Improving population health at a national and global scale through equitable access to healthy places will require a comprehensive change of practice in the real estate industry. Traditional public health interventions, used in isolation, are often not well suited to driving large-scale change in private industry sectors. However, partnerships with nonhealth sectors allow new tools and capacities to be applied, frequently yielding new insights and improved results (IOM, 2014). In this paper, we apply principles of market transformation, the strategic framework used within the green building industry, to analyze and recommend opportunities to drive broad-scale consideration of health and wellness outcomes within real estate development. Our recommendations are based on market research conducted as part of an interdisciplinary collaboration between public health and green building researchers at the University of Virginia School of Medicine and the U.S. Green Building Council (USGBC). Specifically, we discuss three primary market conditions that currently inhibit systematic investment in health and wellness in the building industry:
• Societal costs and savings linked to health impacts of real estate development currently operate as economic externalities; they are unmeasured, unregulated, and largely unconsidered. This inhibits broad-scale action and investment to promote healthy places.
• Project teams, including architects, urban planners, and real estate developers, lack sufficient practice-based tools and metrics to apply public health evidence on a routine basis.
• Real estate investors cannot competitively benchmark or differentiate property into tiers of performance based on health-promoting attributes, preventing targeted investment.
We conclude the paper by highlighting emerging efforts to address these inhibitory market conditions by applying green building principles (and tools) of market transformation in order to drive investment in healthy places and help improve population health at a national and global scale.