Could planning help reduce health inequalities?

East Midlands Councils

9 July 2020

Julia ThriftDirector, Healthier Place-makingTCPA

@TCPAhealth @juliathrift @theTCPA

TCPA’s mission:

To secure a good home for everyone in inclusive communities that support people to live healthy lives.

Reuniting health with planning:

www.tcpa.org.uk/Pages/Category/health

Published by NHS England in 2019 a practical guide to creating healthier new places, full of advice and evidence, free to download from:

www.england.nhs.uk/ourwork/innovation/healthy-new-towns/

Progressive planning was inspired by the mapping of poor environmental quality and its relationship with healthand social exclusion…

The creators of the garden city model of development realised that people would live healthier and happier lives if they lived in good homes in greener environments… leading to the creation of 20th century garden cities.

20th century garden cities

‘Fifty percent of all GP appointments are for illness that could have been avoided’BMJ

‘One third of children age 2-15 are overweight or obese… obesity doubles the risk of dying prematurely…’Government Childhood Obesity Plan (updated 2017)

‘Between 5 – 18% of UK adults feel lonely often or always… feeling lonely is linked to early death, on a par with smoking…Government Loneliness Strategy (2018)

21st century: epidemic of preventable illness…

The links between homes and neighbourhoods, and people’s health and wellbeing, has become starkly apparent…

Where you live shapes your choices, and so your health.

The pandemic has highlighted inequalities…

What are health inequalities?

‘Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society.

Health inequalities arise because of the conditions in which we are born, grow, live, work and age.’

www.England.nhs.uk/ltphimenu/definitions-for-health-inequalities/#health-inequalities

There are big inequalities in how long people live…

There are big inequalities in how much of their lives are lived in good health.

Health inequalities are getting worse

‘For part of the decade 2010-2020 life expectancy

actually fell in the most deprived communities outside

London for women and in some regions for men.

For men and women everywhere the time spent in poor

health is increasing.’

Michael Marmot, ‘Health Equity in England’, 2020

www.instituteofhealthequity.org

Insights from Marmot’s work

The places where people live, grow, work and age have a big impact on their health…

To address health inequalities we need policies that benefit everyone, but focus the most resource on those experiencing most disadvantage….

What does this mean for planning?

Source: H. Barton and M. Grant

The joint strategic needs assessment (JSNA) is a statutory document that is produced by the local health and wellbeing board. It sets out evidence about the health of the population and priorities for improving it.

The JSNA should inform

your Local Plans and policies…

And Public Health England

Has a wealth of data…

See: https://fingertips.phe.org.uk/

Understand the health needs of your community

The joint strategic needs assessment (JSNA) is a statutory document that is produced by the local health and wellbeing board. It sets out evidence about the health of the population and priorities for improving it.

The JSNA should inform

your Local Plans and policies…

And Public Health England

Has a wealth of data…

See: https://fingertips.phe.org.uk/

Understand the health needs of your community

If new development creates places that help people who are already fit and healthy get even more healthy…

…but neglects the needs of the least healthy, then health inequalities will increase…

What does this mean for… active travel?

planning, health and social justicewww.tcpa.org.uk/Pages/Category/health

Sign-posts saying how long it takes to get to a place encourage less fit people to walk…

Benches along the way allow people to rest…

Public loos give people confidence to set out…

What does this mean for… green spaces?

planning, health and social justicewww.tcpa.org.uk/Pages/Category/health

A local garden with places to sit and things to see might tempt less fit people out of their homes and down the road….

Green spaces with just one use, ega sports pitch, are of little use to less active people…

What does this mean for… new development?

planning, health and social justicewww.tcpa.org.uk/Pages/Category/health

Can new development support the health of existing local communities…?

Eg if there is evidence of high childhood obesity nearby, could the development include places for kids to be active?

Benefits of healthier populations…

The link between healthy populations and economic productivity is starting to be made….

Financial Times 13 August 2018

‘Put simply, skilled, healthy and independent people are

crucial to bring jobs, investment and therefore prosperity

to Greater Manchester.’ www.gmhsc.org.uk/wp-content/uploads/2018/04/GM-Strategic-Plan-Final.pdf

Conclusion

The places where people live, grow, work and age shape the choices they can make and consequently their health.

Planning shapes places…. It can help increase or decrease health inequalities…

Understanding the needs of the least healthy can help planners shape places that will support better health across the population.

The JSNA and public health teams locally can provide evidence to support policies and plans that aim to address health inequalities.

Planning is just one of many influences on health and wellbeing – but it has an important role to play.

Julia ThriftDirector, Healthier PlacesTCPA

tcpa.org.uk

@theTCPA @TCPAhealth@JuliaThrift