Planning and healthy cities. Volume 2


I cant speak the language of planning.

Nor to I have anything like anything other than a rudimentary understanding of the systems or the law in this space.

Here are some cliff notes on why planning is so very important for our health.

“Health” people (aka NHS or indeed public health professionals aren’t the answer), it needs to be addressed through the local and national planning framework.

1 Why is planning process important to health

Crap places kill people.

Good places can be good.

We wont solve the crisis in adult social care or NHS by more adult social care (or NHS), we will solve it by primary prevention, planning better places where we move more, are less fat, drink a bit less, more socially cohesive etc

The National Planning Policy Framework mentions “health” in passing. My guess is that most pay lip service to it. The way we organize urban living, and the planning system is a huge opportunity for improving well being (and by default) health outcomes, directly and indirectly – health and ecological damage: for instance higher levels of inequality and extreme poverty, and poor air quality.

Well being is arguably a core organising concept for role of local govt. Planning process has an important role in this.

2 What’s the ask

The challenge is to design a city where well being (for eg using the Five Ways to Well Being as the default operating model) is priority from individual through to neighbourhood then to city.

Should the default expectation be that OUR planning process leads to more “health” being created than may happen by path of natural default.

In simple terms the challenge is to create a city that is less fat, more active, more socially cohesive where well being is the default and easiest option.

Will and can the planning process effectively reinternalize the externality? The development process may seek the path of least resistance, developers certainly will. That may set up externalities. The externalities of that are felt elsewhere by others in the present and in the future. Essentially the privatisation of profit of development, socialisation of risk.

3 probably five main areas of work

Can work at multiple levels – policy, strategy, SPD – develop policy, review applications with a particular lens, support planners put “health” into applications.

1.Planning policy development – both Core Strategy, SPG. What does “health” as a core part of core strategy actually mean?

2.“health” as a consequence of planning applications and downstream consequences on other sectors. ‘health in all policies’ in policy development, SPG, application, early work with developers. Mitigation of negative effects, optimisation of positive potential at all stages. Minimising barriers to being healthy – make it as easy as possible to be healthy, if we haven’t done this its hard to talk about how people should be changing their lifestyles

3.Support planners (policy, strategy, SPD) with planning process – develop policy, review applications with a particular lens, support planners put “health” into applications.

4.Proactive planning – a list of considerations that prospective developers might consider. Prioritisation process of planning prioritises against the list.

5.Community impact assessments and formal HIA. What is the voice of communities in the planning process

4 What – some specific target areas
I don’t speak “planning” or have a good understading of the process. Here are some suggesitons


• I wouldn’t over focus on Health Impact Assessment. Quickly can become tick box in nature.

Extent to which we expect HIA and other forms of impact assessment in major and minor pieces of planning work. Formal and informal. Externally commissioned and done quick and dirty. Where WE think there’s most gain to be had, rather than pushes from external stakeholders (eg Bannerdale vs most of Eastern Sheff)


Develop / deploy list of considerations that prospective developers might consider. Prioritisation process of planning prioritises against the list.

PH role in helping our own planners in dealing with the opposition. Contextualising risks, push back against poor quality evidence put forward by developers – who will be keen to develop as cheaply as possible. Externalities of that cheap development will be felt by others in the future.

Use of space, physical and social

Land use and mix, land density – Social regeneration – and role of planning in this. Not segregated – socially mixed developments. Build on the Glasgow research, referenced at bottom. Social regeneration – and role of planning in this. Not segregated or “gated developments” – socially mixed developments. Build on the Glasgow research, referenced at bottom. Location issues (mixed developments, not all executive housing in zone x and social housing in zone y)

safe, convenient, accessible, well designed built environment and interesting public spaces and social infrastructure that encourages community participation and social inclusion for all population groups including: older people, vulnerable adults, low income groups and children.

Pay close attention to who lives where – cities are diverse mixes of classes, ethnicities, cultural memory, immigration history, vested interests – and development which doesn’t consider this will be a long term failure. See Mike Nightingale Trust (SA) and the Glasgow University work in this area. Implications here in terms of gentrification.

• Manage land value in public interest

• Retail Offer – not all takeaways

Carbon, sustainability and environment

greening applications, enabling developers to make more attractive and saleable developments (profit), that go through DC more smoothly.

Resilience of developments and cities – floods, AQ. City resilience needs much more prominence. Moving focus within EPPR work from extreme shocks to long term stressors.

• Climate change – impact of planning policy. Long term infrastructure – the drains? Open and green space.

Planning process should work to support a huge upgrade in public transport and active travel so that every drop of oil possible remains in the ground and every drop of physical activity is squeezed out of city space –

Does planning process embed low carbon technology as the default

Links between planning function and others

links between policy / DC and academic depts. Encourage deeper links

links between policy / DC and communities. How does this operate. Expectation that planning process actually links to communities. Taking a CD approach – getting to talk to developers, finding out their issues and concerns / constraints. Actively promoting and enabling community leadership and participation in planning, design and management of buildings, facilities and the surrounding environment and infrastructure

Transport and travel

What are the transport implications of development – air q, activity, carbon and sustainability, active travel and move more. Active travel infracstucture should be hardwired

walkable environments being the default option and the hierarchy given to different modalities of transport – car = last etc. see the Arup report… walkable environments being the default option and the hierarchy given to different modalities of transport – car = last etc. See also the TfL Healthy Streets initiative. walkable environments being the default option and the hierarchy

Transport / housing / employer links – issues around agglomeration. There’s something to be said about building employment zones miles away from residential zones and how this structurally builds in air pollution, car use (and the sitting this entails) etc.


food environment, activity, obesogenic environment etc. hot food outlet density. Concentration. We don’t need any more concentration of fast food. How do we use SPG to change the food environment. Obesogenic environment etc. access to fresh, healthy and locally sourced food (e.g. community gardens, local enterprise) and managing the type and quantity of fast-food outlets.

Green space

Open green space – mental well being, activity. building green space, municipal space, parks / playgrounds INTO new developments the default – activity, mental well being, Open green space – should be hardwired into new developments, ditto Play facilities. See that design council blog. convenient and equitable access to a range of interesting and stimulating open spaces and natural environments built into all developments as default. (“green” and “blue” spaces) providing informal and formal recreation opportunities for all age groups.

Invest in clever use of green space – horizontal, vertical, diagonal, planted, vegetables, water features – evidence on positive mental and physical health effects is now very strong (though some caveats e.g. allergenic effects, trees trapping air pollution)

Housing and homes

Housing standards – trip hazards, cold homes and insulation, housing design, disability and all age friendly homes as default. Lots to learn from SHU here. Healthy building standards inc Age and disability friendly housing. Built in the principles of lifetime neighbourhoods and promotes independent living.

• Exploit new types of standards emerging (e.g. Well Building) which combine livability, environmental impact, reducing building sickness syndrome. The cost of a building over a typical lifecycle – looking at rent, maintenance, and salary and benefits of those who use the building – is 90% sunk into the salary and benefits of workers so need to invest in spaces which work for people


living wage type as a default expectation in applications for new retail or industry developments

• Noise pollution

Demographic stuff and planning health care facilities within developments

Building in community safety into design– defensible spaces, planning out crime, reclaim the streets, space for community events and gathering

Consideration of the structural, macroeconomic models underlying cities within the planning system. No one sector – public, private, third holds all of the cards, and each is reliant on each other. Cities have a role in redefining our approach to economic development, planning has a role in this.

Can planning acellerate the notion of local healthcare systems as economic anchors

5 It’s more work

This isn’t about “more work” – were all busy enough…. Yes of course capacity is an issue. But we simply have some shared aims.

If we get it right  we will create far more health than all the cities doctors put together. If we don’t, we will continue to have adult social care and health system that struggles to meet demand. If we don’t get it right the NHS and Social Care will have no choice but to continue to react – it cant solve the problems that are created elsewhere. Some of this is built envirionment, some is social, the mix of the two is akso important

What if any take do the planning committee have on this?

Worth exploring with key members as well as key officers – what do they think their role is.


ADPH submission to Raynsford

healthy new town principles:

NHSE Healthy Towns

Cities, urban design, sustainability, health: some reflections on Health City Design International 2017

The health impact of planning

Worth a look at this V useful guide on creating health promoting environments from the TCPA

Annex is also worth a look


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s