New review links public health with spatial planning.
Professionals in the built environment have always been interested implicitly or explicitly in the relationship between place and wellbeing, yet there there is little clarity on effective design and policy measures that link the two areas of public health and spatial planning.
A newly published 2017 review carried out by BRE in partnership with both the planning and public health departments of the Southwark and Lambeth Councils, sponsored by the Guy’s and St. Thomas’ charity, attempts to remedy a deficit in “causal evidence” that might help to address “competing policy priorities and differing cultures of practice” between health and planning..
Professor Kevin Fenton, Director of Health and Wellbeing at Southwark Council explains in the introduction: “This timely literature review investigates the relationship between place, planning policy and three locally identified health themes of interest: social isolation, obesity and access to health services.”
The “healthy planning” project led by Southwark and Lambeth seeks to “combine extensive local knowledge with scientific evidence” in the approach to planning healthy communities and hopes that sharing their findings from this review can help other planning authorities to get access to evidence and examples of community engagement and policy which may work for them.
It found a range of innovative community engagement and planning activities being carried out, which “often related to specific major developments or funded projects and do not yet appear to be part of normal planning processes”. The review recognises the importance of local context and that solutions may not always be transferable; however the overarching message is to recognise the value in engaging local communities to help policies and design respond to local problems and assets.
Principal findings about healthy built environments are:
Social interaction – Greater effort in planning should be made to consult with older people and young parents (who may be more socially isolated because of local built environment characteristics) to understand better the features of the built environment that encourage social engagement, which can include: mixed land use; residential density; green space; street layout and design and particularly the interface between between public and private space in relation to crime and antisocial behaviour; public transport; and local facilities for leisure and recreation and community activities.
Physical inactivity – Closely related to the factors which relate to social isolation or interaction, there is a positive correlation between levels of physical activity, street design and density (of housing, circulation intersections, public transport and parks or other green spaces). Increased urban sprawl, traffic density and speed can be associated with obesity.
Health services – A move towards ‘integrated care’ combining health services and social care services can reduce the level of non-emergency cases attending A&E, duration of hospital stays, and “costs per patient per site visit”. A Big Lottery Fund evaluation of Healthy Living Centres (co-locating health and social care facilities) shows a range of community benefits.
The review also notes that a complex set of factors influences local food culture; however the diets of children may be more influenced by density of local convenience stores and fast-food outlets than for adults. However greater availability of healthy foods through local stores and markets may not in itself change behaviours without community engagement “to understand current attitudes and requirements”.
Source: Pineo, H. 2017. Healthy Planning and Regeneration: innovations in community engagement, policy and monitoring. BRE, Watford.