UK government misses the mark on shaping healthy urban policies, finds review

A large-scale review of two key U.K. policy areas reveals that health outcomes are largely missing when it comes to shaping our urban centers.

Published today (Thursday 19 October) in the Journal of Urban Affairs, researchers at the University of Bath and University of Bristol examined housing supply and transport policies to establish how written guidance for local government and developers support or hinder measurable health objectives. These two areas were chosen because they are essential for regulating land development and providing places to live and work. One of the authors, Krista Bondy, is now at the University of Stirling.

They found that in 38 U.K. policy documents since 2010, health is largely absent. When it is included, health is assumed to be an indirect outcome of delivering other policy areas such as improving the economy or increasing housing supply.

The study is part of TRUUD, a transdisciplinary research project led by the University of Bristol, which aims to reduce non-communicable disease (such as cancers, diabetes, obesity, mental ill-health and respiratory illness) and health inequalities linked to the quality of urban planning and development.

Dr. Geoff Bates at the University of Bath's Institute for Policy Research led the research and believes that this new evidence adds to the call for health considerations to be explicit and direct to help manage this complex policy area.

He said, "The World Health Organization clearly states that if we want to prioritize our health, then it should be central to the planning and governance of urban areas.

"The U.K. government has tools to embed and enforce health considerations such as in the local planning system which is highly centralized with nationally set regulations and targets. We found that while there is much justification to support housing supply and transport policies, health is largely absent in importance.

"We can see that national urban development policy is falling short in setting the context needed to support the creation of healthier places in the mission to build 300,000 homes per year across England during the next decade. Studies show that the new homes are likely to be of lower quality and fail to meet standards for internal space and that national policies fail to account for regional needs. All of which comes at a time of great change and uncertainty around the Net Zero and Leveling Up agendas.

"To prevent our towns and cities from making us ill through pollution, poor quality housing or lack of green space we need to place health on an equal footing with other cross-sectoral policy agendas, such as growing the economy. Cross-Whitehall strategies to reduce health inequalities have had success previously in the U.K. and action is becoming more critical against the backdrop of a struggling health care system and cost of living crisis."

Jo Bibby, director of health at the Health Foundation, said, "Living conditions and access to good transport shape our health but unfortunately, national and local policies often overlook this fact. This means many people are missing out on critical building blocks of health.

"Prioritizing health outcomes in policy development is crucial, given the widening health inequalities and stalling improvements in life expectancy across the U.K.

"To reverse this societal gap and build a prosperous future for all, national and local policymakers should consider using Health Impact Assessments when formulating policy."

"Urban policies and the creation of healthy urban environments: A review of government housing and transport policy documents in the United Kingdom" is published in the Journal of Urban Affairs by Geoff Bates, Md Nazmul Hasan, Andrew Barnfield and Krista Bondy.