Moving planetary health upstream
​in urban development decision-making
​2015 - 2019

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Project Description
​A three-year pilot, UPSTREAM, funded by the Wellcome Trust under their flagship programme: Our Planet Our Health. The goal of our project was to understand how planetary health might become a priority for those in control of urban development decision-making. The project was split in to three main activities:

1. Reviewing the evidence in the health literature linking quality of urban environment to health outcomes (UWE Bristol leading)
2. Estimating the economic cost-benefit of that evidence (University of Bath leading)
3. Interviewing senior executives on the barriers and opportunities in creating healthy urban development (db+a with UWE Bristol)

​db+a developed and led the proposal in partnership with Gabriel Scally (GSPHA), Alistair Hunt (UoBath) and Judy Orme (UWE Bristol) with support from Kris Ebi (UoWashington) and Roderick Lawrence (UoGeneva). UWE Bristol was the lead partner/contract holder. db+a co-coordinated the project in close partnership with the project steering group - Gabriel Scally, Judy Orme, Alistair Hunt and Paul Pilkington - and wider research team. db+a led on integration of work streams, interviews with case study partners, and advisor liaison. 

Project Report, Website, Public Engagement, Video

Project Report: Moving planetary health upstream in urban development decision-making - a three-year research pilot
​Project website: http://urban-health-upstream.info/
​Public Engagement: Our City Our Health
Project Video

Artwork

 We commissioned local artist, Luek Jerram, to help us communicate the impact of unhealthy urban environments. He conceived the idea of showing people what a particle of soot looks like by enlarging it by 3 mission times. See Luke's website here.

Academic Papers

• Ige-Elegbede, J., Pilkington, P., Orme, J., Williams, B., Prestwood, E., Black, D. and Carmichael, L., (2020) Designing healthier neighbourhoods: a systematic review of the impact of the neighbourhood design on health and wellbeing. Cities & Health, pp.1-16. Available from: https://www.tandfonline.com/doi/full/10.1080/23748834.2020.1799173​
• Black, D., Pilkington, P., Williams, B. et al. Overcoming Systemic Barriers Preventing Healthy Urban Development in the UK: Main Findings from Interviewing Senior Decision-Makers During a 3-Year Planetary Health Pilot. J Urban Health 98, 415–427 (2021). https://doi.org/10.1007/s11524-021-00537-y 
• Scally, G., Black, D., Pilkington, P. et al. The Application of ‘Elite Interviewing’ Methodology in Transdisciplinary Research: a Record of Process and Lessons Learned during a 3-Year Pilot in Urban Planetary Health Research. J Urban Health 98, 404–414 (2021). https://doi.org/10.1007/s11524-021-00542-1 
• Carmichael, L., Prestwood, E., Marsh, R., Ige, J., Williams, B., Pilkington, P., Eaton, E. and Michalec, A. (2020) Healthy buildings for a healthy city: Is the public health evidence base informing current building policies?. Science of the Total Environment, 719, p.137146. Available from: https://doi.org/10.1016/j.scitotenv.2020.137146
• Ige, J., Pilkington, P., Orme, J., Williams, B., Prestwood, E., Black, D.,Carmichael, L. and Scally, G. (2018) The relationship between buildings and health: a systematic review. Journal of Public Health. Available from: http://eprints.uwe.ac.uk/37521
• Black, D., Scally, G., Hunt, A., and Orme, J (2018) We must look further upstream to enable planetary health-literate urban development. The Lancet Planetary Health. Vol 2, No.4, e145-e146, April 2018. Elsevier. URL: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30045-7/fulltext (PDF)
• Black, D., Scally, G., Orme, J., Hunt, A., Pilkington, P., Lawrence, R., and Ebi, K. (2018) Moving Health Upstream in Urban Development: Reflections on the Operationalisation of a Trans-disciplinary Case Study, Global Challenges, Wiley. URL: https://onlinelibrary.wiley.com/doi/full/10.1002/gch2.201700103 (PDF)

Conference Presentations

• Ige, J., & Pilkington, P. (2018, December). The state of the evidence: What we know, and don’t know, about the interaction of environment and health. Presented at Building health into the urban environment: Evidence and opportunities, London, England. Available from https://uwe-repository.worktribe.com/output/1493923
• Eaton, E., Hunt, A. (2018, December). Building health into the urban environment: Evidence and opportunities, Royal Society of Medicine, London, England.  
• Larbey, R. (2018, December). Building health into the urban environment: Evidence and opportunities, Royal Society of Medicine, London, England.
• Pilkington, P., Black, D., & Ige, J. (2017, April). Upstream: Moving health upstream in urban development planning. Paper presented at Inaugural Planetary Health Alliance Annual Meeting.
• Black, D., Ige, J., Pilkington, P., Williams, B., Prestwood, E., Hunt, A., …Ogilvie, F. (2017, February). Moving health upstream in urban development decision-making. Presented at The Sustainable Transport & Health Summit.
• Black, D. Eaton, E. (2017, October) International Conference on Urban Health  – Healthy-Polis Seminar, University of Coimbra, Portugal.
• Ige, J., Pilkington, P., Black, D., & Prestwood, E. (2017, October). The impact of the built environment on health: An evidence review. Presented at Healthy City Design International Valuation of the Urban Environment by its potential impact on human health. Planetary Health Alliance AGM, Stanford University, USA. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(19)30147-0/fulltext
• The economic case for healthier urban development: the UPSTREAM project. National Planning Conference, San Francisco, USA. https://www.planning.org/conference/
• Our City, Our Health: Experience of communicating with the public on health and the built environment. Royal Society of Medicine Conference – Epidemiology and Public Health: “Building health into the urban environment: Evidence and opportunities” https://www.rsm.ac.uk/events/epidemiology-and-public-health/2018-19/epm01/
• Evidence and opportunities for creating healthy urban environments – Royal Society of Medicine Conference https://www.db-associates.co.uk/blog
• Making the case for prevention at local level.  Joseph Rowntree Foundation, Building Climate Resilience in Health and Social Care, Leeds

Public Engagement

Shape Our City, the public engagement arm of UPSTREAM, sought to pilot different creative ways in which the public, and particularly marginalised groups (children, the elderly, rural. low income, BAME), can contribute to urban decision-making. Working closely with the researchers, Shape Our City was able to use the latest science on health in cities to inform both the artwork used and the conversations had with community groups and the wider public. We wanted to understand: What does healthy urban development mean to them? What their perceived role is in the decision making process? And what actions, if any, can they take to affect change?

Public Engagement Video: https://vimeo.com/311438519vimeo.com/311438519

Media

BBC News
British Medical Journal
Bristol Evening Post
Bulgarian News Agency
BBC Radio Bristol
Heart FM
Meanwhile, our online game has been featured in Bristol 247 and The Spark magazine.

Partners

Funder