhood Lead Exposures and Associated Health Impacts
by Environmental Protection Agency: A blueprint for reducing lead exposure by collaborating with a wide range of stakeholders. - Healthy Homes
by HUD Office of Lead Hazard Control: A program to support jurisdictions working toward improving healthy homes. - Implementing a Health in All Polices Approach to Lead Poisoning Prevention
by ASTHO - State and Local Lead Laws
by National Center for Healthy Housing: Examples of jurisdictions that have enacted lead prevention laws. - State Health Department Policies for Children with Elevated Blood Lead Levels
by National Center for Healthy Housing: A resource outlining state health department policies on interventions for children with elevated blood lead levels. - Lead (for Health Professionals)
by Pediatric Environmental Health Specialty Units: A resource about lead exposure, testing, and clinical management. - How to Prevent Firearm Injury Using a Public Health Approach, with Examples and Resources
by ASTHO: A toolkit with information and resources on the prevention of firearm injuries. - Project ChildSafe Educational Materials
by National Shooting Sports Foundation: Resources and toolkits on providing comprehensive firearm safety education. - Suicide is Everyone’s Business: A Toolkit for Safe Firearm Storage in Your Community
by U.S. Department of Veteran Affairs: A toolkit including information on effective methods for safe firearm storage, developing a community coalition, creating a community outreach plan, and monitoring and evaluating impact. - Office of Gun Violence Prevention and Intervention Approaches
by the Colorado Department of Public Health & Environment: A series of resources on effective strategies, implementation guides, and evidence on secure firearm storage, out-of-home storage, and lethal means safety counseling.
This resource reflects the collective efforts of many contributors, including ASTHO staff Alison Maffey, MSW, Vice President, Social and Behavioral Health; Caitlin Langhorne-Griffith, Director, Injury, Suicide, & Violence Prevention; Rachel Scheckman, Senior Analyst, Intersection of ACEs, Suicide & Overdose Prevention; and Erin Wright-Kelly, DrPH, MA, of Community Impact Partners, LLC.
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