Healthy Places

Build ways to move.

Walkable, bikeable, and connected streets help people be active and safe every day.

Active transportation encompasses getting around by walking, biking, rolling, or using transit. By making these options safer, more accessible, and more connected, Tennessee communities can improve public health, reduce chronic disease, and strengthen mobility for all. 

Walkability

What is walkability?
Walkability is a measure of how friendly an area is to walking, running or wheelchair rolling. 

Why it matters

• Even modest increases in walking lead to meaningful physical-health benefits (reducing risks of heart disease, diabetes, obesity, cancer) and better mental health.
• Walkable communities support local economic vitality, higher property values, and social connection. 

Key features of a walkable place

• Connected sidewalk networks, safe crosswalks, curb extensions, vegetated buffers, traffic calming
• Connectivity to destinations (schools, shops, parks, transit stops)
• Design that considers people with mobility challenges and supports universal access

Strategies for communities

• Retrofit streets with sidewalks or crossings
• Implement safe routes to school programs
• Use design tools and checklists (e.g. Steps to a Walkable Community) 

Bikeability

What is bikeability?
Bikeability is the extent to which a route or network supports safe, comfortable, and accessible bicycling for people of all ages and skill levels.

Why it matters

• Bicycling offers a low-cost, low-impact way to get more physical activity.
• Better bike networks can reduce traffic, improve air quality, and expand access to key destinations. 

What makes a route bikeable?

• Protected bike lanes, buffered lanes, or clear shared lanes
• Smooth surfaces, lighting, low-speed traffic, minimal debris
• Secure places to park/lock bikes
• Bicycle signage, road markings, signal timing for safe crossings 

How to improve bikeability

• Use assessment tools & checklists (e.g. from FHWA, NHTSA) 
• Strategically prioritize key routes that connect neighborhoods to schools, business districts and transit
• Adopt policies such as lower speed limits, complete streets design, maintenance standards 
• Engage cyclists and community groups in planning

Transit

What is transit?
Transit (or public/mass transportation) includes buses, vans, trains, trolleys, shuttles, and ferries. 

Health & environmental benefits

• Transit access encourages walking or rolling to stations, increasing daily physical activity.
• Fewer vehicle trips help reduce air pollution, greenhouse gas emissions, and traffic-related injuries. 
• Transit supports more efficient land use, enabling denser, mixed-use development. 

Supporting transit in Tennessee

• Multiple transit systems serve Tennessee communities (e.g. WeGo, CARTA, MATA, KAT) 
• Many transit vehicles and systems now include accommodations for people with disabilities or mobility constraints. 
• States and communities can coordinate transit expansions, paratransit services, and multimodal access to stops

Multimodal Transportation

What is multimodal transportation?
Multimodal transportation refers to the integration and coexistence of various modes—walking, biking, transit, rail, freight, and motor vehicles—in one network. 

Why multimodal matters

• Provides travel choices that suit different needs, ages, incomes or abilities 
• Enhances network resilience: if one mode is disrupted, others remain viable
• Promotes equity and inclusion, especially for those who cannot drive
• Supports economic growth and sustainable urban development

How Communities Can Act

• Conduct assessments: Use walkability and bikeability checklists, GIS tools and community surveys to identify gaps.
• Plan strategically: Prioritize corridors that link housing, schools, employment centers and transit stops. Adopt Complete Streets or multimodal design policies.
• Implement visible improvements: Add sidewalks, crosswalks, bike lanes, bus shelters, signage and lighting. Apply “road diets” or lane reallocation where feasible.
• Maintain and manage: Ensure upkeep—fix cracks, clear debris, repaint markings, maintain landscaping.
• Engage the public & partners: Foster collaboration among transportation agencies, health departments, planning departments, advocacy groups and communities.
• Track progress: Use indicators (e.g. percent of trips by walking / biking / transit, injury rates, air quality) to monitor outcomes and guide next steps.

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Plan for healthy growth.

Smart zoning and neighborhood design bring housing, jobs, and services closer together.

How land is shaped—in where we build, how we grow, and how we design—affects community health, equity, mobility, and resilience. Thoughtful land use can help people live more actively, protect the environment, and strengthen social connection.

Placemaking

Placemaking is a people-centered approach to designing public space—streets, plazas, parks—that reflects a community’s culture, identity, and needs. Tennessee State Government

Why it matters:

• Invites walking, gathering, social interaction
• Strengthens sense of belonging and civic pride
• Encourages healthy behaviors through active uses

How to start:

• Observe how people already use a space
• Clean, beautify, add seating, shade, art, lighting
• Invite input from residents, artists, local groups
• Use temporary interventions (pop-ups, murals) to test ideas

Planning

Land use planning is the blueprint for how communities grow—guiding what goes where, preserving open space, and balancing development with infrastructure. Tennessee State Government

Core tasks planners address:

• Zoning and land-use regulation
• Community or comprehensive plans
• Transportation, parks, and environmental planning
• Historic preservation, resilience, sustainable growth

Health connections:

• Planning can embed goals for active transportation, green space, affordable housing
• Zoning can require sidewalks, mixed uses, or limit harmful land uses
• Public involvement ensures plans match community priorities

Development

Development means altering land—creating housing, commercial buildings, subdivisions, or repurposing existing properties. 

Health implications of development:

• Well-designed development can promote walking, biking, transit
• Poor or sprawling development can increase traffic, pollution, and isolation
• Redevelopment and infill reduce pressure on open land and infrastructure costs

Good practices:

• Favor smart growth over sprawl: higher density, mixed uses, compact form
• Reuse brownfields, reduce “edge” development
• Use zoning incentives or design standards to shape healthy outcomes

Downtowns

Downtowns are traditional centers of commerce, culture, gathering, and history.

Why focus downtown?

• Compact, walkable layout encourages active transportation
• Heritage and identity strengthen community character
• Central areas can drive local economy and civic life

Keys to revitalization:

• Mix uses: retail, residential, offices
• Streetscape improvements: sidewalks, lighting, shade, bike parking
• Public art, wayfinding, green infrastructure, stormwater design
• Partner with state Main Street programs and local stakeholders

Neighborhoods

Neighborhoods are the building blocks of everyday life—places people live, walk, socialize and form relationships. 

Characteristics of healthy neighborhoods:

• Safe, connected streets, sidewalks, bike paths
• Parks, open spaces, trees, inviting public amenities
• Access to transit, services, nearby destinations
• Diverse housing forms, for all ages and incomes

How neighborhoods can influence health:

• Enabling walking or rolling trips replaces car dependence
• Social cohesion enhances mental wellbeing
• Well-maintained housing reduces exposures to hazards

Rural Areas

Rural Tennessee comprises most of the land area and presents unique challenges and opportunities. 

Challenges in rural settings:

• Fewer healthcare, transit, and recreation services
• More distance between homes, stores, schools
• Infrastructure constraints, limited budgets and resources
• Higher prevalence of chronic disease, transportation barriers

Opportunities for rural health through land use:

• Leverage natural assets: trails, greenways, scenic routes
• Shared use agreements (e.g. school fields, recreational spaces)
• Safe walking or biking connections to local services
• Conservation development to preserve farmland, forest and open space

Suburban Areas

Suburban areas are lower-density zones that separate residential from commercial spaces, often surrounding or within commuting distance of cities. While many suburbs offer amenities and quality of life, they also face unique challenges and opportunities for healthful, sustainable growth.

Key Features & Health Context

• Suburban residents often enjoy higher income, education, and access to health care compared to rural or urban counterparts.
• They typically benefit from better access to nutritious food, outdoor recreation, utilities, and broadband.
• Yet, suburban growth can contribute to sprawl — a pattern marked by low density, separated uses, disjointed street networks, and absence of activity centers.'
• Sprawl is linked to negative outcomes like lower physical activity, reduced air quality, social isolation, longer commutes, and higher risk of traffic injury.

Encouraging Physical Activity in Suburbs

• To make suburban living healthier and more active, communities can:
• Invest in sidewalks, bikeways, trails, greenways, and safe crossings
• Support playgrounds, sports fields, nature parks, and public pools
• Promote walking, biking or bus riding to school through Safe Routes programs
• Preserve and enhance connections between neighborhoods, parks, transit, and services

Planning & Governance in Suburbia

• In urbanized areas (50,000+ population), Metropolitan Planning Organizations (MPOs) and Transportation Planning Organizations (TPOs) oversee transportation planning across jurisdictions. 
• Tennessee has 9 Development Districts coordinating regional planning and development across city and county lines.
• Economic development agencies offer programs (e.g. Community Development Block Grants, main street programs, incentive grants) to support community improvement and vitality. 

Conserving Green Space & Healthy Growth

• Rapid suburban expansion can threaten wetlands, forests, farmland, and natural habitats — undermining environmental quality and property values. 
• Tools like conservation development (which integrates growth with preserved open space) and easements/land trusts can protect green infrastructure and community character. 

Zoning, Health & Multimodal Access

• Zoning is a powerful tool for health: it determines what uses go where — whether homes, shops, roads, parks, or industries. 
• Smart zoning can slow sprawl, require or incentivize mixed-use development, and embed infrastructure for walking, biking, public transit, and green space. 
• A multimodal transportation network (walk + bike + transit + road) ensures people have choices and safer options, especially for children, the elderly, and those with disabilities. Urban Areas

Urban Areas

Urban areas include cities and towns with high population density and many built structures (residential, commercial, institutional). The U.S. Census defines Urban Clusters (pop. 2,500–50,000) and Urbanized Areas (≥ 50,000). Many urban places serve as employment and service hubs for their surrounding regions. 

Urban Design & Physical Activity

• Urban environments inherently lend themselves to more active lifestyles when thoughtfully designed:
• Because destinations are closer together, walking, biking, and transit become viable options for daily trips (e.g., errands, school, work) 
• Common urban amenities include sidewalks, crosswalks, bike lanes, parks, greenways, pools, skateparks, public recreation spaces, and more 
• Safe street design and connectivity further support physical activity and daily mobility 

Potential advantages

• Easier access to health care, education, jobs, and services 
• Shorter commutes correlate with less stress and more time for other activities 
• A compact built environment supports longevity, social interaction, and walkable living 

Common challenges

• Increased air and noise pollution, congestion, and stress in dense areas
• Traffic intensity and pedestrian/vehicle conflicts
• Issues of housing affordability, gentrification, displacement
• Unequal distribution of resources and concentrated disadvantage in some neighborhoods 

Housing, Equity & Revitalization

• Affordable and mixed-income housing programs and zoning policies can help ensure that more residents benefit from urban amenities. 
• Gentrification occurs when rising property values displace long-time, lower-income residents. Mitigating strategies include inclusionary zoning, community land trusts, or mixed-tenure housing.
• Revitalization of neglected urban areas focuses on infill development, public improvements, infrastructure upgrades, public art, and encouraging local enterprise in existing neighborhoods. 

Multimodal & Complete Transportation

In densely populated urban cores, transportation options beyond the private car become essential:

• Multimodal systems (walking, biking, transit, shared mobility) broaden access and reduce dependency on parking or car ownership.
• Integration of sidewalks, bike lanes, safe crossings, transit shelters, and connectivity supports safety, accessibility, and mobility for all ages and abilities. 

Environmental & Infrastructure Conditions

• Air quality tends to be more challenged in urban areas due to vehicle emissions, industrial sources, and heat island effects. 
• Stormwater & runoff issues are significant as impervious surfaces (roads, parking lots, rooftops) increase.
• Urban areas often contract utilities, water/sewer infrastructure, and public services that can support public health — though aging systems must be maintained. 

Urban Communities in Tennessee

Tennessee hosts multiple metropolitan regions, each with varying size, demographics and growth trajectories. Examples include Nashville, Memphis, Knoxville, Chattanooga, Clarksville, and more.  These urban hubs influence and are influenced by their surrounding suburbs and rural places, often functioning as economic, cultural, and service centers.

Who Plans & Governs Urban Change

• City governments, regional planning agencies, and transportation authorities lead urban land use, zoning, infrastructure, and redevelopment efforts. 
• Zoning policies are powerful levers:
• Mixed-use zoning integrates residential, commercial, institutional functions to reduce the need for long trips and support active living. 
• Zoning can require or incentivize sidewalks, bike lanes, parks, green space, affordable housing, and design standards supportive of health.

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Design buildings that support health.

Homes, schools, and workplaces built with air quality, safety, and activity in mind make healthier lives possible

Creating and maintaining healthy buildings is essential to the well-being of all Tennesseans. The Tennessee Department of Health promotes environments where people live, learn, work, and worship that support physical, mental, and social health.  Healthy buildings reduce disease, improve quality of life, and foster stronger communities. Whether it’s a classroom, home, office, or sanctuary, every space can be designed and maintained to support health.

Healthy Schools

Schools are vital to children's development. Healthy school environments:

• Support nutrition, physical activity, and emotional well-being
• Improve academic performance and reduce absenteeism
• Promote lifelong healthy habits

Key initiatives include:

• Coordinated School Health: A statewide model integrating health into education
• Active Students, Active Learners: Promoting physical activity to boost learning
• Safe Routes to School: Encouraging walking and biking safely

Healthy Housing

Good health starts at home. Healthy housing is:

• Dry, clean, pest-free, safe, contaminant-free, ventilated, and well-maintained
• Linked to reduced asthma, lead exposure, and injury risks
• A foundation for stronger communities and property values

Resources include:

• Guidance on healthy housing
• Health in public housing

Healthy Workplaces

Workplaces influence employee health and productivity. A healthy workplace:

• Encourages physical activity, healthy eating, and mental well-being
• Features natural light, ergonomic design, and green spaces
• Leads to lower absenteeism and higher job satisfaction

Tools and strategies:

• Active Design Guidelines: Design recommendations for health-promoting workspaces
• CDC Workplace Health Model: Framework for comprehensive wellness programs

Healthy Faith-Based Places

Places of worship can be powerful promoters of health. Healthy faith-based spaces:

• Host wellness events, support groups, and health screenings
• Provide safe, accessible spaces for all ages and abilities
• Encourage physical activity through walking trails, gardens, and play areas

Ideas for action:

• Start a sustainable garden
• Offer nutrition education
• Conduct an energy audit or pursue green certification

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Give everyone a fair chance.

Good health depends on access — to food, housing, transit, and safe places.

Health equity means that everyone has a fair and just opportunity to be as healthy as possible. The Tennessee Department of Health (TDH) works to eliminate health disparities and promote environments that support health for all—regardless of age, ability, income, or background.

Child Health

Children’s health is foundational to lifelong well-being. TDH supports:

• Physical activity: Kids need 60 minutes daily for physical, mental, and emotional development.
• Healthy environments: Safe, walkable neighborhoods, clean air, and toxin-free schools.
• Gold Sneaker Initiative: Promotes wellness policies in child care centers.
• Lead and asthma prevention: Reducing environmental triggers in homes and schools.
• Nature and play: Encouraging outdoor exploration for physical and mental health.

Healthy Aging

Aging well means staying active, connected, and independent. TDH promotes:

• Livable communities: Safe, walkable, and socially engaging environments.
• Fall prevention: Programs like Stepping On reduce injury risk.
• Nutrition and activity: Access to healthy food and exercise opportunities.
• Preventive care: Screenings and immunizations for adults 50+.
• Aging in place: Supporting seniors to remain in their homes and communities.

Accessibility

Accessibility ensures people with disabilities can fully participate in society. Key efforts include:

• ADA compliance: Removing barriers in public spaces and services.
• Inclusive design: Features like ramps, wide doorways, and visual/auditory cues.
• Digital access: Websites and tools that work for all users.
• Advocacy partners: Organizations like Disability Rights Tennessee and the TN Disability Coalition.

Universal Design

Universal design creates spaces usable by everyone, regardless of age or ability:

• Principles: Equitable use, flexibility, simplicity, and safety.
• Examples: Step-free entries, curb ramps, lever handles, and wide hallways.
• Benefits: Encourages physical activity, supports aging in place, and increases property value.
• Visitability: Homes designed to welcome all guests, including those with mobility challenges.

Environmental Justice

Environmental justice ensures all communities are protected from environmental harm:

• Fair treatment: Equal enforcement of environmental laws and policies.
• Community voice: Involving residents in decisions that affect their health.
• Civil rights: Title VI of the Civil Rights Act prohibits discrimination in federally funded programs.
• Focus areas: Pollution, land use, and access to clean air and water.

Food and Nutrition

Access to nutritious food is essential for health:

• Food security: Addressing affordability, availability, and sustainability.
• School nutrition: Programs that provide balanced meals and promote healthy habits.
• Breastfeeding support: Community-based encouragement and education.
• Farmers markets & CSAs: Connecting residents to fresh, local produce.
• Community gardens: Promoting health, activity, and neighborhood pride.

Safety

Safe environments reduce injury and promote well-being:

• Built environment: Designing streets, parks, and buildings to prevent harm.
• Traffic safety: Reducing pedestrian and cyclist injuries.
• Crime prevention: Collaborating with law enforcement and communities.
• Emergency preparedness: Ensuring readiness for natural and public health emergencies.

Health Disparities

Health disparities are preventable differences in health outcomes:

• Root causes: Social, economic, and environmental disadvantages.
• Impact: Higher rates of disease, disability, and death in marginalized communities.
• TDH efforts: Data collection, community engagement, and targeted interventions.
• Goal: Achieve equity by addressing systemic barriers and improving access to care.

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Create space to connect.

Parks, trails, and greenways strengthen communities, promote activity, and boost mental wellbeing.

Recreation is essential to physical, mental, and social well-being. The Tennessee Department of Health promotes access to parks, trails, green spaces, and cultural sites to help communities thrive through active living, tourism, and environmental connection.

Tourism and Health

Tourism supports local economies and encourages physical activity. Visitors often walk, hike, or bike while exploring Tennessee’s natural beauty and cultural landmarks. Events like marathons and heritage festivals promote movement and community pride.

Cultural & Historical Places

Tennessee’s cultural and historical sites—such as museums, civic buildings, and historic neighborhoods—offer more than education:

• Encourage walking and exploration
• Foster community identity and pride
• Support mental health through learning and reflection
• Promote preservation and adaptive reuse of historic spaces

Parks

Tennessee’s 56 state parks and numerous local and national parks offer:

• Health benefits: Reduced stress, improved fitness, better mental health
• Activities: Hiking, biking, swimming, birdwatching, camping, and more
• Programs: Healthy Parks Healthy Person app rewards physical activity with real incentives
• Accessibility: Inclusive design and safety features for all ages and abilities
• Economic impact: Parks boost tourism, property values, and local jobs

Explore Tennessee State Parks

Green & Open Spaces

These undeveloped areas—like fields, plazas, and community gardens—offer:

• Mental restoration and stress relief
• Physical activity through walking, play, or exercise
• Environmental benefits: Stormwater filtration, air quality improvement, and urban cooling
• Community value: Beautification, social cohesion, and increased property values

Greenways & Trails

Greenways and trails are linear open spaces that connect neighborhoods, parks, schools, and cultural sites. They:

• Promote active transportation and recreation
• Follow natural or historic corridors (e.g., rivers, railways)
• Are supported by the Tennessee Greenways and Trails Plan, which offers guidance on development, funding, and community engagement

Learn more about Greenways & Trails

Water Recreation

Tennessee’s lakes, rivers, and streams offer year-round opportunities for:

• Physical activity: Swimming, kayaking, fishing, paddleboarding, and more
• Tourism and identity: Waterfronts attract visitors and define communities
• Safety and stewardship: TWRA and public health agencies promote safe, clean water use

Tips for safe water recreation:

• Swim with a buddy
• Wear life jackets
• Check for advisories and water quality updates

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Protect the basics.

Clean air, water, and soil are the foundation of every healthy community.

Clean air, land, and water are essential for healthy communities. The Tennessee Department of Health works with partners to monitor environmental conditions, reduce pollution, and promote safe, livable places for all residents.

Brownfields Redevelopment

Brownfields are properties where redevelopment is complicated by the presence or potential presence of hazardous substances. These may include former gas stations, dry cleaners, or industrial sites.

The Tennessee Brownfields Redevelopment Program:

• Assists communities in assessing and cleaning up contaminated sites
• Supports economic revitalization and environmental restoration
• Has helped return over 1,700 properties to productive use since 1996

Learn more from the EPA’s Brownfields Program

Air Quality

Clean air is vital for respiratory and cardiovascular health. Poor air quality can trigger asthma, lung disease, and other health issues.

Common pollutants:

• Outdoor: Ozone, particulate matter (PM2.5 and PM10), nitrogen dioxide, sulfur dioxide
• Indoor: Tobacco smoke, mold, radon, carbon monoxide

Key efforts:

• Air Quality Index (AQI) alerts help residents avoid exposure
• TDEC monitors air quality across Tennessee
• Public education on reducing exposure and improving indoor air quali

Land Use and Conservation

Land is a finite resource essential for housing, agriculture, recreation, and conservation.

Healthy land use includes:

• Preserving green spaces, forests, and natural areas
• Promoting walkable, mixed-use communities
• Encouraging zoning policies that support health and reduce pollution

Benefits of green spaces:

• Improve air and water quality
• Support mental health and physical activity
• Increase property values and reduce crime

Water Quality

Water is essential for drinking, hygiene, recreation, and industry. Tennessee’s water comes from rivers, lakes, and groundwater sources.

Key concerns:

• Contaminants from agriculture, industry, and stormwater runoff
• Drought and flooding risks
• Septic system maintenance and private well safety

State efforts include:

• Monitoring public water systems
• Promoting water conservation and stormwater management
• Educating residents on testing and protecting water source

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Turn data into action.

Use checklists, indicators, and funding guides to plan and build healthier Tennessee places.

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The Tennessee Department of Health provides a wide range of tools, data, and learning materials to help communities plan, design, and implement healthier environments. These resources support decision-making, grant applications, and community engagement.

Health Impact Assessment (HIA)

A Health Impact Assessment (HIA) is a structured process that evaluates the potential health effects of a policy, plan, program, or project before it is implemented.

Benefits of HIA:

• Considers social, economic, and environmental health impacts
• Engages stakeholders and builds consensus
• Offers practical recommendations to improve health outcomes
• Helps identify impacts on vulnerable populations

When to use an HIA:

• When decisions may affect education, income, housing, or transportation
• When community input is needed
• Before major investments or policy changes

Data & Indicators

Access to reliable data is essential for planning and evaluating healthy communities.

Available data includes:

• Population demographics
• Chronic disease rates
• Traffic and environmental data
• Health disparities and social determinants

Indicators help communities:

• Compare conditions across regions
• Track trends over time
• Support grant applications and policy decisions

Tools include:

• Livable Communities Checklist
• CDC’s Environmental Public Health Tracking Network
• Tennessee Vital Signs and Health Statistics

Publications

A curated library of publications supports public health integration into planning and policy.

Featured resources:

• Physical Activity Guidelines for Americans by HHS
• AARP’s Roadmap to Livability series
• Reports from APA and APHA on planning, and health equity

Newsletters

Stay informed with newsletters focused on health and the built environment.

Examples include:

• TDH Built Environment & Health Newsletter
• TDEC Monthly Newsletters
• Green Government Catalyst
• AARP Livable Communities
• Smart Growth America

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See what's working.

Communities across Tennessee are improving health through planning, design, and collaboration.

Current Case Studies and Success Stories Coming Soon...