Future Research Directions

This research provides an initial step towards understanding barriers and enablers to the uptake and delivery of healthy planning and active living initiatives. There is likely value in future research exploring the following aspects in greater detail:

• Adopting a socio-ecological perspective on the determinants of health but then focusing predominantly on built form changes to encourage one determinant (activity levels) of health (albeit an important one given current health trends across the globe and in Australia) is a limitation of many ‘healthy planning’ initiatives and studies across the world (including this research). There is room for the healthy planning field as it currently exists (including in Australia) to consider more encompassing concepts such as EcoHealth (for instance, see Kingsley et al., 2015; Saint-Charles et al., 2014; Wilcox et al., 2004) and planetary health (Capon et al., 2018; Editorial, 2017; Horton & Lo, 2017; Lerner & Berg, 2017). While there is emergent Australian work on this in the liveability field (Lowe et al., 2015) and with regard to climate change (Zhang & Beggs, 2018), further widening the scope of ‘healthy planning’ to focus on the links between built environment changes, human well-being and planetary health is likely to be a rich (and important) area of future work.

• The findings of this research are relatively broad, and it is hoped they will have relevance for Australian LG across administrative boundaries, however these could provide a starting point for more detailed studies. This might involve the examination of the identified barriers and enablers at a micro scale such as through the use of specific cases of implementation, and within a single LG.

• Further to above, while the findings are relatively broad and hoped to have applicability to global contexts in which governance structures reflect those of Australia, or in settlements facing similar challenges (such as NCD prevalence) as Australian communities, there is likely value in undertaking similar assessments in different global contexts, cultures and governance structures. This might provide for comparisons between settings and could also further inform comparative analysis of the Australian state-of-play against other countries, particularly where international case studies and best practice examples globally were explored.

• Employing data saturation limited the sample size collected and also limited a sample that included all states or equal representation amongst professions and fields of employment to be achieved. Purposive sampling employed for survey collection and purposive key informant sampling employed for the semi-structured interviews also reduced the representativeness of the sample across states or professions. The findings of this research could be extended to future research employing random sampling and potentially a larger sample size, which could in turn allow for a more representative sample across states or fields of employment to be achieved.

• The exploratory nature of this research, particularly focused at the reasons for the slow uptake of healthy planning and active living initiatives, led to the employment of qualitative methods. It is noted that quantitative analyses are less commonly employed in research in the healthy planning and active living field, and that such are likely to have value in future research. It is anticipated that the qualitative findings from this research will inform future quantitative research in the field, including but not limited to quantitative comparative analyses and quantitative case study comparisons such as those between specific cities, towns or communities.

• The perception by advocates that it was not viable to discuss the details of what healthy planning and active living initiatives entail presents a barrier on multiple levels and has generally not been tested in the literature. Future research could compare community perceptions regarding general notions of community health (such as ‘well-being’) and more specific components (such as activity levels) against details of what changes to improve community health might entail.

• The scope of this research limited it to considering project uptake and implementation, yet various structural barriers to healthy planning also emerged, such as the limited legislative powers of LG in the Australian governance setting and cultural factors relating both to urban planning practice and the community, including a planning system that due to current practice and standards preferences (in many cases inadvertently) the creation of obesogenic environments over more sustainable forms that are health promoting. These structural barriers could be examined in further detail, such as examining failed projects.

• The two approaches recommended as potential ways to advance healthy planning in Australia are through health by stealth and the framing of health as an urban planning issue to be addressed by LG. The clear tensions between these approaches (and lack of agreement amongst practitioners and advocates over which is a more effective approach) could be further examined.

• Given findings on the value of health by stealth that emerged during the research (after the scope of the thesis was set), it is likely that this study overlooks projects that were not explicitly framed as benefiting health but that nevertheless provided community health benefits, such as through increased opportunities to participate in physical activity. Future research could examine the barriers and enablers to projects where concepts of health by stealth are employed (such as where projects are framed to be primarily driven by economic considerations). Related to the previous point, a comparison of the effectiveness of these two approaches might be beneficial.

• Limited consideration in the healthy planning field has been given to who actually participates in the decision-making process. Examining public participation generally, as well as with a focus towards indigenous and culturally diverse people with regard to participating in, making decisions about and organising such initiatives might provide useful insights.

• Research into barriers and enablers could also be undertaken to the other key built form contributors to healthy living, being healthy eating and connected communities. A comparison between the factors that impact the three contributors might then be possible.