Abstract
The built environment can influence both physical and mental health outcomes. However, the urban development system is complex with many actors with differing priorities, and health and wellbeing is often not prioritised. This study sought to untangle the complexity of decision-making in the urban development system to understand how to influence creation of healthier places.
As part of the TRUUD project (‘Tackling Root causes Upstream in Unhealthy Urban Development’), 123 semi-structured interviews were conducted with 132 multi-sectoral stakeholders spanning public, private and third sector organisations. This included professionals from property development, urban and transport planning, public health, sustainability, real estate, finance, and elected representatives.
Researchers from nine diverse disciplinary backgrounds collaboratively coded interviews and developed discipline-specific summaries to untangle complex elements of the system of urban development decision-making. Thematic analysis was then conducted to develop three main themes from the data: ‘Competing priorities’, which highlight potential trade-offs and perverse incentives for three key groups (national government, local/regional government, and private sector property development); ‘Rules and relationships’, which can control and influence how priorities are addressed; and ‘Justifying a focus on health’, which points to the need for greater clarity and consensus around what is defined as ‘healthy’ urban development, in a system where few stakeholders appear to view health as their responsibility.
Findings highlight potential tensions across stakeholders between healthy urban development, profit/cost and public opinion. Building on the socio-ecological model, potential individual, organisational and structural leverage points in the system are explored. Greater clarity and objectivity around what is ‘healthy’ urban development appears important: for individuals to demand healthier places to be built; for organisations to prioritise creation of healthy environments; and to justify structural changes that integrate health into policies, regulations and legislation to enable healthier place-making.
As part of the TRUUD project (‘Tackling Root causes Upstream in Unhealthy Urban Development’), 123 semi-structured interviews were conducted with 132 multi-sectoral stakeholders spanning public, private and third sector organisations. This included professionals from property development, urban and transport planning, public health, sustainability, real estate, finance, and elected representatives.
Researchers from nine diverse disciplinary backgrounds collaboratively coded interviews and developed discipline-specific summaries to untangle complex elements of the system of urban development decision-making. Thematic analysis was then conducted to develop three main themes from the data: ‘Competing priorities’, which highlight potential trade-offs and perverse incentives for three key groups (national government, local/regional government, and private sector property development); ‘Rules and relationships’, which can control and influence how priorities are addressed; and ‘Justifying a focus on health’, which points to the need for greater clarity and consensus around what is defined as ‘healthy’ urban development, in a system where few stakeholders appear to view health as their responsibility.
Findings highlight potential tensions across stakeholders between healthy urban development, profit/cost and public opinion. Building on the socio-ecological model, potential individual, organisational and structural leverage points in the system are explored. Greater clarity and objectivity around what is ‘healthy’ urban development appears important: for individuals to demand healthier places to be built; for organisations to prioritise creation of healthy environments; and to justify structural changes that integrate health into policies, regulations and legislation to enable healthier place-making.
| Original language | English |
|---|---|
| Publication status | Published - 10 Nov 2022 |
