Towards healthy urbanism: inclusive, equitable and sustainable (THRIVES) – an urban design and planning framework from theory to praxis

Figures & data

Box 1 – Foundation definitions for this article

Built environment professions include architects, construction managers, engineers, facilities managers, landscape architects, planners, project managers, surveyors, and urban designers (Construction Industry Council n.d.). Framework is a visual diagram that represents relations among different factors or concepts. It ‘can provide a scaffold and common language to conceptualize the system’ and should provide clear definitions for all components to avoid extended debates during its implementation (Yee et al. 2012, p. 415). Health and wellbeing refers to physical and mental health and wellbeing together, recognising their determinants as being a wide set of individual characteristics and societally influenced factors. This builds on the recognised deficiencies of the WHO (1946) definition, instead adopting Bircher and Kuruvilla (2014) definition of health as ‘a state of wellbeing emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants’ (p. 363). Urban development is ‘the process of physically producing the built environment, by bringing together multiple actors from construction companies to development financiers to local planners and others’ (Rydin 2010, p. 15). Development encompasses all property sectors and infrastructure and may be large or small in scale, including major urban redevelopment projects and incremental improvements to existing buildings.

Table 1. List of topics measured in urban health indicators within four sub-classes of Pineo et al.’s (2018a) taxonomy.

Scope sub-classes	Topics
Environment	Transport, housing, water quality, air quality, land use, services and utilities, food environment, urban design, natural environment, pollutants, public open space, waste management, and noise
Social	Crime and safety, education, behaviours, leisure and culture, demographics, social networks, local democracy, disasters, and other
Health	Health outcomes, health and social services
Economic	Employment/income, and economy

Table 2. Analysis of included frameworks including target audiences, practices they advocate, tools they include, and topics they describe.

	Target Audiences									Recommends …				Includes …				Describes …
Framework publication	Planning	Development	Other BE	Health General	Public health	City departments	City leaders	Community members	Other	Collaboration	Community knowledge	HIA or other assessment	Monitoring	Indicators	Checklist	EBP & design measures	Case studies	Co-benefits	Policy structures	Equity	Inclusion	Sustainability
Edwards and Tsouros (2008)				Y		Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Gen	Y	Y	M
Sport England (2015)	Y	Y	Y	Y				Y		Y	M	Y	Y	N	Y	Y	Y	Y	CS	Y	Y	M
Pineo et al. (2018b)			Y				Y			Y	N	N	Y	Y	N	N	M	Y	N	Y	N	M
BC Centre for Disease Control (2018)	Y	Y		Y		Y		Y		N	N	N	N	N	N	Y	M	Y	CS	Y	Y	M
National Heart Foundation of Australia (Victorian Division) (2012)	Y		Y	Y	Y	Y				Y	Y	Y	N	N	Y	Y	Y	Y	CS	N	M	M
CIP and HP Lanarc – Golders (n.d.)	Y			Y				Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	CS	Y	M	Y
Gehl Institute (2018)	Y		Y		Y		Y	Y		Y	Y	N	Y	Y	N	Y	Y	N	N	Y	Y	N
Northridge et al. (2003); Northridge and Sclar (2003)	Y				Y					Y	Y	Y	Y	Y	N	N	N	Y	N	Y	N	Y
Mithun Inc. and Denver Housing Authority (2012)									Y	Y	Y	Y	Y	Y	N	Y	Y	N	CS	Y	Y	Y
Ross and Chang (2014)	Y		Y		Y		Y	Y		Y	Y	Y	Y	N	Y	Y	Y	M	CS	Y	M	M
TCPA (2017)	Y	Y	Y	Y	Y					Y	M	Y	Y	N	Y	Y	Y	Y	CS	Y	Y	Y
Barton (2005; Barton and Grant (2006)	Y		Y		Y	Y			Y	Y	Y	Y	Y	N	N	N	N	Y	N	Y	Y	Y
Pineo and Rydin (2018)		Y	Y							N	Y	Y	Y	N	N	Y	Y	Y	N	Y	N	Y
Rajan and Manoj Kumar (2016)			Y							N	N	N	N	N	N	Y	N	N	N	N	N	M
UK Green Building Council (2016)		Y	Y							Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	Y	Y

BE: built environment, M: minimally, EBP: evidence-based policy, Gen: general, CS: context specific, Y: yes, N: no.

Figure 1. THRIVES Framework (Towards Healthy uRbanism: InclusiVe Equitable Sustainable).

Table 3. Evaluation of two design strategies using the THRIVES Framework scales of health impact and core principles.

		Example urban development scenarios, selected design strategies and associated health benefits
		Scenario 1: Improvements to neighbourhood-scale mobility infrastructure.	Scenario 2: Redevelopment of a 1960s housing estate.
Framework principles and scales of health impact		Design strategy: New solar-powered street lighting	Design strategy: Publicly accessible outdoor play space
Core principles	Inclusive – Process	Community street audits can identify where to put lights to best support local needs.	Co-design process can inform factors such as prioritisation of play space features, including target ages.
	Inclusive – Outcome	Improved sense of safety (from more street lighting) leads to increased physical activity and social interaction for all residents, including disabled, women, elderly, and children.	Installation of features such as benches, shading, water fountain (etc.) supports the needs of vulnerable residents, including children, grandparents and nursing mothers.
	Equitable	In addition to the above, increased sense of safety in deprived community leads to opportunities (e.g. jobs, schools, etc.) in wider areas.	Creation of publicly accessible on-site amenities in the play space benefits low-income residents, within and beyond the estate.
	Sustainable	Reduced fossil fuel use (to power lighting) lowers pollution, while supporting a green lighting business and associated jobs.	Reduced flooding and car use (see below) leads to reductions in air/water pollution and carbon emissions.
Scales of health impact	Planetary health	Reduced fossil fuel use leads to lower pollution, thereby decreasing health impacts of climate change.	Local amenity reduces the need to drive to parks, thereby reducing health impacts caused by climate change and air pollution. Sourcing sustainable/ethical materials reduces pollution and negative impacts in the supply chain.
	Ecosystem health	Reduced pollution (from switching to renewable energy) increases health benefits from functioning ecosystem.	Permeable surfaces and planting in the play space can be part of sustainable drainage systems, reducing flooding and water pollution, thereby leading to ecosystem health benefits.
	Local health – neighbourhood scale	Improved sense of safety results in greater physical activity and social interaction through incidental interactions.	Play space provides local amenity to increase physical activity and social interaction for children and parents (within and beyond the estate’s boundary).
	Local health – building scale	Lights can be placed/angled to reduce light pollution in buildings.	Green infrastructure in the play space can decrease the urban heat island effect, resulting in better thermal comfort in homes.

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