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Public Health Research and Practice Public Health Research and Practice Society
The peer-reviewed journal of the Sax Institute
RESEARCH ARTICLE (Open Access)

A participatory system map of the adverse influence of urban environments on population health: integrating urban development and preventive health expertise

Jason Prior A B C * , Rupert Legg A C and Erica McIntyre A B C
+ Author Affiliations
- Author Affiliations

A Institute for Sustainable Futures, University of Technology Sydney, NSW, Australia

B Research Institute for Innovative Solutions for Wellbeing and Health (INSIGHT), Faculty of Health, University of Technology Sydney, NSW, Australia

C Healthy Populations and Environments Platform, Maridulu Budyari Gumal: Sydney Partnership for Health, Education, Research and Enterprise, NSW, Australia

* Correspondence to: jason.prior@uts.edu.au

Public Health Research and Practice 33, e3342335 https://doi.org/10.17061/phrp3342335
Published: 6 December 2023

2023 © Prior et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objectives: A growing number of urban development and public health professionals are developing expertise in how urban environments influence population health to support preventive health (PH) planning, implementation and outcomes. This study aimed to address the growing interest among these experts in Sydney, Australia, to move beyond silo-based approaches to PH planning and urban development by developing a preliminary mapping of the complex adaptive system. This is a network of agents and parts that collectively relate and interact, where they seek to intervene by meshing the disparate knowledge of their multidisciplinary expertise. This mapping will help experts to better integrate PH approaches by linking primordial and primary prevention within urban environments, collectively prioritising areas for intervention within the complex adaptive system, and developing a better understanding of relations between multiple factors at play within it. Methods: The system map was developed using a unique participatory system-mapping (PSM) process involving a modified Delphi technique consisting of three rounds between October 2019 and August 2020 and 15 urban development and public health experts engaged in PH in Sydney’s urban environment. Results: The final system map encompassed features of the local environment, determinants of health and wellbeing in urban environments, pre-clinical health and wellbeing impacts, and clinical health outcomes, providing a comprehensive map of the adverse effects of urban environments on population health. There was a high level of agreement among experts on the final system map. While experts from different disciplines generally agreed on priority areas for intervention, consensus was higher among those from similar disciplinary backgrounds. Conclusions: The study highlights how the collective intelligence of experts from diverse disciplines can generate PSM. Furthermore, it illustrates how using systems mapping can help experts interested in complex public health problems to take a broader view of the complex adaptive system for PH planning, support collaborative prioritisation, and offer valuable insights for targeted interventions.