In 2008, the City of Baltimore, Maryland launched a multiyear effort to comprehensively revise the city's zoning code, which had not been updated for forty years. In order to help ensure that the revision considered the role zoning can play in creating healthier communities, a group of researchers at Johns Hopkins collaborated with the city health department to conduct a health impact assessment of the draft new code between October 2009 and September 2010. The project focused on some of the most pressing health issues facing the city: obesity, physical activity, nutrition and violent crime. The HIA recommended measures such as: 1) maintaining increased allowances for mixed use development (i.e., residential mixed with commercial), in order to allow residents to walk to needed services; 2) defining and offering zoning incentives for stores that carry healthy food, in order to increase access to healthy food options; 3) limiting the concentration of off-premises alcohol sales establishments, in order to prevent violent crime; 4) including Crime Prevention Through Environmental Design (CPTED) guidelines that help to create pedestrian-friendly environments and "eyes on the street," in order to reduce crime; and 5) improving measures for communicating about zoning changes and setting criteria for evaluating suggested revisions to the code, in order to maximize transparency.
The HIA made 36 recommendations. Fourteen of these recommendations were included in the first draft of Transform Baltimore