Healthy placeshaping in practice: how to embed health into planning across urban and rural settings

Background

Healthy placeshaping (HP) is an emerging agenda seeking to embed health and equity considerations within spatial planning systems. In England, policy frameworks increasingly emphasise the role of planning in shaping population health, yet implementation is inconsistent. This study evaluates the activities of two HP teams to understand how health is integrated into planning across urban and rural settings.

Methods

A qualitative public health evaluation was conducted of two HP teams supporting eight local governments in Southern England. The study combines document review of planning documents (using an adapted quality assessment framework), logic modelling, and 44 semi-structured interviews with key stakeholders, including planners, public health practitioners, and community members. Data were analysed thematically to explore teams’ activities, impacts, and barriers and enablers.

Results

HP was operationalised in a flexible, staged approach, fostering collaboration between planning and public health first, before integrating health at policy-level and embedding Health Impact Assessments within planning applications. The hybridity of HP teams, bringing together planning and public health expertise, was a key enabler. However, significant barriers existed, including misaligned developer incentives, national housing delivery targets, and resource constraints. As a result, progress was uneven, with variation in the quality of health integration across policy and practice, evidenced in the document review.

Conclusions

HP offers a promising approach to integrating health within planning but delivery is shaped by structural constraints and local capacities. Hybrid teams can support both policy development and implementation, yet sustained progress requires alignment across national policy and effective local governance. The findings highlight the importance of flexibility, collaboration, and local adaptation in advancing HP within complex planning environments.

Key messages

• Embedding health in planning requires a staged approach: public health-planning collaboration first, with subsequent attention to developing policy frameworks and enhanced application processes.

• Hybrid public health–planning teams can enable integration, but structural constraints necessitate context-sensitive, relationship-based approaches.