Tackling Health Inequalities through Sector-Based Policies within the Urban Built Environment in England

Abstract

BACKGROUND AND AIM: Health inequalities (HIs) has proven to be a convoluted issue in many urban environments, involving a multitude of sectors for its persistence. Hence, to achieve maximum outcomes, HI-focused interventions require its prioritisation as well as the inter-sectoral collaboration across both the public and private domains. Although this has long been recognised, current systems still lack its best practice. This research aims to evaluate whether key sectors within the built environment or urban planning policy arena have prioritised the issue, and pave way for inter-sectoral collaborations to form. For this study, England is chosen as the geographical scope. METHODS: To achieve its aim, the research carried out a systematic review of reviews to determine the key policy sectors pertaining to HIs within the built environment. A conceptual framework, connecting the key sectors and determinants to HIs, was then developed based on this review. This resulting framework became basis for the subsequent analysis of public sector documents of the key sectors. Specific mentions and references to HIs and inter-sectoral collaboration were noted and analysed. RESULTS:The findings reveal that, although the health implications of urban planning are generally acknowledged, explicit mentions to HIs are scarce. Furthermore, policies and strategies specifically targeting low-income and deprived communities were found to be minimal. Interventions tackling the behavioural, compositional explanations to HIs are the most prevalent, despite the continuous calls for investment on upstream, contextual interventions as suggested by the systematic reviews. CONCLUSIONS:Inequalities, particularly in health, are clearly still widely overlooked in the UK urban planning context. Although tackling HIs cannot be concluded to give a platform for effective and efficient inter-sectoral collaborations to form, there is potential for it to be. KEYWORDS: built environment, policy, policy and practice, environmental disparities, health co-benefits.