The Effectiveness of Healthy Community Approaches on Positive Health Outcomes in Canada and the United States

Healthy community approaches encompass a diverse group of population based strategies and interventions that create supportive environments, foster community behavior change and improve health. This systematic review examined the effectiveness of ten most common healthy community approaches (Healthy Cities/Communities, Smart Growth, Child Friendly Cities, Safe Routes to Schools, Safe Communities, Active Living Communities, Livable Communities, Social Cities, Age-Friendly Cities, and Dementia Friendly Cities) on positive health outcomes. Empirical studies were identified through a search of the academic and grey literature for the period 2000–2014. Of the 231 articles retrieved, 26 met the inclusion criteria with four receiving moderate quality ratings and 22 poor ratings using the Effective Public Health Practice Project Quality Assessment Tool. The majority of studies evaluated Safe Routes to School Programs and reported positive associations with students’ active commute patterns. Fewer studies assessed benefits of Smart Growth, Safe Communities, Active Living Communities and Age-Friendly Cities. The remaining approaches were relatively unexplored in terms of their health benefits however focused on conceptual frameworks and collaborative processes. More robust studies with longer follow-up duration are needed. Priority should be given to evaluation of healthy community projects to show their effectiveness within the population health context.