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

doi:10.1016/j.healthplace.2023.103023

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

Health Place. 2023 May:81:103023. doi: 10.1016/j.healthplace.2023.103023. Epub 2023 Apr 18.

Authors

Anna Le Gouais¹, Geoff Bates², Rosalie Callway³, Heeseo Rain Kwon⁴, Lisa Montel⁵, Sian Peake-Jones⁶, Jo White⁷, Md Nazmul Hasan⁸, Caglar Koksal⁶, Andrew Barnfield⁹, Krista Bondy⁸, Sarah Ayres⁹

Affiliations

¹ University of Bristol, Bristol Medical School (Population Health Sciences), UK. Electronic address: Anna.legouais@bristol.ac.uk.
² University of Bath, Institute for Policy Research, UK.
³ University of Bristol, Bristol Medical School (Population Health Sciences), UK.
⁴ University of Reading, Henley Business School, UK.
⁵ University of Bristol Law School, Centre for Health, Law and Society, UK.
⁶ University of Manchester, Manchester Urban Institute, UK.
⁷ University of the West of England, Centre for Public Health and Wellbeing, UK.
⁸ University of Bath, School of Management, UK.
⁹ University of Bristol, School for Policy Studies, UK.

PMID: 37079969
DOI: 10.1016/j.healthplace.2023.103023

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'.

Keywords: Decision-making; Environmental determinants; Population health; Qualitative; System; Urban development.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Decision Making
Environment Design*
Humans
Population Health
Qualitative Research
Urban Renewal*

Abstract

Publication types

MeSH terms

Grants and funding