Leveraging neighborhood-scale change for policy and program reform in Buffalo, New York.

Background: The Healthy Communities Initiative (HCI) affects 8500 employees working in the Buffalo Niagara Medical Campus and 8925 residents of adjacent neighborhoods, where 37% of people live below the poverty line, and a majority (68.7%) identify themselves as African-American.

Intervention: The HCI partnership, which includes multi-sectoral and multi-disciplinary organizations and neighborhood residents, implemented the Active Living by Design community action model with greatest emphasis on achieving policy and planning changes to support active living behaviors.