BOX 1.

Key Actions for Developing Infrastructure Legislation

Action	Example
Delineate the communities affected, the existing health challenges they face, and how the infrastructure will immediately ameliorate or exacerbate these health challenges.	With proposals to build new freeways and housing developments, the first questions on the table should be, “Which neighborhoods will be displaced in the process? Who lives in these neighborhoods? Who will be the beneficiaries of the new housing developments? Will these infrastructural changes make it easier or more difficult for current residents to access employment opportunities and health care facilities?”
Consider long-term health consequences associated with infrastructural investments.	Although freeways may serve as connections to jobs and produce economic growth in distressed communities, the resultant pollution from largely external traffic and deleterious health consequences may outweigh any short-term benefits.
Engineer infrastructure projects to simultaneously provide communities multiple benefits.	With new freeway construction comes opportunities to reroute underground pipes to provide communities with cleaner drinking water, among other projects. Additionally, after the freeway has been constructed, can local community members be hired to regularly maintain the pavement, thereby minimizing greenhouse gas emissions from vehicles?
Scale successful infrastructure initiatives from the local and state levels based on evidence of tangible and quantifiable health benefits.	In the late 1990s, the New Communities Program in Chicago, Illinois was implemented,10 which focused on engaging residents in the preparation of a community quality-of-life plan, as well as early childhood development and youth programs across 5 programmatic domains: housing and real estate, connection to regional economies, family income and wealth generation, education, and public health and safety. This model is now operating in almost 100 neighborhoods in 24 other metropolitan areas.