530376 research-article2014
RSH0010.1177/1757913914530376In PracticeIn Practice
In Practice
In Practice How should public health teams engage in area planning? Using public health to ensure a ‘wider determinants of health’ approach is considered in area planning. The built environment has a major impact on health and wellbeing. Public health (PH) teams within local authorities can help capture health benefits by working with planning colleagues to ensure that as well as protecting the public from environmental hazards, opportunities to promote health through improving the wider determinants of health are maximised.
Quick Overview of the Planning System There are two key elements of the planning process. The first is the strategic planning process, where the core strategy for an area is produced. This leads to a second strategic document, which identifies sites for development and defines policies through supplementary planning documents (SPDs), alongside guidance for understanding the documents. These SPDs specify conditions for any developments in the area – for example, how green space will be protected. These are refreshed fairly infrequently, and take a long time to produce. The second element to the planning system is development control. For big developments, developers will meet with council officers to discuss their proposal and how their development can comply with the council’s requirements. Applications for permission to build are judged against the national guidance and the Local Authorities core strategy and sites and policies. For major developments, this decision is made by elected members, who do not have to follow advice from planning officers. Decisions can be appealed, in which case it will be decided by a planning inspector who will judge whether the
decision is in keeping with national guidance and local plans.
How should PUBLIC HEALTH contribute to planning? 1. Contribute to strategic documents. Because a planning inspector will judge appeals against the strategic documents, it is important that these have input from PH staff who take a ‘wider determinants of health’ approach to them. PH staff should be looking at these documents and consider how they can do the following: promote local employment, active transport, and access to greenspace; improve social cohesion; and consider the needs of vulnerable/ special groups. They should also look at how healthcare infrastructures such as general practitioner (GP) surgeries, pharmacies, and health and wellbeing buildings are provided for. 2. Health Impact Assessment (HIA). HIA has been defined as ‘a combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population’.1 HIA can use both research evidence and local knowledge and experience. As a result, HIA is not entirely objective, and will include areas where the evidence is contentious. Local discussion can strengthen the planning process by including local communities and their views. One option to increase HIA use would be making developers pay for them. However, the expense of performing them may deter developers from investing in the most deprived areas
where development work would be most beneficial to health. A full HIA requires a lot of time and capacity. Given current resource constraints it is only realistic to expect a full HIA on the most major developments. Proportionate triggers for HIA are needed, and we need methods for doing a quick table-top HIA that briefly considers all the wider determinants where resources are limited. It is vital this occurs early2 at the pre-planning application stage, to maximise benefits and minimise the cost to developers of implementing improvements. 3. Contribute to discussions on the Community Infrastructure Levy (CIL). The CIL is a tax on development in the area, which can be used to fund other infrastructure, even in a different part of a borough to the one in which it was charged. This could help fund healthcare infrastructure as well as projects that address the wider determinants of health – for example, creation and maintenance of green space in deprived areas. 4. Help deprived communities produce local plans. Producing a local plan (as specified in the Localism Act) can benefit deprived communities by ensuring they are seen as favourable sites by developers, and also by increasing the amount that is available to them as a ‘meaningful proportion’ of the CIL.
Dr Jason Horsley Honorary Clinical Lecturer in Public Health Medicine, University of Sheffield Email: [email protected]
References 1. Chadderton C, Elliott E, Green L, Lester J, Williams G. Health Impact Assessment a Practical Guide. Available online at: http://www. apho.org.uk/resource/item.aspx?RID=44257 (2012, Last accessed 14th March 2014).
2.
Gray S, Barton H, Mytton J, Lease H, Joynt J, Carmichael L. The Effectiveness and Cost Effectiveness of Health Appraisal Processes Currently in Use to Address Health and Wellbeing During Project
Appraisal. Available online at: http://www. nice.org.uk/nicemedia/live/ 12111/53885/53885.pdf (2010, Last accessed 14th March 2014).
May 2014 Vol 134 No 3 l Perspectives in Public Health 123 Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 1, 2015
RSH0010.1177/1757913914530376In PracticeIn Practice
In Practice
In Practice How should public health teams engage in area planning? Using public health to ensure a ‘wider determinants of health’ approach is considered in area planning. The built environment has a major impact on health and wellbeing. Public health (PH) teams within local authorities can help capture health benefits by working with planning colleagues to ensure that as well as protecting the public from environmental hazards, opportunities to promote health through improving the wider determinants of health are maximised.
Quick Overview of the Planning System There are two key elements of the planning process. The first is the strategic planning process, where the core strategy for an area is produced. This leads to a second strategic document, which identifies sites for development and defines policies through supplementary planning documents (SPDs), alongside guidance for understanding the documents. These SPDs specify conditions for any developments in the area – for example, how green space will be protected. These are refreshed fairly infrequently, and take a long time to produce. The second element to the planning system is development control. For big developments, developers will meet with council officers to discuss their proposal and how their development can comply with the council’s requirements. Applications for permission to build are judged against the national guidance and the Local Authorities core strategy and sites and policies. For major developments, this decision is made by elected members, who do not have to follow advice from planning officers. Decisions can be appealed, in which case it will be decided by a planning inspector who will judge whether the
decision is in keeping with national guidance and local plans.
How should PUBLIC HEALTH contribute to planning? 1. Contribute to strategic documents. Because a planning inspector will judge appeals against the strategic documents, it is important that these have input from PH staff who take a ‘wider determinants of health’ approach to them. PH staff should be looking at these documents and consider how they can do the following: promote local employment, active transport, and access to greenspace; improve social cohesion; and consider the needs of vulnerable/ special groups. They should also look at how healthcare infrastructures such as general practitioner (GP) surgeries, pharmacies, and health and wellbeing buildings are provided for. 2. Health Impact Assessment (HIA). HIA has been defined as ‘a combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population’.1 HIA can use both research evidence and local knowledge and experience. As a result, HIA is not entirely objective, and will include areas where the evidence is contentious. Local discussion can strengthen the planning process by including local communities and their views. One option to increase HIA use would be making developers pay for them. However, the expense of performing them may deter developers from investing in the most deprived areas
where development work would be most beneficial to health. A full HIA requires a lot of time and capacity. Given current resource constraints it is only realistic to expect a full HIA on the most major developments. Proportionate triggers for HIA are needed, and we need methods for doing a quick table-top HIA that briefly considers all the wider determinants where resources are limited. It is vital this occurs early2 at the pre-planning application stage, to maximise benefits and minimise the cost to developers of implementing improvements. 3. Contribute to discussions on the Community Infrastructure Levy (CIL). The CIL is a tax on development in the area, which can be used to fund other infrastructure, even in a different part of a borough to the one in which it was charged. This could help fund healthcare infrastructure as well as projects that address the wider determinants of health – for example, creation and maintenance of green space in deprived areas. 4. Help deprived communities produce local plans. Producing a local plan (as specified in the Localism Act) can benefit deprived communities by ensuring they are seen as favourable sites by developers, and also by increasing the amount that is available to them as a ‘meaningful proportion’ of the CIL.
Dr Jason Horsley Honorary Clinical Lecturer in Public Health Medicine, University of Sheffield Email: [email protected]
References 1. Chadderton C, Elliott E, Green L, Lester J, Williams G. Health Impact Assessment a Practical Guide. Available online at: http://www. apho.org.uk/resource/item.aspx?RID=44257 (2012, Last accessed 14th March 2014).
2.
Gray S, Barton H, Mytton J, Lease H, Joynt J, Carmichael L. The Effectiveness and Cost Effectiveness of Health Appraisal Processes Currently in Use to Address Health and Wellbeing During Project
Appraisal. Available online at: http://www. nice.org.uk/nicemedia/live/ 12111/53885/53885.pdf (2010, Last accessed 14th March 2014).
May 2014 Vol 134 No 3 l Perspectives in Public Health 123 Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 1, 2015
