Healthy Cities: Enhancing Sustainable Development for Immigrants

1. Another way U.S. immigrants are assimilated: Weight gain • Bad news for new Americans: A study published today shows that simply moving to the USA packs on the pounds.

2. The immigrant experience suggests that:

6. ‘North-South Health Divide is widest for 40 years’ Feb 2011 • 1/5 more likely to die early (>75) • 1.5 million extra deaths since 1965 • Smoking main cause (14%) • Built and natural environment vs socioeconomic? • Recession?

7. Burgoine et al., (2011) Assessing the obesogenic environment of North East England, Health & Place • Availability of food consumed within the home • Availability of food consumed outside of the home • Residential density • Street connectivity • Land use mix Explained 16.2% of risk of being overweight

9. Environment & Health

10. Freiburg, Germany • 1970s Nuclear plant turned down – local alternatives • CO2 target 25% reduction of 1992 levels • 400km cycle lanes, 1/3 journeys by bicycle, 35% no car • 140,000 tonnes (1988) – 50,000 tonnes of waste • 42% of territory is nature reserve • €1,000,000,000 turnover in Environment Sector

11. Cross Street South

12. Strategic Environmental Assessment (SEA) Strategic Environmental Assessment (SEA) has been defined as: “the formalised, systematic and comprehensive process of evaluating the environmental impacts of a policy, plan or programme and alternatives, preparing a written report on the findings, and using the findings in publicly accountable decision-making” Therivel(2004).

13. “ The likely significant effects on the environment, including on issues such as biodiversity, population, human health, fauna, flora, soil, water, air, climatic factors, material assets, cultural heritage including architectural and archaeological heritage, landscape and the interrelationship between the above factors. These effects should include secondary, cumulative, synergistic, short, medium, and long-term permanent and temporary, positive and negative effects. ” Source: Annex I (f), SEA Directive 2001/42/EC SEA in relation to health

14. SEA: to what does it apply? Land Use and Spatial Plans: Local Development Documents Minerals Plans Waste Plans Non-Planning: Regional Economic Strategies Transport Plans Community Strategies Waste Strategy 2000 AONB Management Plans Oil and Gas Licensing Rounds

15. Examples of actions requiring SEA

16. Why is a health response required? Protecting human health Lifelong health improvements The institutionalisation of health policies Coordination of action The elimination of costs of treating health consequences of non-health policies Greater equity in health Reallocation of resources Health poorly assessed

17. A: Screening + Baseline B: Scoping + Alternatives C: Impact Assessment D: Environmental Report E: Monitoring Stages of SEA • Health input • Which? • When? • Who? • How?

18. Draft Guidance on Health in SEA Aims of the Guidance To inform the health community how to get involved when to get involved what data to provide To inform planners/ Responsible Authorities who/when to consult health what data are available and health determinants to consider during scoping http://www.dh.gov.uk/en/Consultations/Closedconsultations/DH_073261

19. Health in Types of Plans and Programmes

20. Health evidence

21. Stages of SEA

22. Planners should ‘approve all individual proposals wherever possible’Developments should go ahead ‘unless the adverse impacts of allowing development would significantly and demonstrably outweigh the benefits’Planners should support ‘strategies for the growth of ports, airports or other major generators of travel demand in their areas’ The new system

23. Timeline • Draft published July 2011 • Comments October 2011 (>10,000 received) • CLG Committee Report December 2011 • DCLG has indicated that the new national • Replace Planning Policy Statements (PPSs) and Planning Policy Guidance notes(PPGs) • > 1,000 to ~ 50 pages • Planning policy published April 2012

24. Key issues • Sustainable development • Brevity vs ambiguity • Transition period • Public participation • Green light to development • ‘Significantly and demonstrably’ • Placeless

25. The three pillars of sustainability economic environmental social 15% 60% 25%

26. http://www.apho.org.uk/default.aspx?QN=P_HIA

27. The more familiar ‘deficit’ approach focuses on the problems, needs and deficiencies in a community. It designs services to fill the gaps and fix the problems. As a result, a community can feel disempowered and dependent; people can become passive recipients of expensive services rather than active agents in their own and their families’ lives.

28. http://www.nice.org.uk/Guidance/PHG/Wave20/55

29. The evidence • NICE’s Spatial Planning and Health Programme Development Group • The location, density and mix of land uses • Street layout and connectivity • Access to public services, employment, local fresh food and other services • Safety and security • Extreme weather events and a changing climate • Open and green space • Affordable and energy efficient housing • Air quality and noise • Community interaction • Transport 12 ACTIONS http://www.spahg.org.uk/

30. ACTION 1: DESIGNING IN HEALTH • Develop local development documents with core strategies that provide the policy direction to address public health and health inequalities. • Develop Supplementary Planning Guidance on healthy living to address matters such as fast food outlets, design and site layout principles, contributions to physical activity including green gyms and access to public space etc • Consult the local Director of Public Health on the possible health effects of the plan • Recognise that change can take time and thus provide a consistent long term vision to help guide that change. • Ensure that there is collaboration between and within local authorities boundaries and in partnership with other organizations to address health and health inequalities at an appropriate scale.

31. ACTION 3: LOCAL DEVELOPMENTFRAMEWORKS AND CORE STRATEGIES • Ensure that the Local Development Framework (LDF) includes specific health policies • Ensure that the LDF includes the spatial aspects of change required to implement the Sustainable Community Strategy and meet the health goals it has defined. • Set out how public and private resources (including changes to land, buildings, transport and associated infrastructure) should be used to improve health. • Ensure that the Director of Public Health comments upon how the Local Development Framework addresses local health objectives.

32. ACTION 6: INTEGRATING HEALTH ASSESSMENT • Involve the Public Health lead for spatial planning • Use appropriate evidence that may include: routine health and other data; the annual public health report; the JSNA; and available literature reviews; • Identify the views of the local community, for example using findings of consultation on the proposal. • Identify which populations will bear each impact and ensure differential impacts are identified • Examine alternative options to safeguard health and wellbeing in both short and longer term • Make recommendations based on the findings to enhance positive and minimise negative impacts on health and inequalities • Seek to alter the plan in light of the findings and recommendations • Recommend appropriate monitoring of the impacts of the plan and the implementation of the mitigation or enhancement measures. • Present findings clearly in a report showing the evidence sources and basis of the recommendations; and draft a summary ‘user friendly’ version • Undertake the assessment at early a stage as possible in the process.

33. ACTION 10: HEALTH AND PLANNING CAPACITY AND COLLABORATION • The Director of Public Health/Public Health Service, the environmental health service and the Chief Planning Officer should designate staff to ensure health and wellbeing is fully integrated into each local authority’s spatial planning process. • The DPH or Public Health spatial planning lead should agree with planning authorities how to ensure appropriate scrutiny of health assessments of planning proposals. • The Public Health Service/ DPHs should create local networks for public health leads on spatial planning, offering regular and informal opportunities to meet with planning staff from local authorities and share information and good practice. • Health and Wellbeing Boards/ Community Planning Partnerships should assess capacity and collaboration across all the relevant organizations and make recommendations as to how capacity can be developed particularly in encouraging GP consortia/NHS boards to engage with spatial planning and non-clinical issues .

35. Using wood for energy Role Play