A new framework to consider equity in urban intervention planning, implementation and evaluation: development and application in a case study on an urban play spaces policy

Improving population health while addressing social inequalities is a key challenge for public health strategies, particularly in urban settings. Effective interventions must consider the unequal distribution of both beneficial and harmful environmental exposures, as well as differential vulnerabilities. The Health in All Policies (HiAP) approach emphasises the role of multiple sectors in shaping health outcomes. To ensure equity, interventions should be assessed for their impact on social inequalities in health, considering the dimensions of environmental justice. We therefore developed a framework, consisting of a logic model of the intervention process with an equity-lens, to incorporate equity aspects into urban interventions to prevent the creation or exacerbation of health-relevant inequities in the urban environment. The framework was developed through extensive literature searches, inter- and transdisciplinary discussions and with expert knowledge. In this paper, we demonstrate its applicability using the example of a case study focussing on planning and implementation of play spaces in Utrecht, NL. Incorporating equity into practice is challenging and requires interdisciplinary efforts to bridge the gap between theoretical consideration of equity aspects and the actual realisation in an intervention process. Our comprehensive framework addresses all phases of urban interventions (initial situation, planning, implementation, evaluation), emphasises environmental justice, and incorporates the HiAP approach, making it a versatile tool for equity assessment across sectors. Applying the framework to the case study revealed previously overlooked equity aspects and highlights how thorough consideration of equity aspects in urban intervention planning, implementation and evaluation will promote health equity. The new framework consisting of a generic logic model and an equity-lens can be adapted to and specified for urban interventions to address equity-relevant issues. In the context of sustainable urban development, the framework is intended to support integrating social and health equity as fundamental principles for the planning, implementation and evaluation of interventions.