What conditions need to be in place for spatial planning and public health to integrate effectively? This paper argues that planning scholarship has prioritised how integration should work, without first ascertaining whether the foundational conditions for integration exist. Inspired by a growing body of research and best practice on integrating the two disciplines, the 4 E's Evaluative Framework was developed in response to a critical gap. Existing analytical tools carry assumptions about institutional capacity and governance maturity that reflect the established systems in which they were developed, rendering them poorly suited to contexts where integration is emergent rather than embedded.

The 4 E's Evaluative Framework, comprising Equity, Embeddedness, Enabling Environment, and Evidence, represents an original methodological and theoretical contribution to this problem. Grounded in critical realism and systems thinking, the framework is designed to assess the structural and governance conditions that enable or constrain planning-health integration, before evaluating how effectively it operates. Drawing on regional planning policy and comparative local council practice in Northern Ireland, the framework maps the current state of planning-health integration and identifies structural gaps across both scales.

Northern Ireland provides an illuminating case, a devolved, post-conflict jurisdiction where planning and public health operate within parallel traditions, health considerations appear inconsistently across Local Development Plans, and governance fragmentation shapes what integration is structurally possible. The paper proposes emergent governance contexts as a distinct analytical category within planning theory, with implications for how the field conceptualises the relationship between institutional structure, knowledge production, and health-equitable outcomes.