New Economic Tool Could Push Cities to Put Health First in Planning

Senior urban development decision-makers have little incentive to consider public health impacts when shaping towns and cities, according to a new study published in the journal Evidence & Policy. The study, co-authored by researchers at the University of East London, the University of Bath and the University of Bristol, highlights an economic valuation tool designed to address the problem.

The tool, called the Health Appraisal for Urban Systems (HAUS), links features of the built environment to health outcomes and their associated economic costs. Researchers argue that local authorities and planning departments could use it to support healthier development choices and reduce diseases including obesity, cancer, cardiovascular disease and respiratory illness. The link between urban environments and public health is well established: housing quality, transport infrastructure, access to green space and walkability all influence the risk of life-threatening disease.

To assess how economic evidence could support more integrated decision-making, the researchers conducted 167 qualitative interviews with stakeholders from government, industry and civil society across England's urban development system. The interviews found that stakeholders recognized HAUS as a new way to support shared decision-making and create incentives for organizations to work together on health outcomes. The tool was developed during an earlier research pilot and refined in collaboration with the UK's Ministry of Housing, Communities and Local Government, which has since adopted it in its appraisal guides for local authorities.

"The HAUS tool enables decision-makers to account for health costs that are linked with the urban environment," said Dr. Andrew Barnfield, senior lecturer in public health at the University of East London and a co-author of the study. "As our work shows, this is vital for making healthier and more equitable places." Professor Sarah Ayres of the University of Bristol's School for Policy Studies said the collaboration with the Ministry has produced a HAUS model for housing, community and local government interventions, adding that there are now methods to quantify and value the potential health impacts of urban interventions for specific populations.

"Making the economic case for pursuing preventive policies is one way to persuade policymakers to act to improve long-term health and well-being," said Dr. Geoff Bates of the University of Bath's Institute for Policy Research. He said improving policymakers' access to tools like HAUS, which demonstrate savings to the public purse from investing in healthier housing and urban environments, is a step toward improving public health.