Building Cities That Make Us Healthier: How real estate investors can help shape urban spaces that support our wellbeing

Cities haven’t always been built with our health in mind, but my research aims to start changing this. My work is helping the real estate investment industry think beyond financial returns and start building places that actually make people feel better.

The health crisis we don’t talk about enough

In the UK, most illnesses today aren’t caused by infections – they’re non-communicable diseases like type 2 diabetes, heart disease and poor mental health. These conditions take a huge toll on people’s lives but are often shaped by the environments we live in, not just our personal choices.

Real estate with a conscience

My research, part of the TRUUD project (Tackling the Root causes Upstream of Unhealthy Urban Development) led by the University of Bristol Medical School, digs into how real estate can be part of the solution. I’ve conducted in-depth analysis and met with experienced stakeholders, and the message is clear: wellness is no longer a ‘nice to have’, it’s become a business imperative. It’s not just about making a return anymore. There’s pressure from investors to deliver something that benefits society too.

Rethinking the industry

Overturning the stereotype of developers chasing profit, my findings show an investment business drive towards a pro-sustainable urban environment.

But there’s a problem: data. While we’ve made progress measuring things like energy use and waste, we’re still in the dark when it comes to health outcomes. Granular information on locally achievable health outcomes is needed.

Turning health into hard numbers

With the help of major investors (for example, Federated Hermes Limited), my team tested a new health valuation model developed by TRUUD health economists at the University of Bath. The idea was to generate monetised health evidence to guide asset management decision-making. In the long term, this can inform financial appraisal and portfolio strategy.

Led by myself and colleagues, two reports have subsequently been published: Paradise, Birmingham: Health Impact Appraisal of Redevelopment Proposals and St Mary Le Port, Bristol: Health Impact Appraisal of Redevelopment Proposals.

Uniquely, the reports focus on urban sites experiencing obsolescence in densely populated cities, where significant disparities in health and wellbeing exist. By applying this innovative model, they demonstrate how sustainable development goals and financial performance in real estate investment can be successfully aligned.

Making the system work together

Urban development is about people, policies and partnerships – not just buildings. I have also been working with the government’s Office for Health Improvement and Disparities working group on design code health guidance; this has been published as Design Codes for Health and Wellbeing. The next step: advice notes for the people who shape our cities, including local authority planners, investors and developers.

Social benefits of collaboration

This work has been powered by a dedicated research team at the University of Reading. The TRUDD project has now concluded but our research findings continue to be communicated and taken forward (for example, via a University of Reading public lecture involving partners in clinical practice and local government, and a workshop with the commercial sector at the RSA for shareholders and investors). By working closely with partner organisations, our Henley research can make a real difference to people’s day-to-day lives.

Check out the TRUUD project at www.truud.ac.uk or to find out more about how this work continues to make an impact, drop me a line at k.pain@henley.reading.ac.uk

This research was supported by the UK Prevention Research Partnership, an initiative funded by UK Research and Innovation councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities.

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