Can the implementation of net gain requirements in England's planning system be applied to health?

James Stewart-Evans, Caglar Koksal, Michael Chang

Research output: Contribution to journalReview articlepeer-review


This Personal View considers the relationship between spatial planning and health and the potential benefits of requiring health net gain from land use decisions and new developments. We explore how a health net gain objective could be applied in spatial planning policy and practice to improve people's health and wellbeing, using England's implementation of a biodiversity net gain objective as a model. This Personal View emphasises the need for a systems approach to the definition and strategic coordination of health gains, recognising the breadth of health determinants and inter-related economic, environmental, and social policy objectives. By considering the potential application of a net gain principle to health in spatial planning, we offer valuable insights into how the spatial planning system could be used to build the conditions of health creation. A road map is provided for exploration of health net gain in other national contexts in support of the operationalisation of global urban health initiatives.

Original languageEnglish
Pages (from-to)e188-e196
JournalThe Lancet Planetary Health
Issue number3
Publication statusPublished - 5 Mar 2024


  • spatial planning
  • net gain
  • biodiversity net gain
  • urban planning
  • health improvement

Research Beacons, Institutes and Platforms

  • Global inequalities
  • Healthier Futures
  • Manchester Urban Institute


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