Interface: Health at the Heart of Spatial Planning

We asked Jenny Crawford, former Head of Research at the RTPI and editor of the April 2010 Interface collection, to reflect on what has happened in this space since publication. She replied:

"Fifteen years ago, the links between health and spatial planning were still inexplicably underdeveloped in practice, despite their close historical origins. Since then, the human health impacts of climate change and environmental degradation, and of course the Covid epidemic and threat of further such events, have underlined how important this topic is for effective planning practice. So, I am delighted that it is the focus of this edition of PRM and welcome the insights from today’s leading researchers who are working in this space."

Summary

The April 2010 Interface collection of the Planning Theory & Practice journal invites its contributing authors to explore the links between two professions: spatial planning and public health. As Crawford notes in her introduction, each emerged in response to the poor health of populations living in overcrowded industrialising cities which lacked adequate water and sewerage infrastructure in the nineteenth century. Yet as Crawford explains, close working relationships between the two are limited, which is an obstacle to achieving better population health and wellbeing outcomes.

The authors of the essays in this Interface collection share insights gained from working at the boundary between health and spatial planning. They consider the extent to which planning and public health practitioners work towards shared goals, how they cooperate, and what barriers prevent this. They also reflect on the relationships between the two professions, and on perceived shifts in their professional paradigms.

Barton argues that “the outcomes sought by planning and public health practitioners are so intertwined that they should be recognised as indivisible: the basis of shared frameworks of urban analysis and policy” and that “ health is a more useful concept than sustainability in breaking down the ‘economy–environment dichotomy of development practice’ ”. He notes that attitudes have been changing rapidly in recent decades, partly due to WHO policy encouraging “healthy urban planning” but that “while many planners do recognise that urban planning influences health, they do not normally perceive that it is their job to worry about it or to study it. Their priorities are elsewhere.”

Drawing on his experience as an urban planner engaging with “health sector” agendas in London and other parts of England, Chapman states that health can reframe professional planning practice, strengthening emphasis on quality indicators and pushing planning to reengage with inequality. He argues that “establishing a clear link between planning decisions and health could provide a funding stream to help deliver better solutions. If the evidence is there, the argument can be made that health services should help fund the provision of a local park/improved local transport/employment training in order to improve people's health outcomes”.

In his piece, Higgins reflects on what features of urban environments lead to better health outcomes for residents and gives examples of joint working between planners and public health professionals in Scotland at the time of writing, e.g. a pilot exploring the potential of the Healthy Sustainable Neighbourhoods Model developed in Glasgow’s planning department. He then considers the overall issue of institutional capacity for greater integration and joint working, and how changes to planning systems enhance or limit this.

Capon and Thompson consider a wide range of Australian policy responses to this agenda and their wider implications. They propose “a transcendence of disciplines” through professional or disciplinary integration. They explain that “climate change and sustainability are now firmly on the planners' agenda, but human health is not quite there yet, and that “creating organisational structures and processes that allow both planning and public health priorities to be addressed seems to be a key objective, albeit one that is perhaps easier said than done.”

These authors offer real-world examples - especially from England, Scotland and Australia - of where planning had been trying to engage with and influence health outcomes over recent decades prior to the 2010 publication. The collection offers critical reflections on the structural, policy and resourcing challenges that remain, both in practice and research. Many of the issues highlighted remain highly relevant today.

This Interface includes the following contributions:

• ‘Strengthening the Roots of Planning.’ Hugh Barton
• ‘Health and the Urban Planner.’ Tim Chapman
• ‘Health Inequalities and Place.’ Martin Higgins
• ‘Planning for the Health of People and Planet: An Australian Perspective.’ Anthony G. Capon and Susan M. Thompson

Full reference

Crawford, J., Barton, H., Chapman, T., Higgins, M., Capon, A. G., & Thompson, S. M. (2010). Health at the Heart of Spatial Planning: Strengthening the Roots of Planning; Health and the Urban Planner; Health Inequalities and Place; Planning for the Health of People and Planet: An Australian Perspective. Planning Theory & Practice, 11(1), 91–113. https://doi.org/10.1080/14649350903537956