Baltimore residents have shorter life expectancies than other residents of the state of Maryland and experience excess mortality due to chronic disease and homicide, among other poor outcomes. It is likely that neighborhood factors contribute to these health disparities, and residents from socioeconomically disadvantaged communities are particularly impacted. Crime rates are elevated throughout the city compared to the rest of the state but are notably high in disadvantaged areas. These areas also lack access to healthy food options and have higher concentrations of potentially unhealthy commercial establishments, such as corner stores and off-premise alcohol sales outlets. Zoning is one policy that contributes to shaping the built environment and impacts health outcomes. Recognizing this, Johns Hopkins researchers developed Zoning for a Healthy Baltimore, a Health Impact Assessment (HIA) of the Baltimore zoning code rewrite. The purpose of the HIA is to maximize the potential for the zoning recode to prevent obesity, decrease crime and other adverse health outcomes.

The goal of Zoning for a Healthy Baltimore is to influence the final version of Baltimore’s new zoning code by informing stakeholders and decision-makers about the new zoning code’s potential to create healthy communities and decrease health disparities, with an emphasis on preventing obesity and crime.

Zoning for a Healthy Baltimore is an HIA of the Baltimore zoning code rewrite in order to maximize the potential to create healthier communities. Since publication, Baltimore has revised its zoning code to incorporate dispersal standards and other strategies related to placement of alcohol outlets.

As part of the Health Impact Assessment, a literature review was performed and a quantitative assessment of the potential for Baltimore’s proposed new zoning code (the draft code) to create healthier communities and decrease health disparities was provided. An emphasis was placed on promoting physical activity, increasing access to healthy foods, and preventing obesity and crime. The literature review showed that off-premise alcohol sales outlets are associated with increased crime; pedestrian-oriented environments are associated with lower crime rates, increased walking and decreased obesity; mixed land use (i.e. residential and commercial) is associated with increased walking and decreased obesity, but more so for higher income than lower income populations; and increased availability of healthy food options, such as supermarkets and farmers markets, are associated with increased healthy eating and decreased obesity. Assessment of the maximum potential impact of the draft code on the built environment and recommendations based on results from expert opinions were also given. Since the development of the HIA, Baltimore City has revised its zoning code to incorporate dispersal standards and other strategies from Zoning for a Healthy Baltimore related to the placement of alcohol outlets.