Background: In the United Kingdom the government’s new health mission aims to reduce the burden on healthcare services by shifting from treating poor health to prevention. Delivering this requires action on health in policy arenas outside of the health sector such as urban development, as urban environments are key health determinants. However, change is challenging in complex and long-established policy systems and structures. Systems methods can enhance research into such contexts and demonstrate opportunities for delivering cross-cutting preventative health agendas. Methods: This study aimed to enhance understanding of how health is integrated in urban development policymaking, and how to bring about change to support healthier development. It was undertaken over two stages. Firstly, a thematic analysis of data from interviews with 37 United Kingdom policy officials exploring urban development decision-making in central government. Secondly, the development of a causal loop diagram based on the variables and connections between them, identified in the interview data. Results: Analysis revealed how health is not well integrated in urban development policymaking. Through mapping 15 important influencing variables, we identified four main areas where change can be delivered: senior leadership on preventative health, responsibility in urban development teams for health, opportunities in urban development for health experts to promote ideas, and the capacity and capability of officials to act. Addressing any of the factors identified will likely have benefits, but it is by bringing change to multiple highlighted areas that health integration will be maximized. Conclusions: If the United Kingdom Government’s health mission is to be effective, policymakers must be empowered and incentivized to act on health in areas such as urban development. There is recent evidence of enhanced leadership on health prevention, but this must be supported in in several ways simultaneously, with increased funding, facilitating joined up working across sectors, and enhancing the use of tools and evidence to understand and promote health outcomes. By taking a systems approach this study adds value to existing understandings by going beyond isolated challenges and opportunities, to illustrate the connections between them and, therefore, how any changes are likely to have wider effects.

This paper evaluates the potential of eco self-build community (ESBC) housing to act as a socially and environmentally sustainable housing solution that can address the demand for self-build and community housing whilst supporting the UK’s 2050 net-zero-carbon commitment. This model of housing is being piloted through schemes such as the Water Lilies project, an upcoming ESBC scheme providing self-finish houses and custom-build flats. The research aims to gain a broad understanding of the market for ESBC housing by analysing the data from people who registered interest in a plot or home and comparing this with data from a similar survey targeted at the market for conventional self-build and custom-build housing. The key findings are that: (1) the ESBC housing market is largely open to more than one build method, but with a greater preference for purchasing a completed home and self-finish than self-build, compared to the conventional market for self-build and custom-build that is primarily interested in self-build; (2) the ESBC housing market is looking for a variety of home sizes, though predominantly 2 and 3 bedrooms, that could be provided through houses and flats, compared to the conventional market for self-build and custom-build that is mostly seeking larger houses on single plots; (3) the most important housing aspects to the ESBC housing market are ‘green lifestyle’, ‘style and construction quality’, and ‘community spirit’, which differ to the conventional self-build and custom-build market, where they are ‘construction quality’, ‘internal appearance/layout’ and ‘location’; (4) living in a sustainable home is important to the market for conventional self-build and custom-build housing and on average, they would be willing to pay 27% more for a highly sustainable home than the average UK new build. The main drivers are that people want to reduce their environmental impact and reduce their home running costs. A key overall conclusion of the study is that a distinct market exists for ESBC schemes, where the priorities of prospective homeowners differ to those from the more general self-build market. For ESBC schemes, the provision of eco-housing and a sense of community are key priorities, whereas for the more general self-build market, location and the need to tailor the house design to the owner’s unique aesthetic and lifestyle preferences tend to be the most important factors. This paper discusses the implications of these findings and identifies opportunities for scaling up the delivery of ESBC housing.