Objective: This study analyzes the links between planning, the built environment, and availability of health-related community services across U.S. urban and rural communities. Method: We analyze the first national survey of health-related community services for seniors (2010 Maturing of America), covering 1,459 U.S. cities and counties. We tested the influence of morbidity (diabetes and obesity), city management, socioeconomic characteristics, planning and the built environment, metro status, and government finance. Results: Community health-related services are more common in places that plan for and involve seniors in planning processes. Places with higher need and government capacity also show higher levels. Service levels in rural communities are not lower after controlling for other population characteristics. Morbidity measures (diabetes and obesity) do not explain differences in service availability. Discussion: Policies promoting planning for aging and elder involvement in the planning process have the greatest impact on the level of community health-related services for seniors.