Quantifying the health impacts of alternative urban development scenarios using the HAUS tool

Local authorities face a capacity challenge to balance policy considerations when master-planning an area for redevelopment. Effects of redevelopment on residents’ health comprise one competing priority alongside financial viability, sustainability and employment provision. The challenge is not a lack of data, but a lack of accessible tools to help LAs synthesise and interpret complex information about health effects. We address this by creating a health-economic valuation model which allows the user to understand health trade-offs entailed in alternative scenarios and relative to other costs and benefits. The model applies evidence to quantify and monetise the potential impact on health outcomes related to characteristics of the urban environment. The model is driven by a set of 200+ environment-health impact pathways supported by systematic reviews of evidence relating to building design, natural environment, community infrastructure and transport. We estimate the societal value of changes to health using a database of economic values for 70+ physical and mental health outcomes. Values include costs of treatment, productivity loss and pain & suffering associated with ill health, and are disaggregated according to who bears the costs, e.g. NHS, police. Values are modelled for a synthetic population which can be tailored to local contexts, allowing for aggregation. We apply the model to a regeneration site in Bristol, UK, identifying health outcomes resulting from alternative land use scenarios for the site. Model outputs were used to inform the process of developing a Spatial Regeneration Framework and preferred land use scenarios within the regeneration site. Our research helped to widen out the number of health impacts considered by the design team, and to build a strong case for healthy policy options such as enhanced green space within the strategic framework, ensuring that health data can be built into negotiations with developers in the implementation phase. KEY MESSAGES: • Economic valuation of health impacts of urban environment leads to better public health decision-making. • The HAUS model allows better-informed trade-offs between health and urban investment to be made.