Evaluating the health effects of urban development

Poor-quality urban environments have substantial impacts on public and planetary health – something of which local planners and public health teams will be well aware.

‘Tackling the Root causes Upstream of Unhealthy Urban Development’ (TRUUD) is a research project based at the University of Bristol, looking at how urban centres can be planned to reduce health inequalities.

It brings together experts from academia, industry and government to recommend and create new tools and processes for healthier cities.

It includes two active case studies in Bristol and Manchester.

At the University of Bath, we have been working on a new tool to evaluate the health effects of urban development proposals, with a recent paper published in the journal ‘Frontiers in Public Health’.

We’ve demonstrated that it is possible to value the potential health effects of our urban environments and weigh these against the traditional financial costs and benefits of city development.

The tool evaluates a range of factors including how buildings, transport, natural environment (including air pollution and green space), socio-economics and community infrastructure in new developments might improve or worsen health for their future residents. By integrating environmental economics with public health systematic reviews and urban design analysis, we were able to value the potential health effects that may result from development proposals and provide evidence to assess the health costs of urban planning decisions.

The tool, which sub-divides the urban environment into 28 characterisations, places a value not just on air pollution, which is most commonly evidenced, but also on a range of factors that could lead to premature death and chronic morbidity, profoundly affecting quality of life and the cost of healthcare. For instance, green spaces provide a range of health benefits, especially for adults in reducing diabetes and risk of weight gain. However, they can also contribute to childhood asthma.

By adjusting scenarios, planners could have a tool for measuring the likely health impacts of increasing or decreasing the amount and quality of green spaces.

We still have some health impacts, such as mental health and chronic pain, where the evidence is incomplete, and where further research will help create a full picture for planners and policymakers.

The tool’s approach was conceived during two previous studies on climate risk, followed by a pilot that shifted the focus of the tool to urban health risk and revealed that there was probably substantial demand from senior decision-makers for a valuation approach such as this.

This is a key paper for our work in attempting to fundamentally change the way we make decisions about how we develop and manage the places in which we live, by reprioritising and more fully accounting for human and planetary health.

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