In the US, a hospital faced with escalating costs associated with the treatment of patients moved beyond its borders to work with neighbours to enhance local facilities which improved health. In 2008, under Medicaid rules, the hospital became accountable for the health costs of people living in the area. This lead to the Healthy Neighbourhood Healthy Families initiative where the hospital worked with local organisations to develop more affordable local housing. It also improved education, healthcare, as well as developing a range of safety and employment initiatives.
In Canada, Alphabet's Sidewalk Labs, are developing a district of Toronto into a prototype sustainable neighbourhoods. This explores new models for dense lower cost housing, enhanced local mobility based on walking, cycling, buses and trains and innovative energy, water and waste systems.
The Built Environment Sustainability Tool (BEST) has been developed to assess the sustainability of neighbourhood and can be used to support communities, local government and other organisations develop structured plans to improve the sustainability of neighbourhoods.