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Healthy Communities, Healthy Lives: How Urban Planning Shapes Sexual Health

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Kai Mendoza in Health & Wellness November 2026 • 4 min read.

"Exploring the impact of community redevelopment on public and sexual health in underserved areas."


In the realm of public health, the concept of “Health in All Policies” (HiAP) has emerged as a transformative framework. HiAP recognizes that health is not solely the domain of healthcare but is intricately linked to various sectors such as transportation, housing, and urban planning. By integrating health considerations into these non-health sectors, communities can foster environments that promote well-being and prevent disease.

One critical area where HiAP can have a profound impact is sexual health. Often stigmatized and overlooked, sexual health is a fundamental aspect of overall well-being. Factors such as access to healthcare, social determinants of health, and community resources play a significant role in shaping sexual health outcomes. When communities undergo structural changes through redevelopment, these factors can be either positively or negatively affected.

Recognizing the importance of addressing sexual health within the context of community development, researchers and public health practitioners have begun to explore the potential of HiAP to create healthier and more equitable environments. This article delves into a case study that exemplifies how HiAP can be effectively utilized to enhance public health and promote sexual health in communities undergoing structural change and redevelopment.

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Measuring Reproductive Health

CDC’s Division of Reproductive Health monitors maternal and infant mortality, described as the most serious reproductive health complications. It also gathers data on maternal and infant morbidity, behaviors, and conditions that can affect reproductive health. CDC FastStats reports that, in 2017–2019, 41.4% of never-married U.S. females ages 15–19 and 40.1% of never-married U.S. males ages 15–19 had ever had sexual intercourse.

Guidelines and Integration

WHO develops guidelines covering clinical care, public health, health systems, health promotion, and implementation strategies. A Lancet discussion identifies funding limitations as a challenge to integrating comprehensive sexual and reproductive health programmes. It also highlights human rights, provider, patient, and community considerations, as well as the evaluation of new technologies for integrated products.

The Fort McPherson Story: A Blueprint for Community Transformation

A diverse community collaboratively building a healthy neighborhood.

Fort McPherson, a 488-acre military base in Georgia, closed in 2011, presented a unique opportunity to reshape the surrounding community. Understanding that changes to the physical environment could impact health outcomes, particularly in an area with high rates of STIs, a series of projects were launched to integrate health considerations into the redevelopment process. These projects employed participatory and community engagement approaches, including Health Impact Assessments (HIAs), Photovoice, and community ethnographic assessments.

The initial step involved incorporating health as a key policy consideration in the redevelopment plan. An HIA was conducted to assess the potential health impacts of different land zoning scenarios. The findings from the HIA helped guide decision-making, ensuring that the redevelopment plan prioritized the health and well-being of residents. Subsequent projects focused on identifying existing data, local policies, and opportunities to promote sexual health within the framework of a “healthy community.”

  • Health Impact Assessment (HIA): Evaluated the potential health effects of redevelopment plans.
  • Photovoice: Empowered residents to document their experiences and perspectives through photography.
  • Community Ethnographic Assessment: Gathered in-depth insights into community needs and perceptions.
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Structural Determinants and Inequity

A WHO Eastern Mediterranean Region systematic review of reviews identified six themes affecting sexual and reproductive health and rights among migrants and refugees. These themes operate across four levels of an adapted Dahlgren and Whitehead social determinants of health model. They include economic crisis and hostile migration discourse, limited legal entitlements and administrative barriers, inadequate resources, poor living and working conditions, cultural and linguistic barriers, and stigma or discrimination related to migration status, gender, sex, and ethnicity.

Community members and service providers were engaged to gather insights on sexual health services and the potential impact of redevelopment. The comprehensive assessment yielded recommendations to address physical changes that would encourage healthier choices and foster social connections. Interactive area maps highlighted the co-occurrence of social determinants of health and STIs, offering a visual representation of the challenges and opportunities within the community.

HiAP: A Path Forward

The Fort McPherson case study demonstrates the power of Health in All Policies as a framework for integrating health considerations into redevelopment decisions. By engaging community members, identifying key assets, and addressing social determinants of health, communities can create environments that promote both public and sexual health. As cities continue to evolve, adopting a HiAP approach can pave the way for healthier, more equitable communities for all.

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Community-Based Action

Research on rural Australia describes a Participatory Action Research project designed to develop and validate a framework for planning, implementing, and evaluating multilevel community-based sexual health interventions for young people. Related Health in All Policies work examined local data, policy, sexual health opportunities, and community and provider perspectives. Together, these projects frame community participation and redevelopment as relevant to how sexual health services are planned and delivered.

Futures-Oriented SRHR

A WHO report on extending sexual and reproductive health and rights to future generations examines trends, uncertainties, and innovations. It identifies five interconnected strategic entry points for futures-oriented action. The report presents these entry points as a way to uphold rights, advance equality, and address inequities for future generations.

What the policing associations say-and do not say

The reported links connect repressive policing of sex workers with higher odds of violence, HIV or other STIs, and condomless sex. These associations do not establish that policing caused those outcomes, and they concern sex workers rather than urban redevelopment generally.[1]

The definition of sexual health extends beyond disease: it includes physical, emotional, mental, and social well-being, and emphasizes respectful, safe, and non-coercive experiences. This broader framing helps distinguish sexual health from infection measures alone.[2]

Where urban-health frameworks leave gaps

An urban-health framework mapped many Sustainable Development Goal targets to urban health, while identifying physical activity, noise, quality of life, and social capital as important aspects absent from those goals. This shows that alignment with global targets does not cover every dimension in the proposed framework.[3]

Questions about redevelopment, policing, and access

  • The urban-health framework identifies aspects it considers important that are absent from the Sustainable Development Goals, leaving open how those dimensions are represented in local planning decisions.[3]

Sources

  1. Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies (pmc.ncbi.nlm.nih.gov)
  2. Sexual and Reproductive Health and Research (SRH) World Health Organization (www.who.int)
  3. Urban health: an example of a “health in all policies” approach in the context of SDGs implementation (pmc.ncbi.nlm.nih.gov)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What does Health in All Policies (HiAP) mean?

Health in All Policies (HiAP) is a framework that integrates health considerations into various sectors beyond just healthcare, such as transportation, housing, and urban planning. It recognizes that health is influenced by multiple factors and aims to create environments that promote well-being and prevent disease by incorporating health into non-health sectors. This approach ensures that decisions across different policy areas contribute positively to public health outcomes.

2

Why are Health Impact Assessments (HIAs) important during community redevelopment?

Health Impact Assessments (HIAs) are crucial for evaluating the potential health effects of redevelopment plans. In the context of community redevelopment, an HIA helps decision-makers understand how different land zoning scenarios or infrastructure changes could impact the health and well-being of residents. By identifying potential risks and benefits early in the planning process, HIAs enable the development of strategies that maximize positive health outcomes and minimize negative impacts.

3

How can community engagement methods like Photovoice and Community Ethnographic Assessments help in redevelopment projects?

Community engagement methods like Photovoice and Community Ethnographic Assessments offer unique insights into community needs and perceptions. Photovoice empowers residents to document their experiences through photography, providing a visual representation of their lives and concerns. Community Ethnographic Assessments involve in-depth studies of the community to gather detailed information about their culture, social structures, and health-related behaviors. Both of these strategies ensure that redevelopment efforts are community-driven and responsive to local priorities.

4

How do social determinants of health impact sexual health, and what can be done to address them during redevelopment?

Social determinants of health, such as access to healthcare, quality housing, and safe environments, significantly influence sexual health outcomes. When communities undergo redevelopment, these factors can be either positively or negatively affected. By addressing social determinants of health through initiatives like improved access to sexual health services and the creation of safe and supportive environments, communities can promote better sexual health outcomes and reduce disparities.

5

Can you explain the importance of the Fort McPherson project?

The Fort McPherson project serves as a practical example of how Health in All Policies (HiAP) can be applied in community redevelopment. By integrating health considerations into the redevelopment plan and engaging community members, the project was able to prioritize the health and well-being of residents. This approach demonstrates the importance of considering health as a key policy consideration and using community engagement to gather insights on sexual health services and the potential impact of redevelopment.

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