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

Citation

Le Gouais A, Bates G, Callway R, Rain Kwon H, Montel L, Peake-Jones S, White J, Nazmul Hasan M, Koksal C, Barnfield A, Bondy K & Ayres S (2023) Understanding how to create healthier places: A qualitative study exploring the complex system of urban development decision-making. Health and Place, 81, Art. No.: 103023. https://doi.org/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
Urban development; Decision-making; System; Qualitative; Environmental determinants; Population health

Journal
Health and Place: Volume 81

• Published Version