Understanding how to create healthier places: A qualitative study exploring the complex system of urban development decision-making

Anna Le Gouais*, Geoff Bates, Rosalie Callway, Heeseo Rain Kwon, Lisa Montel, Sian Peake-Jones, Jo White, Md Nazmul Hasan, Caglar Koksal, Andrew F R Barnfield, Krista Bondy, Sarah A Ayres

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)


Tackling complex system challenges like creating healthy environments requires understanding priorities and structures affecting multiple actors. This qualitative study, involving 132 multi-sectoral stakeholders spanning the urban development decision-making system, explores how to influence healthier place-making. Using thematic analysis we develop themes around competing stakeholder priorities; structural ‘rules’ and influential relationships; and justifying a focus on health, requiring greater clarity and consensus around definitions of ‘healthy’ urban development. Building on the socio-ecological model we highlight how a multi-faceted approach is required for change at multiple levels in the complex system to target individual actor motivations, organisational priorities and structural ‘rules’.
Original languageEnglish
Article number103023
Number of pages12
JournalHealth and Place
Early online date18 Apr 2023
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
This work was supported by the UK Prevention Research Partnership (award reference: MR/S037586/1 ), which is funded by the British Heart Foundation , Cancer Research UK , Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council , Economic and Social Research Council , Health and Social Care Research and Development Division (Welsh Government), Medical Research Council , National Institute for Health Research , Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome .

Publisher Copyright:
© 2023 The Authors

Structured keywords

  • SPS Centre for Urban and Public Policy Research


  • Urban development
  • decision-making
  • system
  • qualitative
  • environmental determinants
  • population health


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