The role of emotion in urban development decision-making: A qualitative exploration of the perspectives of decision-makers.

People's feelings about their neighbourhoods are important for health, but they may be undervalued in urban development decision-making. This study explores how decision-makers understand and respond to residents' emotions. Reflexive thematic analysis was conducted on a secondary dataset consisting of 123 interviews with influential professionals in urban development decision-making. We developed three themes and one subtheme: '(mis)understanding residents' emotions', 'neglecting the health impact of positive emotions', 'avoidance of emotion in community engagement' and 'sanitized emotions'. We recommend decision-makers engage directly with residents' emotions during urban development processes to ensure healthier place-making.

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

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'.

Integrating Health into Local Plans: A Comparative Review of Health Requirements for Urban Development in Seven Local Planning Authorities in England.

A local plan is a statutory policy document that supports urban development decisions across a local government area in England. Local plans are reported to need more specific requirements for development proposals regarding wider health determinants to address potential health outcomes and health inequalities. This study reviews the integration of Health in Local Plans of seven local planning authorities through documentary analysis methods. A review framework was formulated based on health and planning literature regarding local plans, health policy and determinants of health and dialogue with a local government partner. The findings identify opportunities to strengthen the consideration of Health in Local Plans, including ensuring that policies are informed by local health priorities and signpost national guidance, strengthening health-related requirements for developers (e.g., indoor air quality, fuel poverty and security of tenure) and improving implementation of requirements for developers (e.g., through adoption of health management plans and community ownership). The study identifies further research needs regarding how policies are interpreted by developers in practice, and on national guidance for Health Impact Assessment. It highlights the benefit of undertaking a comparative review, contrasting local plan policy language and identifying opportunities to share, adapt and strengthen planning requirements regarding health outcomes.

What needs to happen to 'level up' public health?

The aim of this article is to examine what needs to happen in central, sub-regional and local government to 'level up' public health in the United Kingdom (UK). The Government's recent Levelling Up White Paper outlined ambitious targets for reducing regional disparities, including a 'mission' to tackle inequalities in healthy life expectancy and reduce inequalities in the social determinants of health outcomes. However, the approach has been criticised for failing to integrate population health policy objectives, programmes and interventions into the implementation of the levelling up agenda and its associated 'missions'. Drawing on a case study of promoting healthy urban development in the UK, we examine how the wider determinants of health might be incorporated into the Government's levelling up strategy. Based on in-depth interviews with 132 urban development actors, our findings reveal that long-term investment in healthy urban development could play a key role in levelling up public health but is not currently part of the Government's plans. We make a timely contribution to the levelling up debate by placing public health centre stage in social science debates. We conclude by offering a series of recommendations for transformative policy change to level up health.

Sharing believable stories: A qualitative study exploring the relevance of case studies for influencing the creation of healthy environments.

Case study examples can inform policy recommendations and action to create healthy environments. This qualitative study, using semi-structured interviews with nine cross-sectoral stakeholders in England, explored the role of context in case study examples. We found that case studies can not only be a 'practical example' but also used as a 'believable story' with the power to influence decision-making. Case studies may be deemed believable if similar and locally relevant, but judgements can be inherently political and politicised. Metrics used to measure case study outcomes can differ in believability. Storytellers who understand different audiences can be used to build support.