P77 Influencing urban planning decision-making through demonstrating health impacts of changes to the built environment: a co-designed intervention

Background Urban development decisions can influence population health and wellbeing: connected, mixed-use neighbourhoods and high-quality housing are associated with positive health outcomes, e.g. from increasing physical activity, air quality and social interactions. Poor designs are associated with negative health outcomes, e.g. from noise, safety concerns and car dependency. Design decisions can involve trade-offs between multiple aims and challenges. Potential health impacts may be overlooked. Early-stage decision-making provides opportunity for influence; however, these processes can be opaque, making it difficult to identify leverage points to support healthy urban development. We sought to explore how, using an embedded researcher model, demonstrating the health and wellbeing impacts of different design scenarios could influence early-stage decision-making for healthier place-making.

Methods An embedded researcher worked part time within local government (Oct 2020 - present) during development of a spatial regeneration framework. The framework guides future development for over 1000 new homes and 500 student units in an existing industrial/warehouse area. Through collaboration and participant-observation of meetings we identified opportunities to use health data to influence decision-making for the framework.

We evaluated potential health impacts associated with four urban development approaches that maximise housing, employment, greenspaces, or take a balanced approached. A new valuation tool compared scenarios by combining epidemiological evidence and economic valuation to forecast and monetise potential health impacts, including for new greenspaces, as a single park, and multiple smaller pocket parks.

Visual summaries were shared with designers involving movement, heat, affordability, greenspace, flood risk, noise, air quality and local shops. Impacts of new greenspaces were presented to senior council officers. Analysis of embedded researcher field notes and reflections identified how health evidence informed the framework.

Results The co-designed approach enabled timely research outputs for decision-makers. The data helped the design team focus attention on health considerations. Showing reduced cases of mental health problems, diabetes, childhood obesity and cancer associated with new greenspaces helped obtain political support. However, we identified multiple urban development trade-offs relating to power and resource imbalances between public and private sector actors, as well as technical constraints, which limited how health impact data could influence place-making.

Conclusion Although based on a single case-study, we identify that embedded researchers can enable timely and relevant health research evidence to inform urban development decision-making. Developing contextual and multi-disciplinary knowledge can bridge between academia and practice. Modelled health data may inform place-shaping decisions and it is important to understand the complex system to identify leverage points.