Policy and intervention briefings

Adding value to existing government guidance with HAUS

The Health Appraisal of Urban Systems model (HAUS) demonstrates the health impacts of a wide range of characteristics of the urban environment to inform planners, investors and developers at the earliest stage of planning new places to live and work.

TRUUD are working with the Ministry for Housing, Communities and Local Government’s (MHCLG) Analysis & Data Division to adapt HAUS for use in the department and for inclusion in its appraisal guide.

Evidence used in the HAUS model

The Health Appraisal of Urban Systems model (HAUS) demonstrates the health impacts of a wide range of characteristics of the urban environment to inform planners, investors and developers at the earliest stage of planning new places to live and work.

New towns and grey belts: healthy place making or housing numbers?

Labour’s pledge to jump start housing delivery through New Towns and ‘grey belts’ is an important response both to housing and affordability issues as well as the major economic crises of the last few decades. However, without quality assurance and strategic incentives, this risks becoming a ‘quantity at all costs’ approach.

Joining up government for public health

Realising Prevention: Practical Policies for Healthier Society

There is growing recognition that tackling complex social problems, like climate change and health inequalities, can only happen by building strong interconnections across policy jurisdictions and sectors. Over the decades, a slew of initiatives have sought to achieve more joined-up government in the UK, from Churchill’s abortive system of ‘overlords’ through to the short-lived levelling up agenda. Despite these and many similar attempts, Whitehall retains a structure of competing departmental fiefdoms.

Empowering mayors for preventative health

Realising Prevention: Practical Policies for Healthier Society

The task of improving the nation’s health is currently split between the NHS and local government. These two vast and complex systems often struggle to work together effectively. The role of local government in England’s health policy should not be underestimated. It includes the £23.69bn social care budget and a £3.6bn public health grant, both of which come with statutory duties that local authorities must fulfil. While this is dwarfed by £181.7bn NHS budget, it is in the areas of social care and public health that we find the roots of the pressures on the NHS. And yet, preventative approaches are only a tiny fraction this vast NHS budget.

Planning reform and public health

Realising Prevention: Practical Policies for Healthier Society

With 708,000 overcrowded households in England, it is clear why the government wants to build 1.5 million new homes over the course of the current parliament. In recent years, both parties have repeatedly insisted that reforming the planning system is the key to unlocking housebuilding. The Labour Government have laid out extensive reforms to the planning system in the Planning and Infrastructure Bill.

Tackling health inequalities with healthy urban development

Realising Prevention: Practical Policies for Healthier Society

Since the landmark Marmot Review was published in 2010, every Labour and Conservative manifesto has promised to rebalance health from treatment to prevention. And yet, despite the ambitions of politicians, change has been far too slow in recent decades.

What ‘health’ means and why that matters

This policy explainer is split into three sections.
1. The first section explains why it is important that that we ask what ‘health’ means;
2. The second examines three main areas of contemporary debate linked to ‘health’; and
3. The third sets out the implications of these for policy and for political responsibility.
We pay particular attention to preventative policies: those that aim to create the right conditions in society for both a lower incidence of ill health, and better and fairer enjoyment of good health by all.

Developing a Healthy Planning Framework

Planning policy, nationally and locally, shapes the environment we live in, and Local Plans can play an integral role in improving both physical and mental population health. Local Plans are produced by local authorities to provide the scope and legal basis for all their urban planning decisions. However, TRUUD research with more than 130 public and private urban development actors in 2021 found that Local Plans are inconsistent and weak regarding the health requirements that are expected from developers when making a planning application.

Using health evidence to influence urban regeneration in Bristol

Built and natural environments affect our physical and mental health. However, urban development can result in towns and cities that do not support good health and wellbeing: homes may be of poor quality; greenspaces may be insufficient; cars may dominate with limited infrastructure to support walking and cycling; and social infrastructure, such as community centres or health centres, may not meet the needs of the local community.

Shaping the use of health impact evidence for government appraisals and decision-making

Providing health impact evidence for government appraisals and decision-making

Mapping health considerations and multi-sectoral interventions in the urban development decision-making system

Using lay knowledge to transform understanding of links between the built environment and health

‘Lay knowledge’ – that is knowledge and understanding held by lay public/s based on their subjective experience – has attained new prominence as a form of evidence for public health in
the UK during recent decades. Collecting and sharing lay knowledge can illuminate the social determinants – that is the conditions in which people are born, grow, live, work, play and age – as well as structural processes which impact on health and lead to health inequalities.

Valuing the external social costs of unhealthy urban developments

The use of economic valuation approaches in measuring, and accounting for, non-market environmental and social “goods and services,” including human health outcomes, has a substantial history. However, its integration into mainstream decision-making has been slow for a number of reasons, not least the considerable challenge of quantifying intangible aspects of health in welfare terms.

Low Emission Zones improve air quality, physical health and mental well-being

Ambient air pollution is a major public health concern. It has prompted novel policy interventions, in the UK and beyond, notably in the form of Low Emission Zone (LEZ) and Ultra-Low Emission Zone (ULEZ) schemes. This policy brief explores the impact of these schemes on physical health and mental well-being, using large survey and administrative data covering the whole of England.

Health in government housing and transport policies

How are local plans promoting healthy and safe communities?

Interest in the building blocks of health is increasingly focused on the role and contribution of spatial planning. The evidence is becoming clear about the effect of policy interventions in the built and natural environment on population health. Achieving healthy places requires planning processes and decisionmakers to proactively consider health and wellbeing.

Embedding healthier decision making in the urban development actor network

Senior real estate industry professionals make clear the complex web of decision-makers involved in creating and recreating cityscapes both in the UK and worldwide. The specific objectives of a diverse range of domestic and international UK investor, shareholder, land and property owner, landlord, tenant, and public authority clients they advise and support, are vitally shaped by financial drivers and constraints that are reflected in the built form, environment, and healthiness of urban places.

Improving the conversation with real estate for healthier urban planning

The need and potential for urban development and planning to combat the rise in non-communicable diseases (NCDs) such as obesity, hypertension, diabetes and mental depression and spatial health inequities, is clear. In the system of English devolved subnational governance, local planning authorities have substantial powers to control and influence the location, use, height, form, and density of development and the deployment of real estate investment capital in cities.

Introducing a health evidence base with Transport for Greater Manchester

The impact of the urban environment on public health is well researched, yet using this knowledge to implements changes in practice is less so. We know that the ability to walk and cycle, the effect of traffic noise and pollution, access to public transport and location of trees and green spaces all impact population health. Translating that into on-the-ground change requires joined up and concerted effort, overcoming political, economic and organisational challenges. Several of the challenges may be most relevant at the scale of a metropolitan area.

What needs to happen to ‘level up’ public health?

Making meaningful public engagement with digital tools

Digital tools are increasingly used in urban planning for engaging the public in early-stage discussions and formal consultations in their local area. Investment in digital tools by both national and local government growing apace. We want to examine how involvement of the public in urban planning and development, particularly those facing health inequalities, can be made more meaningful.

Law, health and planning: Using Health Impact Assessments to improve urban health

Local government urban planners can lack legal capacity to promote healthy urban developments. This means, for example,they can lack confidence, resource or knowledge that would help them use the law to promote health; to reduce the risks of noncommunicable diseases (including poor mental health) and reduce health inequalities. This lack of capacity undermines their ability to effectively incorporate health into decisions about individual applications and ensure that health is given due weight in urban decision making.

What types of health evidence are persuasive in a complex system?

Tackling complex health problems requires joined up cross-sector working between stakeholders with diverse objectives. Evidence is one tool that can be used to bring stakeholders together and to influence decision-making processes. However, the challenge of using evidence to persuade policy actors to think more about health is enhanced when working in a complex system with multiple stakeholder groups with different priorities, preferences, values and skills.

Changing corporate mindsets for healthier urban development decision-making.

When speaking to decision-makers in urban development, they make two things clear: one, current thinking around urban development and how it is practiced is not well suited to respond to complex issues such as climate change and health crises; and two, very few people feel they have sufficient power to be able to bring health and health equity more centrally into their own professional practice.

How value is considered and used in urban development with implications for the levelling up agenda.

Examining how value is considered and placed in the decision making process for urban development reveals who shapes the rationale. Where is the influence and how does this affect urban development? What does this mean for health in decision making processes?

Revealing the health costs of the urban planning policy environment