Urban Liveability: Emerging Lessons from Australia for Exploring the Potential for Indicators to Measure the Social Determinants of Health

It has long been recognised that urban form impacts on health outcomes and their determinants. There is growing interest in creating indicators of liveability to measure progress towards achieving a wide range of policy outcomes, including enhanced health and wellbeing, and reduced inequalities. This review aimed to: 1) bring together the concepts of urban 'liveability' and social determinants of health; 2) synthesise the various liveability indicators developed to date; and 3) assess their quality using a health and wellbeing lens. Between 2011 and 2013, the research team reviewed 114 international academic and policy documents, as well as reports related to urban liveability. Overall, 233 indicators were found. Of these, 61 indicators were regarded as promising, 57 indicators needed further development, and 115 indicators were not useful for our purposes. Eleven domains of liveability were identified that likely contribute to health and wellbeing through the social determinants of health. These were: crime and safety; education; employment and income; health and social services; housing; leisure and culture; local food and other goods; natural environment; public open space; transport; and social cohesion and local democracy. Many of the indicators came from Australian sources; however most remain relevant from a 'global north' perspective. Although many indicators were identified, there was inconsistency in how these domains were measured. Few have been validated to assess their association with health and wellbeing outcomes, and little information was provided for how they should be applied to guide urban policy and practice. There is a substantial opportunity to further develop these measures to create a series of robust and evidence-based liveability indices, which could be linked with existing health and wellbeing data to better inform urban planning policies within Australia and beyond.