Tackling the Root Causes of Unhealthy Decision-¬‐making Upstream in Urban Development (TRU3D)

We aim to understand how prevention of NCDs might be fully considered and factored in to the decision- making of those in control of the quality of our urban environments, focusing on major new infrastructure and critical, unresolved issues of governance (e.g. dominance of unhealthy food, drink and motorised transport). Working with senior decision- makers, related stakeholders and advisors at national, regional and city level we will identify critical decision making contexts (e.g. land disposal, procurement, regulation), then develop and test a prioritised range of intervention case studies. Meaningful and effective engagement witthe lay public in this highly complex area of governance will also bea priority in order to sense check approach and findings, with a particular focus on issues of equality. The
umbrella output will be a systems- wide decision support framework that sets out the systemic blockages identified and incorporates targeted industry- driven improvements to existing processes alongside decisionsupport tools. Success criteria will include demonstration of upstream change within the project period (e.g. attitudes, adoption of new processes and tools) as well as feedback from a
wide range of key decision-¬‐makers, influencers and publics on the potential for change. In addition to exploring existing decisions, structures and processes (e.g. the role of economic valuation in decision- making, alternative decision and valuation mechanisms, legal mechanisms such as Social Value Act), we will seek to understand the systemic blockages inhibiting improvement in health outcomes (e.g. corporate structures, values, incentives).