Abstract
This paper sets out the main findings from two rounds of interviews with senior representatives from the UK's urban development industry: the third and final phase of a 3-year pilot, Moving Health Upstream in Urban Development' (UPSTREAM). The project had two primary aims: firstly, to attempt to value economically the health cost-benefits associated with the quality of urban environments and, secondly, to interview those in control of urban development in the UK in order to reveal the potential barriers to, and opportunities for, the creation of healthy urban environments, including their views on the use of economic valuation of (planetary) health outcomes. Much is known about the 'downstream' impact of urban environments on human and planetary health and about how to design and plan healthy towns and cities ('midstream'), but we understand relatively little about how health can be factored in at key governance tipping points further 'upstream', particularly within dominant private sector areas of control (e.g. land, finance, delivery) at sub-national level. Our findings suggest that both public and private sector appeared well aware of the major health challenges posed by poor-quality urban environments. Yet they also recognized that health is not factored adequately into the urban planning process, and there was considerable support for greater use of non-market economic valuation to help improve decision-making. There was no silver bullet however: 110 barriers and 76 opportunities were identified across a highly complex range of systems, actors and processes, including many possible points of targeted intervention for economic valuation. Eight main themes were identified as key areas for discussion and future focus. This findings paper is the second of two on this phase of the project: the first sets out the rationale, approach and methodological lessons learned.
| Original language | English |
|---|---|
| Pages (from-to) | 415-427 |
| Number of pages | 13 |
| Journal | Journal of Urban Health |
| Volume | 98 |
| Early online date | 3 May 2021 |
| DOIs | |
| Publication status | Published - 30 Jun 2021 |
Funding
All authors contributed substantially to this paper. Daniel Black led the interviews, primary analysis and reporting with support from Paul Pilkington and Gabriel Scally. Ben Williams, Janet Ige and Emily Prestwood led the interview recording, coding and parallel analysis. Figure in this paper was conceived and produced by Daniel Black. The economic valuation work in UPSTREAM was undertaken by Eleanor Eaton and Alistair Hunt at the University of Bath’s Department of Economics. All members of UPSTREAM Consortium inputed into discussions during the project, especially Judy Orme and Laurence Carmichael, but also Jim Longhurst, Kris Ebi, Roderick Lawrence, Sophie Laggan, Ruth Larbey and Margarida Sardo. Thanks also to our external advisors—Neil Smith, George Ferguson, Yolanda Barnes, Ian Cox and Barra Mac Ruairí—for contributing their time at the start of the pilot to helping develop the initial thematic areas of enquiry. This paper has been benefitted too from broader consideration and input through the early development of the five-year TRUUD research programme ( Tackling Root Causes Upstream of Unhealthy Urban Development ), which is funded through the UK Prevention Research Partnership and includes: the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and the Wellcome Trust [, ]. All authors contributed substantially to this paper. Daniel Black led the interviews, primary analysis and reporting with support from Paul Pilkington and Gabriel Scally. Ben Williams, Janet Ige and Emily Prestwood led the interview recording, coding and parallel analysis. Figure 1 in this paper was conceived and produced by Daniel Black. The economic valuation work in UPSTREAM was undertaken by Eleanor Eaton and Alistair Hunt at the University of Bath?s Department of Economics. All members of UPSTREAM Consortium inputed into discussions during the project, especially Judy Orme and Laurence Carmichael, but also Jim Longhurst, Kris Ebi, Roderick Lawrence, Sophie Laggan, Ruth Larbey and Margarida Sardo. Thanks also to our external advisors?Neil Smith, George Ferguson, Yolanda Barnes, Ian Cox and Barra Mac Ruair??for contributing their time at the start of the pilot to helping develop the initial thematic areas of enquiry. This paper has been benefitted too from broader consideration and input through the early development of the five-year TRUUD research programme (Tackling Root Causes Upstream of Unhealthy Urban Development), which is funded through the UK Prevention Research Partnership and includes: the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and the Wellcome Trust [17 , 76].
