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The expanding research of complexity economics has been signalling its preference for a formal quantitative investigation of diverse interactions between heterogeneous agents at the lower, micro-level resulting in emergent, realistic socioeconomic dynamics at the higher, macro-level. However, there is scarcity in research that explicitly links complexity perspectives in economics with the systems thinking literature, despite these being highly compatible, with strong connections and common historical traces. We aim to address this gap by exploring commonalities and differences between the two bodies of knowledge, seen particularly through an economics lens. We argue for a hybrid approach, in that agent-based complexity perspectives in economics could more closely connect to two main systems thinking attributes: a macroscopic approach to analytically capturing the complex dynamics of systems, and an inter-subjective interpretivist dimension, when investigating complex social-economic order. Illustrative discussions of city sustainability are provided, with an emphasis on decarbonisation and residential energy demand aspects.

Due to the COVID‐19 pandemic, it has become increasingly important and necessary to conduct research and teaching activities online. While many universities quickly started the transition to online teaching, most in‐person research activities were typically postponed. However, in order to not significantly delay research, researchers are increasingly seeking to conduct activities, such as workshops, in a virtual setting. Following this initial period of disruption, it is expected that many online or hybrid activities will continue to be used and, in some cases, may replace in‐person interactions due to cost, time, convenience, and environmental concerns after the COVID‐19 crisis has passed. Researchers and/or stakeholders are often geographically dispersed, which independently motivates the use of online or hybrid workshop activities.

Copyright: © 2022 by the authors.Urban green spaces provide environmental, economic, societal and health benefits to cities. However, policy and planning interventions aiming to improve usage have often led to unintended consequences, including, in some circumstances, an actual decline in usage. Previous research has identified factors influencing the use of urban green space, more often with a focus on the ‘quality’ and physical features of the space, rather than on the broader social factors. This study aims to unpack the complexity of factors that influence the use of urban green space through the application of Systems Thinking. A qualitative mixed-method approach integrating System Dynamics with rapid ethnography was adopted to elicit the views of local residents in Thamesmead, London. A thematic analysis of interviews was undertaken to systematically map the causal relations between factors, which were compared to wider stakeholders’ views. Our findings highlight the relevance of dynamics and social influences on the use of green space, which include social interactions and stewardship, health conditions, availability of services and amenities. These are factors that are underexplored in the literature and, sometimes, overlooked in urban green space policy by decision-makers. We infer that attendance of urban green spaces requires time, which may be occupied in other practices determined by local conditions and needs. Expanding the spatial and temporal boundaries of investigation, wider than debates on ‘quality’, should, in our view, increase the chances of identifying critical influences and foster an increased use of green space. Wellcome Trust (CUSSH project, ref. no. 209387/Z/17/Z); U.K. Natural Environment Research Council (CAMELLIA project, ref. no. NE/S003495/1).

Heat pumps (HPs) are seen as an increasingly important technology able to contribute significantly towards the decarbonisation of the domestic stock in the UK. However, there appears to be a performance gap between predicted and real-life HP performance, with several studies highlighting the need to include the HP’s interaction with users when examining their performance. This study examines the role of user behaviour in mitigating this performance gap from a systems perspective. A sample of 21 case studies was selected from 700 domestic HPs monitored across the UK via the government’s Renewable Heat Premium Payment Scheme for the collection of qualitative and quantitative socio-technical data. The application of systems thinking facilitated the identification of the underlying interactions between the HP system and its users. The systems analysis revealed that HP performance relies on complex socio-technical system interactions, including behavioural patterns, and that enabling feedback information processes can have a significant impact on user behaviour. The study enabled a deeper perspective on performance influencers relating to behavioural patterns and achieved new insights into the requirements for well-performing HPs. These findings have important implications for policy makers, installers and manufacturers of HP systems and their users.

Sustainable development is best supported by intersectoral policies informed by a range of evidence and knowledge types (e.g. scientific and lay). Given China’s rapid urbanisation, scale and global importance in climate mitigation, this study investigates how evidence is perceived and used to inform urban health and sustainability policies at central and local levels. Well-informed senior professionals in government/scientific agencies (12 in Beijing and 11 in Ningbo) were interviewed. A thematic analysis is presented using deductive and inductive coding. Government agency participants described formal remits and processes determining the scope and use of evidence by different tiers of government. Academic evidence was influential when commissioned by government departments. Public opinion and economic priorities were two factors that also influenced the use or weight of evidence in policymaking. This study shows that scientific evidence produced or commissioned by government was routinely used to inform urban health and sustainability policy. Extensive and routine data collection is regularly used to inform cyclical policy processes, which improves adaptive capacity. This study contributes to knowledge on the ‘cultures of evidence use’. Environmental governance can be further improved through increased data-sharing and use of diverse knowledge types. Policy relevance • Insights are provided into the ‘cultures of evidence use’ in urban sustainability and health governance in two Chinese cities, noting the complex interconnections between national policy agendas, the public and evidence. Policies are centrally led and informed by officially commissioned scientific evidence. • Environmental health data were used for monitoring policy implementation, and they were interpreted with careful consideration of public opinion and economic priorities. • There were opportunities for local priorities to shift the policy agenda, particularly when the public became aware of a specific environmental health threat. • Environmental governance could be strengthened in these settings through increased cross-sector data-sharing and integration of diverse knowledge types. • A strength of China’s approach is routine data collection that feeds a monitoring and policy cycle rarely achieved elsewhere. This cycle provides feedback to government departments, allows policy adjustment over time and can inform decisions during crises.

This article is included in Complex Urban Systems for Sustainability and Health: CUSSH collection. Data availability: No data are associated with this article. Copyright: © 2021 Davies M et al. This paper describes a global research programme on the complex systemic connections between urban development and health. Through transdisciplinary methods the Complex Urban Systems for Sustainability and Health (CUSSH) project will develop critical evidence on how to achieve the far-reaching transformation of cities needed to address vital environmental imperatives for planetary health in the 21st Century. CUSSH’s core components include: (i) a review of evidence on the effects of climate actions (both mitigation and adaptation) and factors influencing their implementation in urban settings; (ii) the development and application of methods for tracking the progress of cities towards sustainability and health goals; (iii) the development and application of models to assess the impact on population health, health inequalities, socio-economic development and environmental parameters of urban development strategies, in order to support policy decisions; (iv) iterative in-depth engagements with stakeholders in partner cities in low-, middle- and high-income settings, using systems-based participatory methods, to test and support the implementation of the transformative changes needed to meet local and global health and sustainability objectives; (v) a programme of public engagement and capacity building. Through these steps, the programme will provide transferable evidence on how to accelerate actions essential to achieving population-level health and global climate goals through, amongst others, changing cities’ energy provision, transport infrastructure, green infrastructure, air quality, waste management and housing.

The Complex Urban Systems for Sustainability and Health (CUSSH) project is a global research programme on the complex systemic connections between urban development and health. Through transdisciplinary methods it will develop critical evidence on how to achieve the far-reaching transformation of cities needed to address vital environmental imperatives for planetary health in the 21st century. CUSSH’s core components include: (i) a review of evidence on the effects of climate actions (both mitigation and adaptation) and factors influencing their implementation in urban settings; (ii) the development and application of methods for tracking the progress of cities towards sustainability and health goals; (iii) the development and application of models to assess the impact on population health, health inequalities, socio-economic development and environmental parameters of urban development strategies, in order to support policy decisions; (iv) iterative in-depth engagements with stakeholders in partner cities in low-, middle- and high-income settings, using systems-based participatory methods, to test and support the implementation of the transformative changes needed to meet local and global health and sustainability objectives; (v) a programme of public engagement and capacity building. Through these steps, the programme will provide transferable evidence on how to accelerate actions essential to achieving population-level health and global climate goals through, amongst others, changing cities’ energy provision, transport infrastructure, green infrastructure, air quality, waste management and housing.

The problem of solid waste management presents an issue of increasing importance in many low-income settings, including the progressively urbanised context of Kenya. Kisumu County is one such setting with an estimated 500 t of waste generated per day and with less than half of it regularly collected. The open burning and natural decay of solid waste is an important source of greenhouse gas (GHG) emissions and atmospheric pollutants with adverse health consequences. In this paper, we use system dynamics modelling to investigate the expected impact on GHG and PM2.5 emissions of (i) a waste-to-biogas initiative and (ii) a regulatory ban on the open burning of waste in landfill. We use life tables to estimate the impact on mortality of the reduction in PM2.5 exposure. Our results indicate that combining these two interventions can generate over 1.1 million tonnes of cumulative savings in GHG emissions by 2035, of which the largest contribution (42%) results from the biogas produced replacing unclean fuels in household cooking. Combining the two interventions is expected to reduce PM2.5 emissions from the waste and residential sectors by over 30% compared to our baseline scenario by 2035, resulting in at least around 1150 cumulative life years saved over 2021–2035. The contribution and novelty of this study lies in the quantification of a potential waste-to-biogas scenario and its environmental and health impact in Kisumu for the first time., Graphical abstract Unlabelled Image, Highlights • We present a system dynamics study of solid waste management in Kisumu, Kenya. • Scenarios involve a waste-to-biogas initiative and a ban on open burning in landfill. • Combined scenario generates 1.1m tonnes cumulative GHG savings by 2035. • Largest contribution (42%) is from biogas substituting traditional cooking fuels. • Combined scenario may save 1,150 cumulative life years by 2035, plus ~220 more p.a.

Natural capital plays a central role in urban functioning, reducing flooding, mitigating urban heat island effects, reducing air pollution, and improving urban biodiversity through provision of habitat space. There is also evidence on the role played by blue and green space in improving physical and mental health, reducing the burden on the health care service. Yet from an urban planning and development view, natural capital may be considered a nice to have, but not essential element of urban design; taking up valuable space which could otherwise be used for traditional built environment uses. While urban natural capital is largely recognised as a positive element, its benefits are difficult to measure both in space and time, making its inclusion in urban (re)development difficult to justify. Here, using a London case study and information provided by key stakeholders, we present a system dynamics (SD) modelling framework to assess the natural capital performance of development and aid design evaluation. A headline indicator: Natural Space Performance, is used to evaluate the capacity of natural space to provide ecosystem services, providing a semi-quantitative measure of system wide impacts of change within a combined natural, built and social system. We demonstrate the capacity of the model to explore how combined or individual changes in development design can affect natural capital and the provision of ecosystem services, for example, biodiversity or flood risk. By evaluating natural capital and ecosystem services over time, greater justification for their inclusion in planning and development can be derived, providing support for increased blue and green space within cities, improving urban sustainability and enhancing quality of life. Furthermore, the application of a SD approach captures key interactions between variables over time, showing system evolution while highlighting intervention opportunities.

Copyright: © 2021 The Author(s). Contemporary challenges linked to public health and climate change demand more effective decision-making and urban planning practices, in particular by taking greater account of evidence. In order to do this, trust-building relationships between scientists and urban practitioners through collaborative research programmes is required. Based on a policy-relevant research project, Complex Urban Systems for Sustainability and Health (CUSSH), this project aims to support the transformation of cities to meet environmental imperatives and to improve health with a quantitative health impact assessment. A case study in Rennes, France, focuses on the role of a policy decision-support tool in the production and use of knowledge to support evidence-informed decision-making. Although the primary objective of informing decision-making through evidence-based science is not fulfilled, the use of a decision-making support tool can lay the foundations for relationship-building. It can serve as a support for boundary-spanning activities, which are recognised for their effectiveness in linking science to action. This case study illustrates that the path of knowledge transfer from science to policy can be challenging, and the usefulness of using models may not be where it was thought to have been. Practice relevance The requirements for an effective policy-relevant research programme depend on the establishment of trust. An analysis of the evolution of relationships between cities’ practitioners and scientists shows the need to establish relationships between stakeholders involved in this kind of research. Even if it does not directly support the implementation of transformational policies for health and sustainability, the use of a decision-making support tool can become essential in building trust relationships and later have ripple effects to achieve its primary goals. Moreover, a dedicated team has a key role to facilitate the links between scientists and cities practitioners—to boundary span. Finally, this paper adds to a growing body of work reflecting upon the success of policy–research partnerships. Wellcome Trust (grant number 209387/Z/17/Z).

Heritage science is an interdisciplinary field and successful heritage science research by necessity involves interdisciplinary collaboration between researchers with different disciplinary backgrounds and professional experience. Successful interdisciplinary research is challenging, and many issues have been identified both within and outside heritage science. However, within heritage science there has never been an attempt to do an in-depth study of how communication in interdisciplinary research works in practice. This paper aims to address this gap by providing an in-depth exploration of a case study. We present the analysis of the transcribed recording of a five-hour workshop and follow-up interviews with the workshop participants that took place within the framework of a collaborative heritage science research project. The analysis looks in detail at the dynamics of communication in the context of this meeting, identifying the main topics of conversation and the nature of the transitions between them. We discuss the way in which researchers use different physical scales when thinking about heritage material degradation. We identify key features of interdisciplinary research such as the sense of community and the use of language. Recommendations and insights for future practice are presented.

Surging amounts of waste are reported globally and especially in lower-income countries, with negative consequences for health and the environment. Increasing concern has been raised for the limited progress achieved in practice by diverse sets of policies and programmes. Waste management is a wicked problem characterised by multilayered interdependencies, complex social dynamics and webs of stakeholders. Interactions among these generate unpredictable outcomes that can be missed by decision makers through their understanding and framing of their context. This article aims to identify possible sources of persistent problems by focussing on what captures, shapes and limits the attention of stakeholders and decision-makers, drawing on the attention-based view from organisation theory. The theory describes the process through which issues and opportunities are noticed and how these are translated into actions, by focussing on the influencers at the individual, organisational and context scale. Views on issues and opportunities for waste management were collected in a series of fieldwork activities from 60 participants representing seven main types of stakeholders in the typical lower-middle income Kenyan city of Kisumu. Through a thematic analysis guided by the attention-based view, we identified patterns and misalignment of views, especially between government, community-based organisations and residents, which may contribute to persistent waste problems in Kisumu. Some point to detrimental waste handling practices, from separation to collection and treatment, as the main cause of issues. For others, these practices are due to a poor control of such practices and enforcement of the law. This study's major theoretical contribution is extending the application of attention theory to multi-stakeholder problems and to non-formalized organisations, namely residents and to the new field of waste management. This novel lens contributes a greater understanding of waste issues and their management in Africa that is relevant to policy and future research. By revealing the “wickedness” of the waste problem, we point to the need for a holistic and systems-based policy approach to limit further unintended consequences., Graphical abstract Image 1, Highlights • Attention-based view helps understand multi-stakeholder waste management problems. • Our analysis highlighted individual, social and contextual factors driving attention. • Household behaviour and government control are pointed as main source of the issues. • Misaligned scales in issues and moves across stakeholders must be tackled. • We rapport waste management wicked problem to multiple actors and agendas.

Urban health indicator (UHI) tools provide evidence about the health impacts of the physical urban environment which can be used in built environment policy and decision-making. Where UHI tools provide data at the neighborhood (and lower) scale they can provide valuable information about health inequalities and environmental deprivation. This review performs a census of UHI tools and explores their nature and characteristics (including how they represent, simplify or address complex systems) to increase understanding of their potential use by municipal built environment policy and decision-makers. We searched seven bibliographic databases, four key journals and six practitioner websites and conducted Google searches between January 27, 2016 and February 24, 2016 for UHI tools. We extracted data from primary studies and online indicator systems. We included 198 documents which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy. Our taxonomy classifies the significant diversity of UHI tools with respect to topic, spatial scale, format, scope and purpose. The proportions of UHI tools which measure data at the neighborhood and lower scale, and present data via interactive maps, have both increased over time. This is particularly relevant to built environment policy and decision-makers, reflects growing analytical capability and offers the potential for improved understanding of the complexity of influences on urban health (an aspect noted as a particular challenge by some indicator producers). The relation between urban health indicators and health impacts attributable to modifiable environmental characteristics is often indirect. Furthermore, the use of UHI tools in policy and decision-making appears to be limited, thus raising questions about the continued development of such tools by multiple organisations duplicating scarce resources. Further research is needed to understand the requirements of built environment policy and decision-makers, public health professionals and local communities regarding the form and presentation of indicators which support their varied objectives. Electronic supplementary material The online version of this article (10.1007/s11524-018-0228-8) contains supplementary material, which is available to authorized users.

Innovations in materials, construction techniques and technologies in building construction and refurbishment aim to reduce carbon emissions and produce low-energy buildings. However, in-use performance consistently misses design specifications, particularly those of operational energy use and indoor environmental quality. This performance gap risks reducing design, technology, sustainability, economic, health and well-being benefits. In this paper, we compare settings of the Chinese and the UK buildings sectors and relate their historical context, design, construction and operation issues impacting energy performance, indoor environmental quality, occupant health and well-being. We identify a series of key, common factors of ‘total’ building performance across these two settings: the application of building regulations, the balance between building cost and performance, skills, construction and operation. The dynamic and complex interactions of these factors are currently poorly understood and lead to building performance gaps. We contend that a systems approach in the development of suitable building assessment methods, technologies and tools could enable the formulation and implementation of more effective policies, regulations and practices. The paper illustrates the application of the approach to the UK and Chinese settings. A full application of a systems approach may help to provide a more dynamic understanding of how factor interactions impact the ‘total’ building performance gaps and help address its multiple causes.

There is a growing awareness among city leaders and policy-makers of the impact of the urban environment on health outcomes and inequalities. Increasingly, practitioners in built environment city d...

Human health and planetary health are both influenced by city lifestyles, city leadership, and city development. For both, worrying trends are leading to increasing concern. It is imperative that b...

Public health practitioners produce urban health indicator (UHI) tools to inform built environment policy and decision-making, among other objectives. Indicator producers perceive UHI tools as an easily understandable form of evidence about the urban environment impact on health for policy-makers’ consumption. However, indicator producers often conceptualise policy-making as a rational and linear process, therefore underestimating the complex and contested nature of developing and implementing policy. This study investigates the health-promotion value of UHI tools in the complex urban planning policy and decision-making context. A thematic analysis was conducted following semi-structured interviews with 22 indicator producers and users in San Francisco, Melbourne and Sydney. The analysis was informed by collaborative rationality and systems theories and the results were used to develop causal loop diagrams (CLDs) of producers and users’ mental models. The preliminary CLDs were tested and improved through a participatory modelling workshop (six participants). A high-level CLD depicts users and producers’ shared mental model in which indicator development and use are embedded in policy development and application processes. In the cases analysed, creating and using UHI tools increased inter-sectoral relationships, which supported actors to better understand each other’s opportunities and constraints. These relationships spurred new advocates for health in diverse organisations, supporting health-in-all-policies and whole-of-society approaches. Constraints to health-promoting policy and implementation (such as those which are legal, political and economic in nature), were overcome through community involvement in UHI tools and advocacy effectiveness. A number of factors reduced the perceived relevance and authority of UHI tools, including: a high number of available indicators, lack of neighbourhood scale data and poor-quality data. In summary, UHI tools were a form of evidence that influenced local urban planning policy and decision-making when they were embedded in policy processes, networks and institutions. In contrast to the dominant policy impact model in the indicator literature, such evidence did not typically influence policy as an exogenous entity. Indicators had impact when they were embedded in local institutions and well-resourced over time, resulting in trusted relationships and collaborations among indicator producers and users. Further research is needed to explore other governance contexts and how UHI tools affect the power of different actors, particularly for under-represented communities.

Background: A growing number of cities, including Greater London, have set ambitious targets, including detailed policies and implementation plans, to reach global goals on sustainability, health, and climate change. Here we present a tool for a rapid assessment of the magnitude of impact of specific policy initiatives to reach these targets. The decision-support tool simultaneously quantifies the environmental and health impacts of specified selected policies. Methods: The ‘Cities Rapid Assessment Framework for Transformation (CRAFT)’ tool was applied to Greater London. CRAFT quantifies the effects of ten environmental policies on changes in (1) greenhouse gas (GHG) emissions, (2) exposures to environmental hazards, (3) travel-related physical activity, and (4) mortality (the number of attributable deaths avoided in one typical year). Publicly available data and epidemiological evidence were used to make rapid quantitative estimates of these effects based on proportional reductions in GHG emissions and environmental exposures from current baseline levels and to compute the mortality impacts. Results: The CRAFT tool estimates that, of roughly 50,000 annual deaths in Greater London, the modelled hazards (PM2.5 (from indoor and outdoor sources), outdoor NO2, indoor radon, cold, overheating) and low travel-related physical activity are responsible for approximately 10,000 premature environment-related deaths. Implementing the selected polices could reduce the annual mortality number by about 20% (~1,900 deaths) by 2050. The majority of these deaths (1,700) may be avoided through increased uptake in active travel. Thus, out of ten environmental policies, the ‘active travel’ policy provides the greatest health benefit. Also, implementing the ten policies results in a GHG reduction of around 90%. Conclusions: The CRAFT tool quantifies the effects of city policies on reducing GHG emissions, decreasing environmental health hazards, and improving public health. The tool has potential value for policy makers through providing quantitative estimates of health impacts to support and prioritise policy options.

Global initiatives have raised awareness of the need for cross-departmental and cross-sectoral activities to support urban health, sustainability, and equity, with respective indicators routinely used as a way to catalyze and monitor action toward pre-defined goals. Despite the existence of at least 145 urban health indicator (UHI) tools globally, there has been very little research on the use of indicators by policy- and decision-makers; more attention has been devoted to their development and validation. This paper describes the second part of a two-part systematic review of the characteristics (part A) and use (part B, this part) of UHI tools by municipal built environment policy- and decision-makers. Part B is a narrative synthesis of studies on the use of UHI tools. This PRISMA-P compliant review follows a mixed methods sequential explanatory design. The search was conducted using seven bibliographic databases, grey literature searches, and key journal hand searches. Ten studies describing the use of ten UHI tools in seven countries were included in the narrative synthesis, resulting in development of a theory of change (ToC). We found that both expert-led and participatory indicator projects can be underpinned by research evidence and residents’ knowledge. Our findings contradict the dominant view of indicator use in policy-making as a linear process, highlighting a number of technical, organizational, political, knowledge, and contextual factors that affect their use. Participatory UHI tools with community involvement were generally more effective at supporting “health in all policies” and “whole-of-society” approaches to governing healthy cities than expert-led processes. UHI tool producers proposed a range of techniques to address urban health complexity characteristics. Finally, in combining data from both parts of the review, we found that potentially important UHI tool features, such as neighbourhood-scale data, were influential in the use of indicators by built environment policy- and decision-makers. Electronic supplementary material The online version of this article (10.1007/s11524-019-00378-w) contains supplementary material, which is available to authorized users.

Cities ultimately are human-made environments. It is this very feature of cities that makes them an appealing target for population health inquiry. That they have been created means that they can also be modified and improved to the end of improving the health of their resident populations. Urban planning is concerned with the development and use of land in urban environments and, in this context, can play a central role in how we may think about optimizing urban environments to improve health. This chapter introduces an urban planning perspective on urban health, discussing how a formal urban planning framework can improve our understanding of the health of urban populations.

The need to renovate high-rise residential buildings to maintain or improve indoor environmental conditions and reduce energy use is becoming prevalent worldwide. Climate change concerns have driven the development of policies, regulations, and standards for building renovation; however, these standards are often narrowly focussed on energy use and fail to consider the complexities of high-rise residential building systems. To understand policy, process, and practice barriers to improving the high-rise residential building renovation process, we first examined high-rise residential building renovation policies, protocols, and guidelines in the UK and Canada – two countries which have significant stocks of aging high-rise residential buildings. This revealed several common limitations across jurisdictions, including a lack of consideration of non-energy and cost-related benefits, failure to adopt the ‘building-as-a-system’ approach and vague or inconsistent use of terminology surrounding the scope and feasibility of renovations which provide excessive latitude for non-compliance. Next, an example of an existing high-rise residential building renovation processes is presented, in which a system dynamics approach is used to identify systemic barriers to improving renovation processes in the UK and Canada. Causal loop diagrams were developed to represent important variables and the causal interrelationships between variables using a combination of grounded theory analysis, validation interviews, and workshops involving stakeholders from both countries. Recommendations for improving renovation policies are presented including: mandatory standards for IEQ; incentivization of integrated design; improvements to practitioner education and training; implementation of feedback mechanisms to inform practitioners of successes and failures; and simplification of material and design certifications.

The rapid development of green buildings world widely has not delivered the anticipated energy related benefits because the real performance of green buildings is not as good as expected. This paper presents a building case study in China by applying a holistic approach which integrates system dynamics and energy performance simulation to evaluate the building performance gap and provide management strategies to minimize the performance gap. The case study in this paper is an office building located in Shanghai, which was awarded “Three Star” in Evaluation Standard for Green Buildings in China (GB/T 50378–2006). Several scenarios including six single management strategy scenarios and four multiple management strategy scenarios are carried out and in each scenario, building performance is analyzed qualitatively in terms of project quality (ranging from 0 to 1), and quantitatively in terms of energy use intensity (kWh/m2). The results of this case study are compared to another green office building located in the UK. The cross case mismatch between qualitative and quantitative results is due to four factors that performed better in reality that they were designed. It is demonstrated that multiple factors could help to increase building performance more than single factor especially when management cost was considered. The comparison of the two cases in China and the UK, shows that design factors should be treated in a more stringent way instead of referring values from local standard authorities only which could induce overdesign of the buildings.

The “performance gap” in the United Kingdom construction industry is a persistent problem as new building development projects underperform more often than not. The “performance gap” is partially attributed to the number of stages involved in building project development and the coordination difficulties of partners with different incentives. The project outcome is important for energy consumption, carbon emissions and occupant well-being. Thus, it is important to study the project management process in terms of the standard time, cost and quality parameters, but also in terms of project partner incentives and coordination, and the subsequent energy performance and resultant indoor environmental conditions. A system dynamics model of project management processes is developed to explore the implications of partner coordination for building quality. The system dynamics model is coupled to a building performance simulation model to explore building energy consumption and Indoor Environmental Quality, and apply this on a recent building project case study. Results show that greater project partner alignment can reduce annual energy consumption up to 12% and CO2 emissions up to 37%, with greater emphasis in the design stage of the project subject to resource availability. The trade-offs involved on value appropriation are considered and discussion of results points to possible ways for improvement.

Background At least 145 urban health indicator (UHI) tools exist internationally. Previous studies have shown that public health researchers and practitioners produce them to inform built environment policy and decision making. Little research exists on their use and how it affects policy. This study used qualitative system dynamics to investigate the benefit and use of UHI tools to promote health in the complex context of urban planning policy and decision making. Methods This qualitative system dynamics study involved semistructured interviews with indicator producers (typically public health professionals) and indicator users (typically urban planners) in case study settings of San Francisco (CA, USA), Melbourne (VIC, Australia), and Sydney (NSW, Australia) to ascertain experts’ understandings (or mental models) of the use (ie, direct reporting of) and value (ie, knowledge gained leading to policy changes) of UHI tools in urban planning policy and decision making. Exemplifying cases of UHI tools (ie, those designed with characteristics to support policy makers) were selected from the literature and we used purposive sampling to approach potential interview participants through departmental websites and the professional network of HP. We did a thematic analysis using collaborative rationality and systems theories. We constructed causal loop diagrams (CLDs) using system dynamics methods (CLDs represented participants’ mental models). We tested whether our preliminary CLDs corresponded to experts’ views through a participatory workshop. Findings Interviews took place on April 5–7, 2016, with six participants in the USA, and March 13–22, 2018, with 16 participants in Australia, and the workshop was on Jan 16, 2019, with six participants in the USA. Indicator users and producers had overlapping mental models of the value and use of UHI tools, and workshop participants broadly agreed with the CLDs. The thematic analysis produced five themes that were represented in CLDs, summarised as follows. Developing and applying UHI tools increases knowledge of the social determinants of health and intersectoral relationships. This supports actors to better understand each other's perspectives and helps create new advocates for health in diverse organisations, supporting health-in-all-policies or whole-of-society approaches. Community involvement in UHI tools and having effective advocates for health reduces obstacles to health-promoting policy. However, the high number of available indicators can create confusion and reduce indicator use. Interpretation UHI tools influence local urban planning when they are embedded in policy processes, networks, and institutions, which often requires long-term funding. Indicator producers should consider such resource requirements and the potential for co-producing indicators to create intersectoral relationships and better respond to users’ information needs. Further research is needed to explore how UHI tools affect the power of different actors in governance processes, particularly of under-represented communities. Funding The Building Research Establishment (BRE) and BRE Trust.

Background Urban health indicator (UHI) tools offer one form of evidence about the urban environment's impact on health to inform built environment policy and decision making, particularly in relation to health and spatial inequalities. Many UHI tools have been developed, potentially duplicating scarce resources, with little knowledge of their subsequent impact on policy. This study aimed to examine the nature and characteristics of UHI tools to increase understanding of their potential use by municipal built environment policy and decision-makers. Methods The methods of this systematic review are detailed in our published protocol, including a PRISMA-P checklist. We defined UHI tools as compilations of UHIs that needed to measure at least two physical urban environment characteristics. We searched seven bibliographic databases, four key journals, and six practitioner websites, and conducted Google searches between Jan 27, 2016, and Feb 24, 2016, for UHI tools. We extracted data from primary studies and online indicator systems. Findings We included 198 documents, which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy of indicators (using a hybrid inductive and deductive approach). The diversity in UHI tools was extensive with respect to topic, spatial scale, format, scope, and purpose, which we identified as key taxonomic classifiers. Over time, the proportion of UHI tools that measured data at the neighbourhood and lower scale increased, as did the proportion of tools that presented data via interactive maps. This increase reflected growing analytical capability, and offered the potential for improved understanding of the complexity of influences on urban health (an aspect noted as being especially challenging by some indicator producers). Interpretation UHI tools of increasing sophistication provide insights into multiple dimensions of the urban environment and their impacts on health, but they are not always used in the policy and decision-making process. In addition, many indicators have only an indirect association with health impacts attributable to modifiable urban environment characteristics. Further research is needed to understand the form and presentation of indicators that are of greatest utility to built environment policy development, and that reflect community input and health and development priorities. Funding HP is fully funded by the Building Research Establishment Ltd. HR was supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust.