A new tool to value the health effects of urban development proposals has been revealed by researchers at the universities of Bath and Bristol and published in the journal Frontiers in Public Health.

The valuation tool evaluates a range of factors including how buildings, transport, natural environment (including air pollution and green space), socio-economics and community infrastructure in new developments might improve or worsen health for its future residents. The accompanying study was authored by Eleanor Eaton and Dr Alistair Hunt from the University of Bath, with Daniel Black from DB+ Associates and the University of Bristol.

By integrating environmental economics with public health systematic reviews and urban design analysis, researchers were able to value the potential health effects that may result from development proposals and provide evidence to assess the health costs of urban planning decisions.

The tool, which sub-divides the urban environment in to 28 characterisations, places a value not just on air pollution, which is most commonly evidenced, but also on a range of factors which could lead to premature death and chronic morbidity, profoundly affecting quality of life and the cost of healthcare.

The work forms a core part of 'Tackling Root causes upstream of Unhealthy Urban Development' TRUUD - a major transdisciplinary research project which aims to reduce non-communicable disease (such as cancers, diabetes, obesity, mental ill-health and respiratory illness) and health inequalities linked to urban planning and development.

For instance, green spaces provide a range of health benefits, especially for adults in reducing diabetes and risk of weight gain. However, green spaces can also contribute to childhood asthma. Similarly, a significant link was revealed between noise from traffic and child conduct disorder (and the cost of treatment medically). By adjusting scenarios, planners could have a tool for measuring the likely health impacts of increasing or decreasing the amount and quality of green spaces.

University of Bath researcher Eleanor Eaton from the Department of Economics, and lead author of the paper explained: “It is possible to value the potential health effects of our urban environments and weigh these against the traditional financial costs and benefits of city development.

“We still have some health impacts such as mental health and chronic pain, where the evidence is incomplete where further research will help create a full picture for planners and policymakers.”

The approach was originally conceived during two previous studies on climate risk, funded by InnovateUK and NERC, followed by a Wellcome-funded pilot project, UPSTREAM, which shifted the focus of the tool to urban health risk and revealed that there was likely substantial demand from senior decision-makers for a valuation approach like this.

The pilot used a major regeneration site in South West England as an initial case study. The TRUUD programme has since enabled a substantial expansion of economic evidence, as well as further testing of the tool in another major project setting.

Programme Director for TRUUD at the University of Bristol Daniel Black added: “This is a key paper for our work in attempting to fundamentally change the way we make decisions about how we develop and manage the places we live in by re-prioritising and more fully accounting for human and planetary health.

“We’re doing more work in this area to develop the model, and to show where the burden of disease falls across the community.”


  • Tackling Root causes upstream of Unhealthy Urban Development (TRUUD) is a research project, based at the University of Bristol, looking at how urban centres can be planned to reduce health inequalities. It brings together experts from academia, industry and government to recommend and create new tools and processes for healthier cities.

  • The project counts the cost of poor health, works with communities to communicate the issues they face and maps out the decision-making process in creating urban centres and includes two active case-studies in Bristol and Manchester. TRUUD is funded by the UK Prevention Research Partnership (UKPRP).