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Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children in their community plans. Those that do, provide more services and have more child-friendly zoning codes. We use a human ecological framework to build structural equation models of child-friendly zoning and services. We find communities with more engagement of families with children and youth and a common vision across generational, race, and ethnic lines report higher levels of child-friendly zoning and services. Collaboration between health providers and schools builds trust and leads to more services. However, child-friendly zoning is lower in communities with higher child poverty, and in suburbs and rural areas. Our results support a dynamic human ecological model where the processes of collaboration, inclusion, and engagement are key to creating healthy places for children. These processes may be especially important in addressing the unique challenges of suburban and rural communities.

Healthy Places for Children: The Critical Role of Engagement, Common Vision, and Collaboration