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PLANNING FOR HEALTH

Better planning is the proper response to a new public health crisis caused by poor environments says CIWEM Executive Director Nick Reeves.

Why do we expect the poorest and the most vulnerable in society to live in the worst urban environments? Most of us live in towns and cities, so you'd think we'd take more care and make urban living desirable for all, and not just for the better off and a café culture elite. No chance……This is identikit Britain, where most towns and cities are blighted by unloved areas that are a breeding ground for poor health, low expectations and a range of social problems. Wild horses wouldn't get Housing Minister, Caroline Flint, or any luvvie-architect, to live in them.

Visit  the vicinity of any industrial area or trading estate in a town near you and you are likely to find the worst kind of social housing. These are latter-day slums for a growing urban underclass that should have been confined to history and where the modern menace of heart disease, obesity and child poverty is now on the increase. Better planning is, surely, the proper response. Unfortunately, planning has become an ashcan for any fashionable phrase or buzzword doing the rounds, 'eco-towns' and 'high standards of sustainability' to name just two. (Eco-towns - a social engineer's concept, which appeals to politicians of an authoritarian turn of mind and those who dream of fantasy communities - will probably be the greatest try-on in the spectacular history of property speculation.)

Town planning has its roots in the public health movement. Born of a desire to open up the Victorian slums and create well-designed cities and suburbs, it was an answer to the evils of cholera, tuberculosis and other infectious diseases caused by poor housing and sanitation and overcrowding. The vision of fresh air, public drinking water fountains (now long gone), clean streets, homes with gardens, public parks and baths was the driving force of early twentieth-century planning. Now, once again, planners must step up to the mark and rise to the challenge of a new public health crisis - especially among the young - that is a consequence of consumer greed, sedentary lifestyles, badly designed estates and public parks and open spaces that have been in decline through lack of investment.

Every day, planners, designers, engineers and architects make decisions that affect the way we live. What I ask is that this is done in a way which makes it easier for people to be physically active and feel safer. And I'm not alone in making this plea. The National Institute for Clinical Excellence (NICE) has published helpful guidance on creating environments to encourage physical activity. It was launched at a conference last January organised by the Wales Centre for Health and the Welsh Assembly Government. It was a real talking point that needs to be better known.

It is now estimated that 65 percent of men and 75 percent of women in England do not achieve the recommended levels of physical activity necessary for good health. But, at long last, politicians, policy wonks and opinion-formers have woken up to the fact that good health and well-being are rooted in green and pleasant places - places where parents feel secure in letting their children play freely and enjoy the parks, green spaces and streets where they live. It is now being understood that the quality of the spaces between the places is essential to a good quality of life and that high quality living environments can help to resolve wider social ills such as youth crime, substance abuse and anti-social behaviour, and contribute to social cohesion. 

NICE guidance is aimed specifically at those involved in land use and environmental planning, in local development frameworks, in local traffic planning, and in local health strategies. The needs of pedestrians and cyclists are put firmly ahead of motorists. Architects are asked to design buildings and neighbourhoods that offer ease of accessibility to people of all ages and levels of mobility and physical ability. Planners are urged to create even more attractive networks of footpath systems and waterways connecting urban, suburban and rural areas. It's all good stuff that could be strengthened if the guidance suggested some minimal levels of budget transfer too. After all, the money spent on treating the very high levels of ill-health resulting from sedentary lifestyles - not to mention the physical and environmental damage wreaked by the private motor car - is enormous. Only a fraction of that sum could bring Britain's parks and green spaces up to the best of Scandanavian levels of quality - but if, and only if, our politicians set their mind to it. And only if the Government delivers on its promise to halt the scandalous sale of playing fields for development.

But, walk down any urban street and look at the clutter of signs, bollards, speed limit restrictions and fences that pile up on each other, an ugly and intimidating attempt to keep people and traffic apart. Public spaces are made less civilized and less safe by industrialised attempts to control human behaviour. This urban anarchy is punctuated by some awful buildings that feels like a conspiracy to make our lives as miserable and unhealthy as possible.

Principles for city-building and planning should be clearer, with an emphasis on healthy living and creating adaptable structures that are appropriate to their context. Improved design will bring harmony between high densities, the townscape and the wishes and well-being of local people. It's time to re-construct identikit Britain for a healthier population and for a better environment.