The ecosystem model of health determinants relating to the built environment developed by Barton and Grant (2006) is widely used, including by the World Health Organisation, to aid understanding of the interactions between different aspects of society and the environment. Based on work by Whitehead and Dahlgren (1991) it provides an holistic model of the relationship between people, their quality of life, and their local and global environment.
The Settlement Health Map
Such models provide an important framework for considering the wider health impacts of development. It is through the wider consideration of opportunities to secure improvements to health and wellbeing that real improvements in health outcomes are achieved.
The checklists of factors to consider when undertaking health impact assessments, including HUDU’s rapid health impact assessment tool, derive from this wider view of health rather than focussing more narrowly on simply the impacts on health services and facilities.
Equally, the wider determinants are key to understanding and tackling health inequalities.