Research Overview

We work with decision makers and communities to prioritise health in urban decision-making processes. Our focus is on how non-communicable diseases (NCDs) can be prevented by changing the way that urban development decisions are made.

NCDs are illnesses that you can’t catch such as heart disease, diabetes or cancer. There has been a lot of research that have proven links between NCDs and the urban environment.

We examine major new infrastructure and transport systems in our case study areas of Bristol and Greater Manchester. We are working with senior decision-makers, related stakeholders (including community partners), and advisors at national, regional and city level. With them, we are identifying how best to influence decision-makers (e.g. land disposal, procurement, regulation, economics), then developing and testing ways to prioritise health.

We are also exploring the existing decision-making system. This will help us understand the blockages in the current system that prevents health being a priority when decisions are made about developments to our urban environment.

Our Phase One report explains our journey from work packages to intervention areas and our initial findings.

The research programme

Phase 1: Understanding the urban decision-making system;

Phase 2: Developing and trialing the intervention;

Phase 3: Refining the intervention;

Phase 4: Sharing our findings.

We’re developing interventions with key users using evidence to target critical points of leverage within the urban development system. There are three components to the intervention:

Leverage points

Identify potential opportunities and mechanisms for improving health outcomes. Looking at health externalities integrated into: a) cost-benefit analysis, b) development control, c) infrastructure investment decision-making, d) governance restructuring.


Using existing evidence to identify potential health improvements.  We’re developing a database to provide an estimated cost for potential changes and health outcomes (the HAUS model).

Public involvement

Devising creative ways to communicate experiences of health inequalities driven by the physical environment.. We are presenting this visual evidence to key decision-makers and community partners, and working with them to identify system changes that are deemed most likely to improve health and reduce health inequalities.

Systems modelling

Using group model building workshops and system dynamics modelling we build and then test, in focus group and workshop settings, the multiple understandings (views) stakeholders have of land use decision-making in urban areas and how these impact on public health. Boundary critique, interdependency mapping and system dynamics modelling are some of the methods and tools being used to understand the problem structure, diagnose challenges and support the design of health improvement interventions.

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