Health improvement and inequality in local authority green infrastructure strategies in England: a policy review

INTRODUCTION: Green spaces are increasingly recognized as critical to public health. This study examines English local planning authorities' green infrastructure strategies, evaluating how health improvement and inequality reduction goals are integrated. METHODS: A quantitative content analysis was conducted on publicly accessible green infrastructure strategy documents. Of 305 potential authorities, 133 (44%) were included based on eligibility criteria. Only strategies published from 2012 onwards were included. Data were coded across themes: health policy and actors, health outcomes, demographics and inequalities, environmental change and health. A scoring system quantified consideration of health and inequality, with descriptive statistics summarizing thematic presence, frequency, regional variation, and temporal trends. RESULTS: The integration of health and inequality varied substantially. Most strategies referenced general health outcomes, but fewer detailed actions targeting health inequalities or specific demographic groups. Regional differences were observed, and methods for monitoring health impacts were limited. CONCLUSION: Local green infrastructure strategies in England increasingly recognize their health improvement potential, but inconsistent integration of health and inequality may limit impact. Stronger collaboration between planning and public health is needed to create equitable, accessible, health-promoting environments. Future research should explore longitudinal health impacts and identify best practices for integrating health equity in spatial planning.