The Agency for Toxic Substances and Disease Registry (ATSDR) includes brownfields as a type of land reuse site. These sites are potentially contaminated properties that could be revitalized or redeveloped. Land reuse sites include previous industrial sites that are now vacant; brownfields; sites permitted to treat, store, or dispose of hazardous waste that may have violated their permit (e.g., Resource Conservation and Recovery Act corrective action sites); landfills; and sites that might be on the U.S. Environmental Protection Agency (EPA) National Priorities List for remediation—commonly referred to as Superfund sites (ATSDR, 2023, September 20). The different types of land reuse sites have different regulatory steps for redevelopment. For example, Superfund sites are prioritized and undergo rigorous investigation under the EPA Superfund program, but this step often requires years of litigation and remediation before reuse can be achieved. Some brownfield sites, such as former industrial sites, have a more complex contamination footprint than others but are not designated Superfund sites. These sites often need varied and costly remediation, requiring more resources and time than less contaminated sites. In contrast, some brownfields have less extensive contamination and can be cleaned up and redeveloped in a short amount of time. In one EPA study, approximately 30% of brownfields had contamination present that was below regulatory concern levels (Jenkins et al., 2006). However, it is important to fully review all available records, such as photos and site uses, and to interview former site owners before determining that brownfields do not require cleanup. Specific to military brownfields sites, namely Formerly Used Defense Sites, the United States Government Accountability Office (GAO) (2002) found that the United States Army Corps of Engineers may have underestimated the number of military sites that did not require cleanup by as much as 38 percent. This occurred due to incomplete review and investigation of potential hazards percent (United States Government Accountability Office, 2002, August).

Living with contamination from brownfields can adversely impact public health. In the U.S., brownfields tend to disproportionately impact communities with higher rates of poverty and a higher percentage of people of different races or cultures. Brownfields exist everywhere, from rural areas to indigenous lands, to urban areas. As brownfields increase in communities, so do health disparities and inequity, particularly from disinvestment and other conditions related to blight (deLeon and Schilling, 2017). It is well documented that people living near hazardous sites may have adverse childhood or adult health effects, such as elevated blood lead levels (Missouri Department of Health and Senior Services, 2001), reproductive health effects (Austin, 2011), or higher rates of respiratory disease (Liu, 2012). Mapping tools, such as ATSDR’s Environmental Justice Index (EJI) (2023) or EPA’s Environmental Justice Screening Tool (2024), indicate overall environmental and socioeconomic impacts in communities, such as proximity to hazardous waste sites, combined with factors such as poverty and race.

When people live among high numbers of brownfields, it is important to consider potential impacts of these sites on community health. As public health practitioners, our mission is protecting the public who live near or among brownfields areas to reduce potential exposures to harmful chemical contaminants while focusing on improving health outcomes overall. In 2006, ATSDR was interested in measuring changes in overall community health outcomes associated with brownfields redevelopment. We began to search the literature for brownfields models, research, or community projects that highlighted environment, sustainability, and public health indicators associated with redevelopment. We found few publications on sustainability or public health indicators associated with redevelopment.

In response, we developed the ATSDR Brownfields/Land Reuse Action Model (the Action Model). The Action Model engages the Development Community (e.g., community residents, city governments, public health departments, planners, and developers) in finding ways to make measurable health improvements part of the revitalization process.

The Action Model has proven to be a useful resource for communities with concerns about brownfields and hazardous exposures. The Action Model can be used to start a conversation about community revitalization and emphasizes the importance of putting the community needs and vision first. The expertise of the community in terms of knowing the history and locations of brownfields and yet-to-be-discovered brownfields, is also invaluable. Using the Action Model as part of redevelopment planning can lead to a health-focused, sustainable redevelopment project, supported by an informed community, which may increase stakeholder participation and sharing of resources. In addition, the Action Model’s fourth step encourages the Development Community to develop and track indicators to measure changes in environmental and overall health of the community, which can maintain community motivation to stay involved in redevelopment planning.

Any community may use the Action Model Toolkit to implement their own Action Models and encourage the selection of common indicators or to derive their own unique indicators through sustainability, public health, and environmental lenses.