Economic tool could help cities boost urban public health

Senior urban development decision-makers have revealed there is currently little incentive to consider public health impacts when shaping towns and cities, according to a new study that highlights the potential of an innovative economic valuation tool to address the problem.

Researchers argue that local authorities and planning departments could use the Health Appraisal for Urban Systems (HAUS) tool – a valuation model which links features of the environment to health outcomes and their associated economic costs – to support making healthier urban development choices, and reduce incidence of diseases including obesity, cancer, cardiovascular disease and respiratory illness.

The study, co-authored by the University of East London (UEL), University of Bath and University of Bristol, revealed that stakeholders from government, industry and civil society recognised the value of the HAUS as a new way to support shared decision-making and create incentives for organisations to work together to improve health outcomes.

The link between urban environments and public health is well established: factors such as housing quality, transport infrastructure, access to green space and walkability in fact influence the risk of developing life-threatening diseases. However, improving urban environments as a preventative public health measure is complex, and requires coordinated action from multiple stakeholders.

To assess how economic evidence could support more integrated decision-making, the researchers conducted 167 qualitative interviews with key stakeholders across England's urban development system. The interviews explored how HAUS could support collaboration and informed decision-making across sectors

The tool was initially developed during an earlier research pilot and was further refined throughout the project in collaboration with the UK's Ministry of Housing, Communities and Local Government.

HAUS quantifies and monetises changes in disease occurrence and premature mortality linked with different urban development interventions and affecting local populations; by translating health outcomes into economic terms, the tool can help decision-makers better understand the long-term value of healthier urban environments and support more informed investment and planning decisions.

Dr Andrew Barnfield, Senior Lecturer in public health at UEL and co-author of the study, said:

The HAUS tool enables decision makers to account for health costs that are linked with the urban environment. As our work, shows this is vital for making healthier and more equitable places.”

The researchers conclude that HAUS provides valuable evidence to encourage cross-sector collaboration and include preventative public health in urban development decisions. The tool has since been adopted by the Ministry for Homes, Communities and Local Government in their appraisal guides for local authorities.

Professor Sarah Ayres, from the University of Bristol’s School for Policy Studies, said:

The collaboration between TRUUD and the Ministry of Housing, Communities and Local Government has created a version of the Health Appraisal of Urban Systems (HAUS) model which is to be used for housing, community and local government interventions. For the first time, there are now methods to quantify and value the potential health impacts of urban interventions for specific populations.”

Dr Geoff Bates, from the University of Bath’s Institute for Policy Research, said:

Making the economic case to pursue preventative policies is one way that can persuade policymakers to act to improve long-term health and wellbeing. Improving policymaker access to evidence and tools like HAUS that demonstrate the savings to the public purse from investing in healthier housing and urban environments is a step towards improving public health.”