How can councils help make development healthy? 18/06/2020 With: Bethan Harris, director, Collectively Kevin McGeough, director of healthy new town programme, Ebbsfleet Garden City Matthew Pearce, head of public health and wellbeing, West Berkshire Council Jenny Rydon, head of healthcare sector, Montagu Evans
SUMMARY With the NHS pressed for resources even before the current crisis, medicine in the UK has increasingly shifted towards being preventative rather than curative, and as such placemakers have a hugely important role to play in helping to further this agenda. Recent decades have also encouraged us to view health in a wider context, and to place greater importance upon our mental health, as well as our physical. Our mental health plays upon our physical, and vice versa, as Bethan Harris of Collectively illustrated with an example about loneliness. “Many of us will associate loneliness with mental health… But there’s a lot of research that it has a very strong link to physical health as well, with some s tatistics showing that it’s as bad for us as smoking fifteen cigarettes a day.” For many of us isolating for months now, loneliness is a big issue. However, as a societal problem it was already growing even prior to lockdown. With their work through their Loneliness Labs, Collectively and their partners are however attempting to halt it. “We’ve been working as a cross sector network since we launched,” Harris explained, “bringing together community organisations, lonely people, artists, activists, developers, local authorities and architects.” It takes a collaborative effort from all of these parties to properly tackle an issue like loneliness. So, for a place to be healthy it needs to encourage social interaction. But what other aspects need consideration? If asked as to what a “healthy place” looks like, the presence of green spaces might be one of the first things that would come to mind. The UK has a proud history in this regard with respect to the garden city movement, as panellist Kevin McGeough of the Ebbsfleet Development Corporation reminded. Ebbsfleet has certainly built upon the ambitions of the original garden cities – the town will have 70 city parks and 200 hectares of green space, more than double the original vision. Ebbsfleet is one the ten pilots for the Healthy New Towns programme, an initiative led by NHS England that is attempting to rediscover the connection between health and housing and to raise it in prominence when we are planning new towns. “We believe there’s a very strong connection between garden city principles about putting people first, compact neighbourhoods, access to green space and delivering a healthy new place.” McGeough stressed the importance of co-designing 2
spaces and working with the people who live there to respond to their needs, and also on seizing upon the impetus that people can take from moving home for making other positive changes in their lives. “When you move to a new house, you always start with great expectations, you’re going to change your lifestyle.” But to make best use of this energy people need to have places to go, and things to do. West Berkshire is currently dealing with both “the response and the recovery phase”, as detailed by Matthew Pearce. Naturally this brings a range of difficulties to contend with, but it also offers the opportunity to appraise how things were done previously – and whether we might do things differently in the future. The climate change emergency was already pushing local authorities to create healthier, more sustainable communities, and this agenda will only amplify post-Covid, with many councils reaffirming their commitments to carbon-neutrality by 2030. “What Covid-19 has done is really almost shone a light on the importance of health and well-being, but also how the environment around us actually shapes our outcomes.” To help enshrine this, Pearce advocated for public health officers being embedded into regeneration teams. “I think that’s really important… So that they can actually influence and work with planners to develop these healthy communities.” These officers can work to build in things like active travel and to implement epidemiological data that has emerged from the current crisis and to use it to influence and inform planning decisions. Already surveys carried out by his team in West Berkshire evidence changing behaviours, and thus needs. Of the 4000 residents surveyed in the borough, 34% will continue to work from home after the pandemic, 40% will travel by car less over the next six months, and 47% will travel by foot more in the same time period. Jenny Rydon gave testament to the inroads that local authorities are making towards ensuring that health and well-being are considered in new developments, while also acknowledging that health inequalities continue to exist across the UK. She drew attention to a recent r eport from the Bennett Institute, highlighting that people living in the most deprived towns will live on average 12 fewer years in good health than those in our wealthiest. “Supporting this is a growing body of evidence,” Rydon 3
elaborated, “to demonstrate that environmental factors do underpin some of these inequalities, such as lack of open space, poor quality housing, and an abundance of fast food outlets.” How then can we even out those inequalities, and start to work toward a future which values public health? Rydon set out an excellent roadmap, with six steps: improving understanding of end-users, mapping community health assets, adopting systems thinking approaches, defining social value and providing means for it to be measured, and maximizing opportunities through mutually beneficial public private partnerships to create empowered communities. A question was raised about co-living: will the concept retain appeal post-pandemic? Is there a conflict there given the new concern to protect the environments in which we live from transmission? “I think co-living can give us an opportunity to think about what needs to be private and what could be shared space” Harris ventured, citing future possibilities of shared gardens and communal workspaces. Harris also spoke to the idea of retrofitting existing communities to encourage and foster senses of community, giving the example of swap-boxes for toys and books as one way this can be achieved. “Can we see a street as a shared living space?” Pearce agreed that co-living brings with it extra risks in terms of transmission, but that as a whole it is a positive thing. “But again, we have to listen to what the public wants and the community wants. There's no point in building things that people don't want, so we need to make sure it works for everybody.” Pearce and Rydon both also pointed to the potential appeal of co-living arrangements to older generations, providing a social element they might otherwise lack in their lives and thus helping to provide for their wellbeing. When we talk about wellbeing however, what do we actually mean? How can we measure it? Unfortunately, there isn’t a clear or obvious answer. West Berkshire is looking to develop a community resilience index, where they can bring together a “composite of different measures that can actually articulate what well-being actually means.” McGeough recommended a recent NHS report as providing useful advice. “For me, wellbeing can’t be measured in a black and white way” McGeough elaborated, “because it’s about people’s personal satisfaction with a place.” 4
Many of the current frameworks that are put in place only focus on the short-term, but McGeough called for longer-term vision when it comes to measuring health and well-being. Harris added that an obsession with metrics and measurements leads to an obsession with targets, which as a model for measuring success doesn’t necessarily work with something as complex as well-being. She takes more heart from knowing that developers who have people within their teams who are cognisant of this complexity, and are willing to give well-being genuine depth and measure in their approach to grappling with it. Harris raised an interesting conundrum that we will have to grapple with as we move out of lockdown. “A lot of the spaces where people would have interacted before, like shops or cafés, lots of people who live on their own might have their only interaction in a day on the high street or in a café. Those spaces, we’re actually focussing on how we keep people apart and how we make them as safe as possible.” This problem is just one of many that local authorities and placemakers will now have to deal with – and a perfect illustration of how issues relating to health and wellbeing, and in particular mental health, can often go under the radar or be superseded by more immediately obvious issues. However, as was demonstrated by the panel, they are of equal importance.
POLLS AND INSIGHT Polls taken from the live audience.
5
6
7
thevoiceofauthority.co.uk/webinar
8