Understanding how to create healthier places: A qualitative study exploring the complex system of urban development decision-making

Anna Le Gouais, Geoff Bates, Rosalie Callway, Heeseo Rain Kwon, Lisa Montel, Sian Peake-Jones, Jo White, Md Nazmul Hasan, Caglar Koksal, Andrew Barnfield, Krista Bondy, Sarah Ayres

Research output: Contribution to journalArticlepeer-review

9 Citations (SciVal)


Tackling complex system challenges like creating healthy environments requires understanding priorities and structures affecting multiple actors. This qualitative study, involving 132 multi-sectoral stakeholders spanning the urban development decision-making system, explores how to influence healthier place-making. Using thematic analysis we develop themes around competing stakeholder priorities; structural ‘rules’ and influential relationships; and justifying a focus on health, requiring greater clarity and consensus around definitions of ‘healthy’ urban development. Building on the socio-ecological model we highlight how a multi-faceted approach is required for change at multiple levels in the complex system to target individual actor motivations, organisational priorities and structural ‘rules’.

Original languageEnglish
Article number103023
JournalHealth & Place
Early online date18 Apr 2023
Publication statusPublished - 31 May 2023

Bibliographical note

This work was supported by the UK Prevention Research Partnership (award reference: MR/S037586/1), which is funded by 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 Wellcome.

Data availability
Data will be made available on request.


  • Public health
  • Urban
  • Qualitative
  • complex systems
  • Decision-making
  • Urban development
  • Environmental determinants
  • System
  • Population health

ASJC Scopus subject areas

  • Health(social science)
  • Life-span and Life-course Studies
  • Sociology and Political Science


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