Director of Public Health Annual Report 2018: Healthy places

The health and wellbeing of our population is vital for the social and economic success of Buckinghamshire. Good health helps people live a satisfying life and achieve their goals. It supports children’s educational attainment, adult’s ability to work and everyone’s ability to participate in and contribute to community life.

This report has shown the myriad ways in which the places where we grow up, live, work, play and age impact on our mental and physical health and wellbeing. It has also highlighted that key groups are more vulnerable to the impact of poor environments particularly children, older people and people with existing health problems. In addition some groups are more often exposed to poorer environmental conditions such as people on low incomes, people living in more deprived areas, older people and those with long term conditions. Communities and neighbourhoods need to be designed with this in mind to ensure they meet the needs of all residents and ensure that everyone has a chance to live as healthy a life as possible.

The impacts of our living environments on our health are wide ranging and are felt throughout life. Where we live can influence how happy we are, whether we know our neighbours and how strong the community ties are. They can also influence how well children develop and how they do at school, crime levels, fear of crime and economic productivity.

When it comes to health the impacts are far reaching. The places and communities in which we live affect our ability to live healthy lives which has a profound impact on our risk of developing a wide range of long term conditions such as high blood pressure, obesity, diabetes, heart disease, stroke, cancer and dementia. As our population ages it is more crucial than ever that our residents age well and delay or prevent the onset of long term conditions, disability and frailty. The opportunities to be active and have access to healthy affordable food also affect the health of our children and young people. Moreover, young people growing up in strong communities are more likely to adopt positive health behaviours and resist harmful patterns of behaviour.

The places and communities in which we live influence our mental wellbeing which affects all other aspects of our health and lives. The presence of strong social connections and community spirit can help protect mental wellbeing and reduce loneliness and social isolation. Well-designed neighbourhoods with welcoming places to meet that are accessible to all help improve social connections. Green spaces and places to be physically active also produce a wide range of mental wellbeing and physical benefits.

The places we live and work determine the quality of the air we breathe and the levels of noise we experience. There is good evidence that poor air quality increases the risk of a wide range of long term conditions and has a harmful impact on child health and development. Noise pollution also has a significant impact on physical and mental health. Significant sources of air pollution include road and rail traffic and construction so it is important that with housing growth and the significant infrastructure developments in Buckinghamshire that action is taken to mitigate the impact of air and noise pollution. Good spatial design can also help mitigate the health effects of extreme weather due to climate change e.g. heat waves and flooding.

Good design and policies can also help reduce energy use and contribute to a more sustainable future.

Finally the provision of a wide range of quality affordable and adaptable housing is vital to our residents, helping them stay physically and mentally healthy throughout life and live in suitable accommodation as their needs change.

Improving the health of our residents makes good economic sense and reduces demand on health and social care and other public sector services.

Improving health through improvements to the environment and community life has additional benefits as it helps Buckinghamshire remain a thriving and attractive place where people want to live and work, can contribute to reducing congestion, air and noise pollution, mitigating the impact of climate change and attract inward investment.

A wide range of stakeholders have a role in determining whether our environment is healthy. Communities have a key role to play in making places successful and attractive to live in. Other key partners include local authorities, developers, across Buckinghamshire to protect and improve the places we live and to strengthen communities. There are very significant opportunities for us all to work together. This includes the recent awarding of Garden Town status to Aylesbury which offers a unique chance to ensure that as the town grows we can create well planned sustainable environments and desirable communities in which to live. There are other place shaping initiatives taking place across Buckinghamshire and opportunities to share good practice across the county and beyond.

To continue and support this good work the following recommendations are for all stakeholders including communities themselves.

1. The promotion and protection of the health and wellbeing of everyone who lives and works in Buckinghamshire should be a major consideration when planning new developments or improving existing developments. This should be supported by health impact assessments where appropriate, to understand the impact of these changes on health and wellbeing particularly for those most vulnerable and with the greatest risk of poor health.
2. Where possible, local authorities and developers should engage communities in co-designing new developments and making improvements to existing developments. They should ensure input from a wide range of current and future residents of all ages and abilities to ensure developments work for all. The WHO ‘Age Friendly’ Cities guidance and UNICEF Child Friendly Cities and Communities initiative offer useful principles to inform discussions.
3. Local authorities, communities, town and parish councils and local area forums should use this report to consider how they might work together to improve the health and wellbeing of their residents, drawing on the assets in their communities and their local knowledge of what might need to change. This could include strengthening the social ties in an area, increasing community engagement and reducing social isolation or making improvements to the built and natural social aspects of a place and help determine priorities for action.
4. The public and private sector, voluntary, community and faith sector including local authorities, the NHS, schools, universities and businesses should use this report to consider how they can help improve health and wellbeing through their actions that impact on the environment and strengthen communities in Buckinghamshire. This can include the services they provide, their policies on community engagement and co-design of services with communities, travel, land use, and corporate social responsibility.
5. We should, where possible, encourage planning for new and existing developments to:

• Be socially inclusive, welcoming and accessible to all sections of our community. Designed on a human scale for people and taking into account the needs of children and older people and those with disabilities.
• Provide safe, welcoming indoor and outdoor public places where people can meet.
• Encourage physical activity, active travel and access to good public transport.
• Incorporate natural landscaping and urban greening and good access to high quality green and blue public spaces e.g. parks and community gardens that people of all ages and backgrounds can enjoy.
• Improve access to healthy affordable food.
• Be designed to help reduce crime.
• Provide healthy good quality homes using lifetime home principles and affordable housing.
• Provide good access to employment, retail and community facilities and health services which can ideally be accessed by walking or cycling through mixed land use policies.
• Minimise the impact of climate change and minimise air, water and noise pollution.
• Foster strong social connections and a sense of belonging and link new and existing communities effectively.