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Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis

Pineo, H; Zimmermann, N; Davies, M; (2020) Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis. Palgrave Communications , 6 , Article 21. 10.1057/s41599-020-0398-3. Green open access

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Abstract

Public health practitioners produce urban health indicator (UHI) tools to inform built environment policy and decision-making, among other objectives. Indicator producers perceive UHI tools as an easily understandable form of evidence about the urban environment impact on health for policy-makers’ consumption. However, indicator producers often conceptualise policy-making as a rational and linear process, therefore underestimating the complex and contested nature of developing and implementing policy. This study investigates the health-promotion value of UHI tools in the complex urban planning policy and decision-making context. A thematic analysis was conducted following semi-structured interviews with 22 indicator producers and users in San Francisco, Melbourne and Sydney. The analysis was informed by collaborative rationality and systems theories and the results were used to develop causal loop diagrams (CLDs) of producers and users’ mental models. The preliminary CLDs were tested and improved through a participatory modelling workshop (six participants). A high-level CLD depicts users and producers’ shared mental model in which indicator development and use are embedded in policy development and application processes. In the cases analysed, creating and using UHI tools increased inter-sectoral relationships, which supported actors to better understand each other’s opportunities and constraints. These relationships spurred new advocates for health in diverse organisations, supporting health-in-all-policies and whole-of-society approaches. Constraints to health-promoting policy and implementation (such as those which are legal, political and economic in nature), were overcome through community involvement in UHI tools and advocacy effectiveness. A number of factors reduced the perceived relevance and authority of UHI tools, including: a high number of available indicators, lack of neighbourhood scale data and poor-quality data. In summary, UHI tools were a form of evidence that influenced local urban planning policy and decision-making when they were embedded in policy processes, networks and institutions. In contrast to the dominant policy impact model in the indicator literature, such evidence did not typically influence policy as an exogenous entity. Indicators had impact when they were embedded in local institutions and well-resourced over time, resulting in trusted relationships and collaborations among indicator producers and users. Further research is needed to explore other governance contexts and how UHI tools affect the power of different actors, particularly for under-represented communities.

Type: Article
Title: Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1057/s41599-020-0398-3
Publisher version: https://doi.org/10.1057/s41599-020-0398-3
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of the Built Environment
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of the Built Environment > Bartlett School Env, Energy and Resources
URI: https://discovery.ucl.ac.uk/id/eprint/10091067
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