Understanding how to create healthier places: A qualitative study exploring the complex system of urban development decision-making. (May 2023)

• Record Type: Journal Article
• Authors: Le Gouais, Anna; Bates, Geoff; Callway, Rosalie; Kwon, Heeseo Rain; Montel, Lisa; Peake-Jones, Sian; White, Jo; Hasan, Md Nazmul; Koksal, Caglar; Barnfield, Andrew; Bondy, Krista; Ayres, Sarah
• Is Part Of: Health & place. Volume 81(2023)
• Publication Date: 2023-05
• Subjects: Urban development -- Decision-making -- System -- Qualitative -- Environmental determinants -- Population health; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2023.103023
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: 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'. Highlights: Urban development stakeholders have competing priorities that may not prioritise health and wellbeing. Policies and legislation may not incentive healthy decision-making. A complex system approach identifies multiple leverage points for healthy place-making: target inidividuals, organisations and structures. More clarity and consensus around definitions of 'healthy' urban development needed.