Senior urban development decision-makers say there is currently little incentive to consider public health impacts when shaping towns and cities, according to a new study highlighting the potential of an innovative economic valuation tool to help address this gap.
Researchers say the Health Appraisal for Urban Systems (HAUS) tool could help local authorities and planning departments make healthier urban development decisions. The model links features of the urban environment to health outcomes and their associated economic costs, providing evidence that could help reduce the burden of conditions such as obesity, cancer, cardiovascular disease and respiratory illness.
The study, co-authored by researchers from the University of East London (UEL), University of Bath and University of Bristol, found that stakeholders across government, industry and civil society recognised HAUS as a potentially valuable way to support shared decision-making. By demonstrating the economic value of healthier environments, the tool could also create stronger incentives for organisations to work together to improve public health.
The connection between urban environments and health is well established. Housing quality, transport infrastructure, access to green space and neighbourhood walkability can all influence health and the risk of serious disease. However, using urban development as a preventative public health measure is complex because decisions involve multiple organisations with different responsibilities, priorities and budgets.
To explore how economic evidence might encourage more integrated decision-making, researchers conducted 167 qualitative interviews with key stakeholders across England’s urban development system. Participants were asked how HAUS could support collaboration and more informed decision-making across sectors. The tool was originally developed during an earlier research pilot and was further refined during the project in collaboration with the UK’s Ministry of Housing, Communities and Local Government.
HAUS estimates changes in disease occurrence and premature mortality associated with different urban development interventions and translates those health impacts into economic values. This allows decision-makers to consider health-related costs and benefits alongside other economic factors when assessing development options, helping demonstrate the longer-term value of investing in healthier housing, transport and neighbourhood environments.
Dr Andrew Barnfield, Senior Lecturer in Public Health at UEL and study co-author, said HAUS enables decision-makers to account for health costs associated with the urban environment, which is important for creating healthier and more equitable communities. Professor Sarah Ayres of the University of Bristol said the collaboration has produced methods that can, for the first time, quantify and value the potential health impacts of urban interventions for specific populations.
The researchers conclude that HAUS could provide important evidence to strengthen cross-sector collaboration and embed preventative public health considerations in urban development decisions. The tool has since been adopted in government appraisal guidance for local authorities. Dr Geoff Bates of the University of Bath said that demonstrating the economic benefits of preventative policies, including potential savings to the public purse, could help persuade policymakers to invest in healthier housing and urban environments and improve long-term health and wellbeing.
More information: Andrew Barnfield et al, How can critical actors be incentivised to take a systems approach to pursue preventative public health? Evidence & Policy. DOI: 10.1332/17442648Y2026D000000107
Journal information: Evidence & Policy Provided by University of East London