23 June 2007

Planning and Health: Findings from the UK Royal Commission on Environmental Pollution

by Andrew Buroni, RPS Group

The UK Royal Commission on Environmental Pollution (RCEP) is an independent body established to advise the Queen, the Government, Parliament and the public on environmental issues.

The Commission's advice is mainly in the form of reports, of which their most recent is on the Urban Environment. In this report the RCEP acknowledges current shortcomings in the planning system and recommends that the UK government and devolved administrations develop a statutory framework for including Health Impact Assessments in the planning process.

This article provides a summary of the RCEP report, detailing the recommendations to Government and future HIA planning requirements.

Planning and Health
The planning system offers an important opportunity for a more coherent effort to develop cities and improve the health and wellbeing of urban inhabitants.
Evidence suggests that planning can not only be applied to tackle and offset many of the adverse health effects of an urban environment, but can also be applied to address and prevent many of today’s significant physical, mental and social health issues.

The mode of health effect is complex and represents a mixture of physical influences such as the removal of environmental risks, social influences brought about through improved connectivity and support through to behavioral responses from improved perceptions of the environment.

Potential outcomes from more health conscientious planning therefore reflect real opportunities to contribute in reducing cardiovascular and respiratory ailments, obesity, diabetes, road traffic accidents, antisocial behavior and crime and foster improved self-rated health, wellbeing and ultimately healthier communities.
The ethical and financial benefits of preventative health measures over treatment are key to Government policy represented through the White Paper, ‘Saving Lives: Our Healthier Nation’ and supported by the Department of Health, the National Institute of Clinical Excellence and regional Health Authorities.

However, to date, consideration of health and wellbeing has had little influence in urban design and planning and the present planning system is still unable to adequately deal with complex public health issues.

Planning applications for large-scale developments often require an Environmental Impact Assessment (EIA). These assessments can include data on environmental problems like air pollution that can cause health effects, but while they may predict environmental emissions from future developments to compare with relevant standards, they do not always look at health impacts in terms of a population’s vulnerability and exposure to health risks.

EIAs and planning applications therefore tend to not consider health and wellbeing issues in a systematic manner do not recognise the complex interrelations between social and environmental factors and rarely identify measures to enhance health benefits.

Recognition of the planning systems failure to adequately address health is not new. The RCEP’s previous report on Environmental Planning, highlighted the general issues and recommended the Government integrate processes such as Health Impact Assessment (HIA) within EIA back in 2002.

In its response, the government recognised the benefits of HIA, but stated that it was “not persuaded that detailed Health Impact Assessments, which require different expertise and methodologies, should form an integral part of Environmental Impact Assessment at individual project level”.

However, during the most recent RCEP study, the Department of Health supported the inclusion of HIA within the EIA process as the best means of considering health issues in the planning process, and the RCEP strongly concur.
The RCEP therefore reinforces its recommendation that Health Impact Assessments be incorporated explicitly in Sustainability Appraisals, Strategic Environmental Assessments and Environmental Impact Assessments.

In order to implement this, the RCEP further recommend that the UK government and devolved administrations develop a statutory framework for including Health Impact Assessments in the planning process.

Future HIA Requirement in the Planning Process
The RCEP’s study reinforces the consensus view of UK health organisations and Local Government in that a formal requirement to assess the potential health effects of development is long overdue.

In the absence of leadership from Government and a lack of a formal requirement to conduct HIA, Local and Regional Government are developing their own initiatives to ensure that health is addressed in the planning process.
  • In London, the Greater London Authority Act (1999) places a duty on the Greater London Authority (GLA) to promote the health of Londoners and to take into account the effect of its policies on health and inequality. Supporting the GLA Act, the Mayor appointed the London Health Commission to drive health improvement in priority areas across London, to investigate specific health issues if it wishes and to drive the practice of HIA across London. Complementing the GLA Act, the Mayor of London has recently released Best Practice Guidance setting out how health inequalities can be tackled through more informed planning, policies and proposals subject to HIA.
    The Welsh Assembly have recently published a Draft Interim Planning Policy Statement on Planning, Health and Well-being, forming the first planning requirement for HIA in the UK.
  • The Department of Health and the Health Protection Agency are developing guidance to advise health authorities on how to integrate health into Strategic Environmental Assessment (SEA).
  • Primary Care Trusts and Strategic Health Authorities are becoming more involved in the planning process and specifically requesting HIA.
  • Developers are voluntarily commissioning HIA to identify potential health risks, to facilitate health improvements and avoid often-costly remediation.
In light of the growing demand and clear benefits of HIA, the RCEP recommendation is likely to be the precursor for the development of the first UK statutory requirement to conduct HIA.

Any further delay by Government may be perceived as a deliberate attempt to avoid tackling the often-emotive topic of health.