NOTE: Findings and recommendations reflect the views of the researchers at the time of writing and are not necessarily the views of the RTPI
Key takeaways:
- Some local authorities in England are starting to shift towards more health-oriented local planning.
- Putting health considerations into local plans, based on the actual health and deprivation characteristics of local authority areas, is not being done consistently across England.
- In particular, the focus on health embedded in policies that promote more active travel and green spaces varies between local authorities in urban and rural geographies.
Map showing local plans in England that reference and take into account identified local health and wellbeing needs as set out in the statutory local Joint Strategic Needs Assessment for health (Chang & Hobbs, 2024).
Summary
The health of populations varies greatly between different types of places in England e.g. urban, rural and coastal. The goal of improving the built environment to deliver better public health for all was a key driver for the emergence of planning as a profession in the early 20th century. This is still relevant today, with expectations placed on planners to deliver better health outcomes across an ever-wider range of health parameters. Yet delivering these outcomes is still a challenge, and knowledge gaps remain.
This paper aims to overcome some of these challenges and gaps by tackling the question of how to plan for better public health through the lens of England’s local plans. The research builds on a health census of local plans adopted by local authorities in England between 2012 and 2023. The census gave a comprehensive snapshot of the state of local planning for health in 2023 across different health-related factors. Through geospatial analyses and mapping, this research project was then able to explore the relationships between health-focused policies in local plans, the geography of local authorities in England, and local contextual indicators.
The results can enable a strategic approach, focussing on specific geographies, to maximise health in local plan coverage and promote healthier communities.
The methodology of the local plans for health census, and the analysis underpinning this research, can be adapted and applied to different international planning systems.
Map showing local plans in England that have a health and wellbeing policy (Chang & Hobbs, 2024).
Recommendations
- Health and wellbeing should be given more prominence at the heart of planning.
- A broader range of public health outcome indicators should be used e.g. obesity, healthy life expectancy, rates of physical activity and self-reported well-being.
- A better spatial understanding can enable more targeted application of healthy planning frameworks for development projects in places of greater health need.
- Planning activities should be tailored to support the health needs of different places e.g. rural settings, coastal communities or areas of high housing demand such as urban brownfield locations.
- More studies would enable a better understanding of the health and geographical disparity patterns inherent in local plans.
Full reference
Chang, M., & Hobbs, M. (2024) ‘Location, location, location: understanding the geography of health policies in local spatial plans in England’, in Cities & Health, 1–9. https://doi.org/10.1080/23748834.2024.2408516
Link to the paper
https://www.tandfonline.com/doi/full/10.1080/23748834.2024.2408516#d1e285
Related outputs
Chang, M., Carhart, N., & Callway, R. (2024) ‘Spatial Plans as a Critical Intervention in Improving Population Health. A Discourse Arising from a Health Census Review of the State of Current Local Planning Policy in England’, in Journal of Planning Literature. https://journals.sagepub.com/doi/10.1177/08854122241229565
Chang, M., Carhart, N., Lee, S. & Stewart-Evans, J. (2025) ‘Public health spatial planning in practice. Understanding the local spatial planning for health system in England through a narrative synthesis of systems approaches’, in Planning Practice & Research 40 (3). https://doi.org/10.1080/02697459.2025.2472114
Chang, M., et al. (to be published in 2025) ‘Challenges and opportunities in reforming the planning system for England: a rapid review of literature and lessons for the future of planning for health’, in Land Use Policy.