Healthy places start with healthier local plans, new research finds

Local government statutory local plans were found lacking in consideration of health priorities and needs according to a new review by UWE Bristol and the University of Bristol. The findings are published in the International Journal of Environmental Research and Public Health.

Produced roughly every five years, local authority (LA) statutory local plans set out principles and standards for most developments including housing, offices and infrastructure to benefit the area the council is responsible for.

In this new study, researchers analysed the plans across seven LA areas to assess whether their local plan policies consider and implement the health implications of urban planning decisions.

The study follows on from interviews with 132 experts involved in urban development comprising, local government planners, real estate investors, public health officials and property developers.

Their results found local plans lacked incentives to target local health and wellbeing priorities. The interviewees indicated that health was not considered a priority and policies were often inconsistent or weakly implemented.

The study recommends further research on how policies are interpreted by developers and national reform, such as for the Planning Inspectorate to better support the integration of health requirements through the local plan.

Local plans can boost health equalities by:

• requiring accessible walking and cycling provision to boost physical activity; promoting tenant rights in the growing rental market to address issues of tenure insecurity;
• mobilising investment in insultation, green and energy efficiency measures to tackle both fuel poverty that affect both mental and physical wellbeing and cut carbon emissions;
• enhancing access to green spaces to reduce urban overheating and improve mental health;
• safe, decent and affordable housing that is designed to meet the needs of individuals and families at different life stages with differing needs;
• locating development sites that are well connected to local services, amenities and public transport to improve social interaction, safety and wellbeing.

The study is part of TRUUD, a major transdisciplinary research project which aims to reduce non-communicable disease (such as cancers, diabetes, obesity, mental ill-health and respiratory illness) and health inequalities linked to the quality of urban planning and development.

Dr Emma Bird, a Senior Lecturer in Public Health at UWE Bristol, said: “This study allowed us to build upon earlier research led by UWE Bristol’s Centre for Public Health and Wellbeing, in applying an evidence-based framework of features of the built and natural environment that influence health. The findings of this study demonstrate that while we know from the evidence that health and environment are inextricably linked, there is scope to better integrate and prioritise health in urban development decisions in practice.” 

Rosalie Callway, a Research Associate at Bristol Medical School at the University of Bristol and lead author on the paper, said: “Local plans offer a great starting point for embedding the health benefits of particular approaches associated with the quality of housing, transport, natural environments, food and neighbourhood design.

“The seven local plans we analysed were very good in many respects but there were clear opportunities where health requirements could be strengthened, especially to target the implementation gap where developers can compromise on conditions once planning consent has been achieved. A requirement for developers to create health management plans and improve local engagement in the design and ownership of new sites could help address this.

“This review identifies the need for greater coherence regarding health requirements in local plans, as well as within national planning policy and guidance. Further research is now being undertaken by my colleague Michael Chang at the Office of Health Improvements and Disparities who is looking across all English local plans. Through this study and the future work we hope to support the improved integration of health priorities in local plans across the country.”