Background: Poor quality urban environments have substantial impacts on public and planetary health. These costs to society are not readily quantifiable and remain largely external to mainstream measures of progress. Methods for accounting for these externalities exist, but their effective application is in development. Yet there is an increasing urgency and demand given the profound threats to quality of life both now and in the future.Methods: We combine data from a series of systematic reviews of the quantitative evidence linking characteristics of the urban environment with health consequences and the economic valuation of these health impacts from a societal perspective within a spreadsheet-based tool. The tool–named HAUS–allows the user to estimate the health impacts of changes in urban environments. The economic valuation of these impacts in turn facilitates the use of such data in broader economic appraisal of urban development projects and policies.Findings: Using the Impact-Pathway approach, observations of a variety of health impacts associated with 28 characteristics of the urban environment are applied to forecast changes in cases of specific health impacts that result from changes in urban contexts. Unit values for the societal cost of 78 health outcomes are estimated and incorporated in the HAUS model in order to allow the quantification of the potential effect size of a given change in the urban environment. Headline results are presented for a real-world application in which urban development scenarios that have varying quantities of green space are evaluated. The potential uses of the tool are validated via formal semi-structured interviews with 15 senior decision-makers from the public and private sectors.Interpretation: Responses suggest that there is significant demand for this kind of evidence, that it is valued despite the inherent uncertainties, and has a very wide range of potential applications. Analysis of the results suggest expert interpretation and contextual understanding is critical for the value of evidence to be realized. More development and testing is needed to understand how and where it may be possible to apply effectively in real world practice.

The city of Bristol currently generates around 48,000 tonnes of household food waste every year. This waste incurs loss of resources and environmental damage throughout the food cycle. In this paper we quantify and value the baseline socio-environmental impacts from household food waste in Bristol before examining the potential costs and benefits that may result from changes to food waste behaviour. In so doing, we look to better inform the choice of food waste reduction methods in public policy. The environmental impacts of two possible policy targets are explored: (1) a 20% increase in food waste recycling and (2) an overall decrease in food waste of 20%. Environmental impacts are estimated for 13 different hazards, including Global Warming Potential, Particulate Matter, Human Toxicity and Water Depletion. The societal consequences of these environmental changes are monetised using non-market values which allows us to directly compare the relative importance of different environmental impacts and the trade-offs between these impacts in each scenario. For example, we estimate that the Global Warming Potential of Bristol’s annual food waste equates to around 110,000 tonnes CO₂, or 25,000 additional cars on the road every year. We find that a 20% improvement in recycling behaviour would lead to an annual reduction of 113 tonnes of CO₂ equivalent, whilst a 20% reduction in food waste would result in an annual reduction of 15,000 tonnes CO₂ equivalent. Findings suggest that the environmental impact of waste management is significantly overshadowed by the impact of resources used in food production and distribution before it becomes waste.

Bristol, one of the United Kingdom’s (UK) nine Core Cities, is seeking to achieve Zero Waste City status by 2049. This study combines macro-economic valuation with transition pathway mapping and adapted participatory scenario planning to stress test the city’s ambitious food waste targets. The primary aim is to enable better understanding of who might be affected by achieving these targets, both locally and nationally, the potential scale of impacts, and therefore the potential barriers and policy opportunities. The valuation focuses on household and commercial food waste, combining available site and city data with national level proxies. Impact areas include changes in sectoral income, employee income, capital owner income, tax revenue, and carbon emissions. Four scenarios, based on two extreme cases, are modelled to consider food waste reduction and potential shifts in consumption patterns. Results indicate that current market and governance failures incentivise waste, and suggest potential routes to transition, including trade-offs and resource reallocation, alongside the need to acknowledge and respond to these profound structural barriers. With further development and testing, the approach may contribute to a better understanding of how to achieve city socioenvironmental targets.

Objectives: The urban environment can have a significant impact on mental and physical health. Health impact appraisal of new developments should address these issues. However, transferable economic valuation evidence for urban planners in the United Kingdom is thin, especially around mental health, making it harder to estimate the cost-efficiency of public health interventions to address these conditions. A further complication is that mental health may be perceived differently from physical health. This study examines willingness to pay (WTP) to avoid Methods: WTP estimates were obtained by applying contingent valuation tasks in an online survey with a representative sample in the United Kingdom (N = 1553). Interval regression models were used to estimate the effects of disease severity, payment frequency, and respondent characteristics Results: Respondents' WTP to avoid both conditions was relatively high (around 5%-6% of stated income to return to current health state). Depression was rated as being twice as burdensome on quality of life than pain, and bids to avoid depression were 20% to 30% more than pain. Analysis of motivation responses suggests mental health treatment is perceived as less easy to access and less effective than the equivalent for pain, and respondents expect a larger burden on their family and Conclusions: Results suggest that depression bids may be affected by uncertainty around access to effective treatment in the healthcare system. This has implications for how mental illness may be prioritized in resource allocation toward public health interventions.

Background: Urban environments are placing an increasing burden on our life support systems. Research is needed further upstream in urban governance and on the role of economic valuation in critical decision-making. The three-year pilot study, Moving Health Upstream in Urban Development (UPSTREAM), funded by Wellcome, has made a small, but important contribution to research in this area. We report here on the results of the workstream to quantify the scale of the impact that the built environment has on health in monetary terms. Methods: Following a systematic literature review carried out by University of the West of England, observed health impacts associated with different characteristics of the environment were applied to a hypothetical population of 1000 people. Unit values for the societal cost of around 60 health outcomes were defined using existing valuation evidence. Reference values were established for the intervals between worst-case and best-case scenarios in the UK new build housing context. Findings: We estimated the societal value of health impacts arising from 26 characteristics of the built environment, including green space, air quality, noise, overheating and proximity to a main road. It is possible to use these findings to compare the relative importance of each feature. Interpretation: Even in the context of a well-regulated sector, the UK new build environment shows potential for significant differences in health impacts between the best and worst quality of design. Although interior conditions such as thermal comfort are important, it is the wider environmental context such as green space and air quality where the largest impacts occur. We have shown that this potential for change can be monetised in terms of the impact on health, using a metric that might be useful for social planners. Funding: The Wellcome Trust.