Periodic Reporting for period 1 - HORUS (Health Outcomes from Raised Urban Settings)
Reporting period: 2023-12-01 to 2025-05-31
Non-communicable diseases (NCDs), particularly cardiovascular diseases and diabetes, are the leading causes of death and long-term disability globally. These diseases disproportionately affect vulnerable urban populations—such as low-income groups, migrants, and ethnic minorities—who often face social and environmental disadvantages, reduced access to preventive care, and limited opportunities for healthy behaviours. Within this context, the HORUS project (Health Outcomes from Raised Urban Settings) seeks to address systemic health inequalities by focusing on how the urban built environment contributes to NCD risk factors and how it can be leveraged to promote health equity. The project aligns with pressing European and global health priorities, aiming to mitigate the burden of NCDs through targeted, evidence-based urban interventions.
The overarching objective of HORUS is twofold: first, to comprehensively analyse the causal links between urban environmental characteristics and NCD risk behaviours; and second, to implement and evaluate co-designed pilot interventions across Spain, Croatia, and the Netherlands. These interventions are tailored to promote sustainable behaviour change and health empowerment in vulnerable communities by improving how individuals interact with their physical surroundings. The pathway to impact is grounded in an interdisciplinary approach that integrates public health, urban planning, social sciences, and behavioural research. The project’s expected outcomes include a reduction in modifiable risk factors and health disparities, as well as practical guidance for policy makers and urban planners across Europe. By addressing the socio-spatial determinants of health, HORUS aims to generate scalable and transferable knowledge that contributes significantly to EU strategies on disease prevention, urban sustainability, and health equity.
The overarching objective of HORUS is twofold: first, to comprehensively analyse the causal links between urban environmental characteristics and NCD risk behaviours; and second, to implement and evaluate co-designed pilot interventions across Spain, Croatia, and the Netherlands. These interventions are tailored to promote sustainable behaviour change and health empowerment in vulnerable communities by improving how individuals interact with their physical surroundings. The pathway to impact is grounded in an interdisciplinary approach that integrates public health, urban planning, social sciences, and behavioural research. The project’s expected outcomes include a reduction in modifiable risk factors and health disparities, as well as practical guidance for policy makers and urban planners across Europe. By addressing the socio-spatial determinants of health, HORUS aims to generate scalable and transferable knowledge that contributes significantly to EU strategies on disease prevention, urban sustainability, and health equity.
During the initial reporting period, the HORUS project has made substantial progress in laying the scientific and methodological foundation for understanding and addressing the links between the urban environment and non-communicable disease (NCD) risk factors. Key achievements include the development of a comprehensive conceptual framework that integrates insights from public health, behavioural science, and urban planning. This framework is designed to guide the collection, integration, and analysis of data on environmental exposures, behavioural determinants, and health outcomes.
A major technical milestone has been the finalisation of the co-creation methodology, which will be applied to the participatory design of pilot interventions in selected neighbourhoods across Spain, the Netherlands, and Croatia. Extensive stakeholder mapping and local health context analyses have been conducted, leading to the identification of target neighbourhoods in each pilot site. The project has also begun primary data collection through co-creation sessions and surveys tailored to vulnerable groups in these communities. Additionally, ethical approvals and data protection protocols have been established, ensuring compliance with GDPR and ethical standards across all research activities. These achievements collectively establish the groundwork for the implementation and evaluation of tailored urban health interventions in the next phase of the project.
A major technical milestone has been the finalisation of the co-creation methodology, which will be applied to the participatory design of pilot interventions in selected neighbourhoods across Spain, the Netherlands, and Croatia. Extensive stakeholder mapping and local health context analyses have been conducted, leading to the identification of target neighbourhoods in each pilot site. The project has also begun primary data collection through co-creation sessions and surveys tailored to vulnerable groups in these communities. Additionally, ethical approvals and data protection protocols have been established, ensuring compliance with GDPR and ethical standards across all research activities. These achievements collectively establish the groundwork for the implementation and evaluation of tailored urban health interventions in the next phase of the project.
The HORUS project is generating results that go beyond the current state of the art by advancing an integrated, systems-based approach to understanding and addressing the socio-spatial determinants of non-communicable diseases (NCDs) in vulnerable urban populations. Existing research typically addresses environmental health risks, behavioural interventions, or urban planning in isolation. In contrast, HORUS combines these domains into a unified framework that links granular environmental data with behavioural and health indicators, supported by participatory methodologies. The co-creation framework developed within HORUS is particularly novel in its structured integration of community engagement, spatial data analysis, and behavioural change theory—laying the groundwork for context-sensitive interventions that are both inclusive and scalable.
Looking ahead, the project has identified key enablers to ensure further uptake and success of its results. These include the need for sustained demonstration activities and pilot evaluations that can generate robust evidence on effectiveness and replicability in diverse urban settings. Moreover, pathways to impact will require supportive regulatory and planning frameworks that can institutionalise the integration of health equity objectives into urban policy. Further research will also be needed to refine and scale the analytical tools and methodologies developed. To promote uptake, HORUS is fostering alignment with national and EU-level strategies on public health and urban resilience. While the current focus is not commercial, future opportunities may arise for IPR protection and the development of data-driven tools for municipalities, urban planners, or public health authorities. The project’s transdisciplinary nature and early engagement with local stakeholders and policy actors position it to contribute meaningfully to long-term structural change.
Looking ahead, the project has identified key enablers to ensure further uptake and success of its results. These include the need for sustained demonstration activities and pilot evaluations that can generate robust evidence on effectiveness and replicability in diverse urban settings. Moreover, pathways to impact will require supportive regulatory and planning frameworks that can institutionalise the integration of health equity objectives into urban policy. Further research will also be needed to refine and scale the analytical tools and methodologies developed. To promote uptake, HORUS is fostering alignment with national and EU-level strategies on public health and urban resilience. While the current focus is not commercial, future opportunities may arise for IPR protection and the development of data-driven tools for municipalities, urban planners, or public health authorities. The project’s transdisciplinary nature and early engagement with local stakeholders and policy actors position it to contribute meaningfully to long-term structural change.