Health Opportunity Architecture
Leveraging Determinants of Health to create better Health Opportunity Architecture.
While there is great emphasis on people needing to change their behavior to be healthier, a fundamental driver of entrenching and increasing health inequalities globally is the lack of opportunities for people to engage in lifestyles that can keep them healthy. In this WG, we aim to explore how determinants of health (social, environmental, digital, commercial, political) can be leveraged to design and implement better health opportunitiy architecture so all people can have an opportunity to be healthy and well.

About
The key leverage points for delivering population health are Determinants of Health (DoH):
"(1) Any factor, whether event, characteristic, or other definable entity, that brings about change in a health condition or other defined characteristic […]
(2) A primary risk factor (causative factor) associated with the level of the health problem, that is, the level of determinant influences the level of the health problem."
(Kindig 2007)
DoH are fundamental causes of health and wellness because they control availability and access, and thus opportunity, to factors that can impact health such as information, money, power and social capital. Furthermore, DoH are beyond the control of individuals within the population but can have population level effects (Alberti and Pierce 2023). DoH can be broadly disaggregated into 5 sub-types:
- Social
- Environmental
- Digital
- Commercial
- Political
In this Working Group, we focus on understanding how DoH shape, and can be used to shape, health opportunity architecture to promote health and wellbeing.
Key research areas
Exploring how:
- Determinants of health shape health opportunity architecture,
- The intersections and interactions between different determinants shapes health opportunity architecture,
- Determinants of health can be leveraged to shape health opportunity architecture to promote health and wellbeing for all
Selected publications
- Jani, A. (2025). Value-based determinants of health: The route to improving population health. In L. Hager, U. Hahn, F. Knieps, B. Klapper, B. Lutz, B. Simon, & J. Nüsken (Eds.), Gemeinschaftsprojekt Gesundheit: Wie Value-Based Care das Gesundheitswesen neu erfindet (pp. 60–74). Medizinisch Wissenschaftliche Verlagsgesellschaft. Read chapter (PDF).
Projects
FEAST
Food systems that support transitions to hEalthy And Sustainable dieTs

Through HORIZON-CL6-2021-FARM2FORK-01-15, FEAST aims to support European food systems to shift away from the current ‘Lose-Lose-Lose-Win' food systems that sees only large food corporations ‘winning’ at the expense of enormous negative consequences for the environment, health and the public sector. The project develops catalysts to shift to ‘Win-Win-Win-Win’ food systems through transition that is just and equitable – vulnerable groups and those facing health inequalities will be front and centre in our project to ensure their needs are met and that food systems are augmented so that all of Europe’s citizens can benefit from healthier and more sustainably produced diets.
HEAL
Health-oriented agri-food systems transformation

The HEAL network aims to address existing gaps and lead an intersectoral, multi-level integration of health and agri-food systems. We seek to bring Health in All Policies (HiAP) and Health for All Policies (H4AP) considerations into research, practices and policy recommendations. Representing upstream and downstream research and practice along the agri-food systems value chain, we are a transdisciplinary team with expertise in agriculture, health, political science, gender studies, communications, business, computer science, logistics, data analysis and modeling and simulation. With HEAL partners in Heidelberg, Stuttgart, and Böblingen, our team is located in three of the top four city/urban districts on Baden-Württemberg's Innovation Index 2022 (B-W 2022).
CUES
Consumers’ Understanding of Eating Sustainably

CUES addresses the urgent need for a more sustainable food system that benefits the environment, society, and the economy. The project aims to foster a Triple Change in the food system concerning culture, food value chain, and policy. To this end, CUES will pilot nine food system interventions and policy dialogues, actively involving consumers, food value chain actors and policymakers. A learning community and toolkits for behavioural change and communication will be developed to motivate 3 million consumers to make sustainable food choices.
Invest4Health
Mobilising novel finance models for health promotion and disease prevention

The project’s mission is to enhance health promotion and disease prevention by incentivising investments and asset maximisation in these critical areas. The need for change is undeniable. With public finances in a fragile state and ongoing efforts to recover from the pandemic, we need cost-effective strategies that span multiple sectors and ensure the efficient utilisation of available resources. It’s time to let go of outdated practices and embrace the wisdom of prioritising prevention over reactive solutions. Prevention and health promotion are not just a cost but a valuable investment that brings personal, societal, economic, and environmental benefits.
To make this vision a reality, the project consortium combines interdisciplinary expertise with real-world test beds in diverse health ecosystems. We’re developing innovative smart capacitating investment (SCI) models, testing them in practical settings, and creating a roadmap for large-scale implementation. To empower citizens and local communities to participate in decision-making and ensure their voices are heard actively, the project will work with the industry to design and test a collaborative platform that offers broader opportunities to actively involve local communities in new governance mechanisms for smart capacitating investments. Delivering tangible results, the project’s validated smart capacitating investment models and tools will enable decision-makers and policymakers to prioritise risk- sharing and resource pooling for health promotion and disease prevention at all levels. Demonstrating the value of smart financing through return-on-investment analysis and strategic pricing, Invest4Health aims to inspire health insurers and funders to invest in effective and efficient services for active and healthy living.
CARE
Countryside access, recreation, and environmental stewardship

There is a drive to increase people's exposure to nature through outdoor exercise and contact with nature given the many health and wellbeing benefits this provides. At the same time, however, there is also a need to ensure that nature is protected - there have been a number of incidences across the UK of undesirable actions and activities taking place, including damage to property and the environment. Many of these incidents came about as the result of a lack of understanding of how to engage positively with the natural environment, rather than
by deliberate acts of damage.
Natural England, which helps the government protect England’s natural places (nature and landscapes), is conducting a series of surveys and pilots tests as part of the CARE (Countryside Access, Recreation, and Environmental Stewardship) project to identify strategies to design solutions that will help people to engage with nature in a way that maintains and preserves it in line with the Countryside Code. The project is being run in collaboration with the University of Oxford, Blenheim Palace, Eden Project, The Ramblers and Oxfordshire County Council. The results will be published as part of a Natural England Research Report.
Team
Dr. Susan T Jackson

Group Co-Leader
Dr. Anant Jani

Group Co-Leader
Prof. Dr. Dr. Till Bärnighausen

Group Co-Leader

Heidelberg Institute of Global Health
University of Oxford (UK)
Group Co-Leader
