Happy new year!
Here’s hoping that sincere wishes for happiness and prosperity in 2025 are met with acknowledgment of some significant challenges that come with this new year – specifically those underpinning our willingness, ability and commitment to build for health.
Momentum on identifying these challenges built steadily throughout 2024, and accelerated at the tail end in December with three publications that, together, give us a unique opportunity to put into practice initiatives to ensure that the homes and places we develop going forward help to improve good health for us all.
First off was the Chief Medical Officer’s Annual Report for 2024 focused on health in cities – making a timely and unprecedented acknowledgement from the government’s medical establishment of the links between public health and urban development. The CMO states
“Cities are unique in their high concentration of buildings, including for accommodation … this presents challenges in terms of access to good housing, green spaces, and a pollution-free environment. Improving the built environment in cities presents an opportunity to significantly improve health for millions of people.”
Next was the publication of “Building Health Equity – the Role of the Property Sector in improving Health” from the Marmot Institute of Health Equity at UCL. This report, commissioned by Legal & General and which I spearheaded two years prior via a roundtable of leaders in the built environment and health sectors, gives an evidence-led account of how the homes and places we inhabit impact our health, and how variation in quality and quantity lead to health inequalities across communities. Building on Professor Sir Michael Marmot’s influential 2010 review on health inequalities in England, the Building Health Equity report focused on housing and neighbourhoods as social determinants of health and engaged leaders in the investment, development and operation of our built environment on how their practice could better consider health outcomes.
And finally, just before Christmas, the government published its updated National Planning Policy Framework which, above all,
reinforces the government’s plan to increase housebuilding and infrastructure development with new definitions of land to be made available for this.
There is acknowledgement that health is impacted by planning for the development of the built environment, and in Section 8 on Planning for Healthy and Safe Communities, the updated NPPF advises that
“planning policies and decisions should aim to achieve healthy, inclusive and safe places which enable and support healthy lives, through both promoting good health and preventing ill-health, especially where this would address identified local health and well-being needs and reduce health inequalities between the most and least deprived communities – for example through the provision of safe and accessible green infrastructure, sports facilities, local shops, access to healthier food, allotments and layouts that encourage walking and cycling”
The recommendations coming from these publications are well supported from research and practice spotlighted earlier in the year, notably:
· A guide for local authorities on “Empowering Healthy Places”, published by the Quality of Life Foundation and Prior & Partners
· the work of two local authorities in Wales working closely with public health authorities to develop robust and evidence-led Health Impact Assessments
· the launch of a campaign for healthy homes from the Town & Country Planning Association
· a strategy for preventative health and improved health equity based on place-based partnerships from the Kings Fund
· Health policy proposals from the Institute of Public Policy Research focused on the creation of Health and Prosperity Improvement Zones targeting preventative health measures in places where need is highest.
I’m hoping 2025 is the year when the learnings and recommendations from these reports can be consolidated and put into practice by a committed group of practitioners in both health and built environment sectors, to move from talking to doing, and by doing, influencing and building healthy places.
We live and work in a noisy and fast-moving world. To effect change, continued, committed campaigning is required. It doesn’t have to be loud, but it must be sustained and evidence-led to build support. It must showcase successes and expose failures, and use these to build an evidence base and a code of practice.
It also must recognise fundamental drivers of change, starting with acknowledging that not everyone gets the connection between our built environment and our health, and this must be communicated in a way that attracts interest and support.
Current and visible issues around housing & infrastructure, and the need to focus on preventative and community-based health as the NHS struggles to provide effective and equitable healthcare will continue to drive meaningful discussions on the impact of building on our health.
And so the call to Build for Health, a nascent campaign to influence four constituencies:
1. investors, developers and operators of our homes and places on their current and potential impact on health
2. Legislators and government bodies on housing, planning and health policy
3. NHS organisations on the prevention agenda
4. Local communities impacted by the development of their built environment on how to engage and activate
Three particular actions embody the challenges we face and provide a platform to engage, debate and change practice:
1. Embed public health in the use of Developer Contributions
also known as Section 106 payments or Community Infrastructure Levy, these are funds intended for community benefit but are often unpaid by the developer, unspent by the local authority or underused by the local community. It’s time to put some principles into practice to see the use of these funds community-led and health-promoting, with incentives for developers and local authorities.
2. Improve the quality and use of Health Impact Assessments
Measuring the health impact of changes in our built environment is essential to building healthy places. There are multiple opportunities to improve and embed the practice of assessing health impact by understanding health equity, accessing the increasing supply of public health data, involving community groups and local residents, collaborating with NHS bodies, and creating a reservoir of health information that all parties can use for continued reference and accountability.
3. Identify and showcase best practice
Continually identifying and showcasing places where investment in the built environment has improved health and health equity will help to inspire good practice by motivating and connecting practitioners, providing evidence to government and supporting community leaders.
At its very core Build for Health is a call to action.
If you are a practitioner in the built environment or health sector, if you believe that good health must drive the development of our built environment, and if you’d like to campaign for this to be embedded in practice, let’s talk.
Let’s make 2025 the year we Build for Health.
Clare Delmar
Listen to Locals
10 January 2025
