Health and wellbeing are significantly influenced by how professionals plan, design and manage the environment.
This book supports those working in the built environment and public health sectors, with the knowledge and insight to maximise health improvement through planning and land use decisions. Supported by examples of policy and approaches, it focuses on implementation and delivery, and sets out what is needed to achieve healthier environments within the parameters of legislative and policy frameworks.
It demonstrates how when we harness the art and science of public health spatial planning, can we begin to effect changes to the policies and decisions that shape population health.
The place in which we live matters to health. This chapter reflects on how the built and natural environment of our neighbourhoods, towns and cities impacts on health and wellbeing, and considers the conditions required to maximise health. These wider determinants of health set the conditions for good health and result from a complex interplay of biological, behavioural, social and environmental factors. There is an increasingly robust public health evidence base upon which to make these assertions and that, in turn, provides a guide to actions that can be taken to improve health and wellbeing through the design and quality of the built environment by means of spatial planning. This chapter sets the wider context by considering the evidence base underpinning the association between the environment and health in the context of the wider determinants, and suggests how this can underpin planning for healthy places.
Spatial planning policy, public health policy and professional priorities have reached a point of convergence that supports the growing movement to reunite local spatial planning and strategies for health and wellbeing. Practitioners are experimenting with creative ways to work within local circumstances and systems to deliver on the priorities that matter most to local communities and are designed to improve health and wellbeing through the planning system. This chapter captures the challenges facing the professional workforce working within the planning system when trying to balance the demands arising from different legislative, policy and skills competency frameworks. These must all be addressed if we are to successfully tackle the challenging public health issues facing this and future generations.
This chapter sets the baseline of the current state of the union and joint working practices between spatial planning and public health, and the extent to which wider political and research landscapes have influenced this union. There is an emerging understanding and evidence base among practitioners and researchers of interventions that work and can be effective in achieving health and wellbeing through spatial planning. What is unknown is how these interventions can and should be applied in different localities under different conditions through the planning system. The unique, place-based composition of the local built and natural environment makes it difficult to develop evidence-based approaches that can be universally applied, and successful practices in one setting may not always be transferrable to another. This chapter synthesises research from academic and practice-based literature to establish an ‘institutional’ memory of the journey in applying the practice of planning for health and wellbeing.
This chapter aims to provide an overview of what Health in All Policies is and its main tools and methods for implementation. It identifies the key drivers for collaboration between spatial planning and public health systems. Health in All Policies is an approach that seeks to improve population health and health equity by looking at public policies across all sectors. It does this by: taking account of the health implications of decisions; seeking synergies between sectors; and avoiding harmful health outcomes and inequalities by mitigating any unintended impacts. It signposts the reader to useful resources that can assist and support practitioners to implement Health in All Policies and use the main tools to drive it forward. The chapter ends with an insider story from Dr Fiona Haigh on integrating health with planning in Australia.
Health impact assessment is a flexible and systematic tool that can be applied to effectively implement ‘Health in All Policies’ and ‘All Policies in Health’ approaches at local, regional and national levels. It considers in an explicit and proactive way populations impacted by development or spatial planning policy and plans, and can address and help to discuss and mitigate any issues before they arise. This chapter outlines the process of a health impact assessment, the roles carried out in a health impact assessment, how it can be used as a beneficial and proportional process to support effective public health spatial planning and decision-making, and its integration in practice.
Definitions and models of health are important when considering and understanding health and wellbeing, and how to integrate them into impact assessments that are relevant to spatial planning. Integrating health into impact assessment at a plan, policy or proposal level can be complicated in nature, being defined not only by an individual’s view of health, but also by that of society, key stakeholders, legislators, policymakers, developers and those commissioned to carry out an impact assessment that has health as an element. This chapter describes how wider health and wellbeing can be integrated into a range of existing impact assessments, including environmental impact assessments and mental wellbeing impact assessments. It introduces two insider stories from Stuart Williams and Gemma Christian on the application of health in strategic environmental assessments in different spatial plans in Wales.
The planning system operates on the primacy of legislative and policy frameworks as the basis for action. This hierarchical nature of spatial planning is a hallmark of the system and dictates how regional/local authorities and stakeholders are able and required to embed health and wellbeing into strategies, plans and policies. This chapter makes the case for the integration of health and wellbeing issues into the policy framework, how to do this and the types of policies needed that are robust and defensible, and that can be tailored to meet local spatial and public health priorities, such as those set out in public health strategies. Most importantly, the chapter provides policymakers and practitioners with the necessary know-how to translate evidence and knowledge into policy and technical requirements. Finally, it provides an eight-stage process for developing planning policies for health that are effective, meaningful and impactful, and that meets the procedural and impact- and outcome-based requirements.
Once policy frameworks are in place, practitioners have the challenging task of translating them into actionable decisions on proposals that range from the individual home or retail premise to large-scale communities. Often, this starts with the basic question of whether and how public health issues have been considered in the planning process. Then, there are questions of how public health professionals are involved in the decision-making process and whether they need to be involved in all decisions given limitations on capacity and resources. Involvement of public health professionals has proved challenging without dedicated capability, which is not common practice, but does exist in some public authorities. This chapter describes mechanisms to frame a better understanding of the decision-making relationships between planners and public health teams where planning decisions can constitute public health decisions.
The professional workforce is the driving force behind planning for health. Public sector managers and political leadership recognise the importance of having the capacity and capability to work more effectively to influence decisions on policy and planning applications. Private sector directors recognise the financial win–win of investing in the upskilling and reorientation of the workforce to maximise the potential of the wellbeing consultancy market. This chapter captures the emerging pivotal role of public health spatial planners in bridging professional boundaries and the training, education and the job descriptions necessary to upskill the future generations of the workforce. It builds on the established respective planning and public health skills and competency frameworks identified in , with shared responsibilities as ambassadors of the profession to ensure that activities are undertaken for the benefit and protection of population health and wellbeing. The chapter illustrates key lessons with three insider stories from Angie Juke in Stockport, Dr Rachael Marsh and Carolyn Sharpe as public health registrars, and Dr John Vick about his team of healthy development coordinators in Tennessee.