Identifying intervention areas to shape healthier urban development in the United Kingdom

Abstract

The quality of urban environments is an important determinant of public and planetary health globally, yet often they do not provide the conditions for good health. Many of the causes of poor-quality environments are located far upstream in areas of policymaking, governance and control of the complex urban development system, involving a diverse range of stakeholders across multiple sectors, tiers of decision-making, and publics. There is a lack of clarity about the challenges involved, and where to prioritise actions to effectively transform the system towards healthier urban development. This article identifies multiple areas in the United Kingdom’s urban development systems where interventions can be targeted to shape the development of healthier and more sustainable urban environments. The study sets out the main findings from the first phase of a large-scale, five year research programme. It takes a systems-based approach to specify and prioritise the upstream problems that restrict healthy urban development. We focus on two key sectors of development that affect health outcomes through a variety of pathways: property development and transport planning. We identify 50 ‘intervention areas’, specifying the problems and where they can be tackled, and report areas prioritised for intervention. The intervention areas identified reveal three broad and mutually reinforcing themes: (i) a lack of prioritisation of health in urban agenda setting and subsequent policy making, (ii) deeper structural barriers, both national and international, and (iii) existing points for leveraging health that do not currently maximise health impacts. The findings contribute to the literature on creating healthy and sustainable urban environments, and extend debates on how health can be understood through systems-based approaches to upstream decision-making and wider structural and institutional forces. Practically, they provide potential areas of intervention for strategies towards improving the quality of urban environments, which are essential for safeguarding future human and planetary health.