Transforming Places, Healing Communities

Summary

In 2025, the International Society of Urban Health (ISUH) committed to developing a resident-led, place-based framework to strengthen neighborhood cohesion, improve health, and close opportunity gaps in communities in the United States. The initiative will launch with a pilot 1.5-year food security project in Buffalo, New York’s East Side, combining food access efforts with community-building programs like peer support groups, intergenerational mentorship, and public conversational spaces. These hyper-local interventions aim to improve nutrition while fostering trust, healing, and long-term community ownership. ISUH will partner with the Buffalo Center for Health Equity, leveraging its deep relationships with residents, institutions, and agencies committed to addressing social determinants of health. Successful practices from the pilot will be codified into a replicable model for expansion across Buffalo and other U.S. cities. This initiative demonstrates that sustainable, community-driven change at the neighborhood level is both achievable and scalable when grounded in lived experience and local leadership.

Approach

The International Society for Urban Health (ISUH) and partners will develop a place-based framework to strengthen neighborhood cohesion, improve community health, and close opportunity gaps. By embedding social connection into housing, public health, and economic strategies, this initiative will serve as a model for systems change centering belonging, mutual respect, and resident-led decision-making.
The cornerstone of this commitment is a demonstration project in the East Side neighborhood of Buffalo, NY, where residents have already chosen to focus on improved access to healthy food access. Neighborhood residents will co-design interventions addressing more immediate needs around food access that will be paired with programs focusing on connection, such as neighborhood peer support groups, block-level learning circles, intergenerational mentorship networks, and publicly accessible conversational spaces. The result will be a pilot of hyper-local programs that will create spaces that improve access to nutrition while fostering trust, accountability, and relational healing. This will allow the work to be community-owned and will build sustainability of these projects for the long term.
The primary goal of this commitment is to achieve measurable improvements in social connectedness, health equity, and neighborhood cohesion in Buffalo through a resident-led, place-based process. The work will be done in partnership with the Buffalo Center for Health Equity, who have deep, longstanding partnerships with resident leaders, anchor institutions, and public agencies and a longstanding commitment to addressing the social determinants of health to achieve health equity for all Buffalo residents. As the work progresses, ISUH and partners will codify successful practices into a replicable framework. Future phases aim to expand citywide and then to other US cities. This approach demonstrates that neighborhood-scale change is not only possible—but scalable, grounded in evidence, and driven by the people most affected.

Action Plan

In Buffalo, ISUH and partners will implement a four-phase, 30-month pilot to demonstrate how strengthening relational infrastructure can improve health, equity, and local capacity.
Phase 1 (Q2 2025–Q4 2025) will focus on foundational research, planning, and asset mapping. ISUH will analyze neighborhood-level health data, community demographics, existing civic infrastructure, and historic disinvestment patterns using tools such as the CDC PLACES dataset and City Health Dashboard (CDC, 2024; NYU GPH, 2024) . Simultaneously, the team will convene local partners—including resident leaders, anchor institutions, and public agencies—to co-develop guiding principles, implementation plans, and site-specific goals.
Phase 2 (Q1 2026–Q3 2026) will emphasize relationship-building, community co-design, and baseline evaluation. Residents will lead a structured participatory planning process to select priority intervention areas—such as housing, healthy food, or youth mentorship—and co-create action plans. Collective finance mechanisms will be used to accomplish this work in a manner that builds equity for all. During this phase, ISUH will conduct baseline surveys and social network mapping to assess neighborhood trust, mental health, civic participation, and chronic disease burden, providing a data-driven foundation for evaluation.
Phase 3 (Q3 2026–Q2 2027) will focus on implementation and learning. The initiative will launch hyper-local interventions co-designed in the previous phase, while also piloting data collection methods and refining a scalable evaluation framework. ISUH will document community-generated practices and emerging impact through mixed-methods research.
Phase 4 (Q2 2027–Q4 2027) will focus on synthesis, dissemination, and early scaling. Lessons from Buffalo will be translated into a replicable toolkit and adaptable framework to support other cities. Initial engagements with other US cities will begin, with a focus on tailoring models to new municipal contexts while deepening the Buffalo site’s sustainability and institutional integration.

Background

Across the United States, social disconnection is a public health crisis. A 2023 U.S. Surgeon General’s Report reveals that loneliness and isolation now rival smoking and obesity as mortality risk factors. In neighborhoods with frayed social fabric, residents face higher rates of chronic illness, substance use, and shorter life expectancy (Kaplan, 2023) . People with weak social relationships face a 29% higher risk of heart disease and a 32% higher risk of stroke (Berkman & Kawachi, 2014) .
Along with poor health outcomes, disconnected neighborhoods are also disproportionately burdened by violence, economic stagnation, educational disinvestment, and environmental injustice. These areas often lose residents with capacity and mobility, while reinforcing generational cycles of inequity.
Yet most U.S. policies still overlook the social infrastructure communities need to thrive (Jacobs, 1992; Syme in Berkman et al., 2014) . While other countries have implemented national strategies designed to strengthen social capital, the US has yet to adopt a comparable approach.
Buffalo, New York offers a compelling US test case. Once a hub of industrial prosperity, Buffalo has experienced population loss—declining by over 50% from its peak—placing it among the most prominent “shrinking cities” in the U.S. This pattern of urban contraction has concentrated poverty, reduced municipal resources, and hollowed out civic institutions, exacerbating both structural and relational disconnection. Public health data reflects this burden, with disparities tracking along racial and geographic lines, shaped by decades of segregation, redlining, and neighborhood disinvestment.
And yet, Buffalo also contains resilient communities, active neighborhood coalitions, and a legacy of mutual aid. This makes it an ideal setting to test a new model of neighborhood regeneration—one that sees social connection not as a byproduct, but as core infrastructure. Through this pilot, Buffalo can lead the way in showing how relational capacity drives both health equity and economic renewal.

Progress Update

Partnership Opportunities

Philanthropic and Private Sector Funders: Organizations committed to health equity, inclusive economic development, and transforming the root causes of urban health disparities. The team welcomes partnerships with funders who see the value in place-based systems change, seeking to invest in interventions that go beyond individual issues to address structural neighborhood inequities. Their support will enable the team to scale this initiative, expand the number of pilot cities, strengthen measurement and evaluation capacity, and build the field of relational infrastructure.

Local Governments: The team seeks to partner with mayors, city managers, and commissioners of planning, public and mental health, parks and recreation, education, innovation, and small business development. The aim is to embed this systems-approach into municipal systems and policy to ensure sustainability and citywide replication.

Academic Institutions: To further support research, training, and evaluation.,Grassroots Community-Based Organizations: ISUH is actively working with community organizations in Buffalo aimed at increasing health equity through an integrated, multi-pronged approach This project can offer partnership with these organizations with others seeking to build true collaborations, in practice not just in name. ISUH and partners will work together to integrate social connection and strengthen impact using the evidence-based framework and tools.

Community-Centered Toolkit and Framework: A key deliverable of this project is the Community-Centered Toolkit and Framework. Partners will gain priority access to piloting the framework within their cities.

Topic Expertise: The project team includes experts in public health, social epidemiology, urban planning, architecture, community development, community engagement, and other topics vital to creating healthy urban environments, all framed in an integrated, systems-thinking approach. Partners will gain access to this expertise across a vast array of disciples and sectors.