City Health Check: How design can save lives and money

Do our cities support healthy, active choices on a daily basis? Does the architecture and urban design of our cities impact on public health? In this health check we compare serious health problems in nine of the most populated cities in England and how these problems relate to our urban environment and levels of exercise.

In the 19th and early 20th centuries, public health pioneers and urban reformers helped overcome infectious diseases like cholera and TB by improving our buildings, streets and neighbourhoods.

Now once again we are examining how we design our cities can play a crucial role in combating some of the biggest public health epidemics of our time: obesity and related chronic diseases such as diabetes and heart disease.

City Health Check short
Today, we have published new research exploring the link between the quality of public spaces and our health and wellbeing.   City Health Check  explores the important role that design can play  in combating the most pressing public health problems of the 21  st Century  whilst at the same time delivering savings of £900 million a year for the NHS.

The report looks at London and England’s eight Core Cities - Birmingham, Bristol, Leeds, Liverpool, Manchester, Newcastle, Nottingham and Sheffield – examining three  major health problems and comparing the amount of green and public space available. The results were clear – the areas of our cities with the poorest health outcomes had the least amount of green space. We outline a series of actions that developers, councils and the Government can take to help make them healthier places.  

Making it happen

In 2013 responsibility for public health was handed over to local authorities across England, bringing with it new possibilities to join up housing, planning and health strategies in order to encourage healthier lifestyles through healthier local environments.

Our report calls on  local authorities  to integrate public health considerations into planning policies and programmes and to have a truly joined-up approach to improve their city’s health through the following steps:

  1. Local authorities that are comprised of less than 50% green space and/or have a housing density of over 5% must  produce a Healthy Infrastructure Action Plan as part of their Local in an in conjunction with Health and Wellbeing Boards . They must outline their strategy for making streets and parks safer and more attractive and they must outline the principles they expect new developments to meet in order to gain planning permission.

  1. Local Authorities that are comprised of less than 50% green space and/or have a housing density of over 5% should  redirect a proportion of their Community Infrastructure Levy (CIL) receipts  to fund their Healthy Infrastructure Action Plan.

We also recognise the crucial role that  central government  has to play in ensuring that planning policy helps foster joined-up thinking and public health funding is targeted at those places with the worst health outcomes. We recommend that

  1. Planning guidance must include  guidance as to how planners and developers can aid healthy lifestyles by ensuring places are safe and attractive, to encourage people to walk and cycle more safely.

  1. Seven of the 10 city local authorities with the worst health performance have not received the higher growth rate (10% or above) of ring fenced grants to spend on public health services. These  local authorities should be prioritised in the next round of grants and should use the increase to invest in actions specified in their Health Infrastructure Investment Plan  .

To truly transform our cities and make them healthier places, we need to think about how we design and build in health from the outset.  Developers and architects  need to recognise the responsibility they have in creating healthier environments. We recommend that:

  1. Built environment organisations, in particular  housing developers and architects should commit to pledges 3 and 4 of the Responsibility Deal Physical Activity Network 

  1. Developers should  use the Design and Access Statement to prove how their new developments will benefit public health though their design of the public realm  and its links to existing infrastructure. They should identity characteristics of the local area and the view of local people as to what constitutes beautiful architecture and public space.  

Read the report