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What stops us from creating healthier places?

25 April 2017 Author: Rachel Toms

Eighty-nine percent of adults in Great Britain support a national health system that is tax-funded, free at the point of use and provides comprehensive care for all citizens, according to the British Social Attitudes survey of 2014.  In essence, this is because people want to be healthy. People want themselves and others – regardless of how much money they have, or where they live – to not suffer with disease.  People want those with power and influence to create structures and systems, and to use money wisely, to prevent and cure disease. 

In planning new developments and regenerating existing places, planners and designers have some power and influence in relation to health. 

Preventable diseases, such as type 2 diabetes and heart disease, along with loneliness and poor mental health, come at an enormous cost to society and to the economy.  Deprived communities are disproportionately affected – see The Marmot Review: Fair Society, Healthy Lives if you’re interested in the issue of health equity.  Reducing preventable diseases is a top priority for the NHS, as set out in its Five Year Forward View

Healthy Living 2

In the built environment, a growing body of research is showing how the buildings, streets, public spaces and neighbourhoods that people live and work in contribute to poor health – physical and mental.  For some key facts, see Public Health England’s evidence to the House of Lords Select Committee in 2015. 

Overall, we have done a good job of designing infectious diseases out of the places people inhabit, but we have inadvertently contributed to sedentary lifestyles, mental distress and social isolation.  This is one of the legacies of low-density sprawl, where you have to drive to get anywhere, and of hostile urban streets that are dominated by traffic, devoid of trees and poorly overlooked.

The reality is that across the country, we continue to deliver housing, re-shape roads and regenerate town centres in ways that work against good health outcomes.

The main way in which planning can tackle preventable disease is to shape the built environment so that healthy activities (like walking to the shops) and experiences (such as using a generous pavement in the dappled shade in the summer) are integral to people’s everyday lives.  Many interventions to boost people’s health, like outdoor gyms, are essentially an add-on that educated, affluent people choose to use – this is not primarily the way to improve the health of a population. 

What the evidence actually points to is compact, mixed-use, highly walkable and cycleable neighbourhoods with leafy, overlooked streets and great parks and parklets.  Correct: there is nothing new here – it’s good urbanism as we already know it, which also supports environmental sustainability, social equity and resilience.

The reality is that across the country, we continue to deliver housing, re-shape roads and regenerate town centres in ways that work against good health outcomes.  But with massive numbers of homes to be built and Brexit adding to the drive to make all parts of the UK attractive to investors, there’s a big opportunity to create healthier places now and over the years ahead.

Tell us what the barriers are

This is why Design Council and Social Change UK are undertaking research to uncover what stops built environment professionals from creating healthier places through the policies, programmes and projects they deliver.  This will identify the barriers to be tackled to make healthy place-making standard in the UK – we expect that we will all have a role to play to overcome those barriers.

The first part of the research is an online survey of built environment professionals.  The survey enables professionals to gauge how good they are at creating healthy places through their work and share their views on the topic.  Respondents can also sign up to receive a summary of the research findings.

We want to hear the experiences and opinions of built environment professionals from all disciplines so please do take part in the survey and share it with your colleagues and contacts.  Good health and good luck!

Guest blogs may not represent the views of the RTPI.



Rachel Toms

Rachel Toms

Rachel Toms is Insight & Standards Manager, Cities Programme at the Design Council