Bruce Laurence, Director of Public Health for Bath and North East Somerset, discusses the importance of healthy and sustainable urban planning. He outlines 12 objectives for integrating health considerations into planning, such as encouraging walking and cycling, mixed use development, and access to local food production. Key areas for cooperation include land use and transport planning, social services strategies, and integrated resource planning. The process of developing urban plans is as important as the objectives, and should involve consultation, establishing a health baseline, exploring options, and coordinating implementation.

1. Bath and North East Somerset – The place to live, work and visit
Healthy and Sustainable
Places
Health and wellbeing stakeholder
engagement event
July 2013
Bruce Laurence
Director of Public Health
Bath and North East Somerset

2. Bath and North East Somerset – The place to live, work and visit
QuickTime™ and a
decompressor
are needed to see this picture.
We know it when we see it…

3. Bath and North East Somerset – The place to live, work and visit
And when we don’t.

4. Bath and North East Somerset – The place to live, work and visit

5. Bath and North East Somerset – The place to live, work and visit
History
» 2500 BCE Indus Valley civilization.
» Evidence of advanced urban planning including
flush toilets, covered sewers, careful spatial plans,
?public baths, egalitarian housing.
» 1860’s
» Massive public health investment in Victorian
England. 1867 Reform Act, improved capital
markets, common interests of capital and labour,
Chadwick and Dickens: the power of persuasion.
» 1980s
» Healthy cities. Bring “Ottawa” on to the streets. A
new linkage of planning and health.

6. Bath and North East Somerset – The place to live, work and visit
12 objectives for health and urban
(and rural) planning
Healthy
Lifestyles
(Exercise and
health, diabetes,
cardio vascular
disease, stress)
Environments that
encourage walking and
cycling. Traffic restriction
(cul de sac). Accessible
recreation. Networks of
open spaces.
Low density housing and distant
facilities demanding long distance
travel.
Social cohesion
(Mental and
physical health).
Create safe, permeable
environments with places
to meet. Mixed use
development in town
centres.
Poor housing developments,
dispersal of communities, severing
effect of roads and other barriers,
large commercial schemes
Housing quality
(Accidents,
respiratory and
cv health, mental
health, injuries).
Good design -for life-.
Use of energy saving
materials. Mixed
affordability, close to
amenities.
Overcrowding, poor insulation, toxic
materials and unsafe structures risk
physical + mental health.
Poor location and design can
promote crime and vandalism.

7. Bath and North East Somerset – The place to live, work and visit
Access to work
(Wealth, employment
and health)
Linking planning to
regeneration will provide
opportunities, retain local skill,
and attract employers. Needs
to be linked to transport.
Employment inaccessible, or
lacking in variety creates un-
or underemployment which is
bad for health and leads to
loss of skills from community
Accessibility for all
(Inequalities and
protection of vulnerable
groups)
Choice of transport to facilities
of all sorts.
Encourage dispersal of main
facilities based on walking and
cycling distances to shops,
clinics, schools. Protect what
serves vulnerable
communities
Local amenities can be cut in
austerity, and the vulnerable
suffer. Out of town
developments can drain life
from neighbourhoods
Local food production
and supply
(Diet and nutritional
awareness, exercise)
Green space for allotments.
City farms. Encourage diverse
retail outlets.
Lack of urban green space.
Centralisation of retail.

8. Bath and North East Somerset – The place to live, work and visit
Safety and its
perception.
(Exercise, sociability)
Traffic calming, design for
natural surveillance, good
lighting.
Threatening and alienating
environment. Poor lighting,
hidden spaces, heavy traffic.
Equity and social
capital.
(Social mobility and
community spirit)
Social and affordable
housing near to common
facilities.. health, schools,
etc. Mixed developments
Gating and “ghettos”.
Air quality and noise
(Respiratory and
mental health)
Transport planning to
minimise car use and
lorry traffic in centres.
Separation of heavy
industry from residential.
Poor transport planning. Lack of
control over factories, lack of
sound insulation. Poor control
over nuisance. Bath!! >90% NO2
traffic based.

9. Bath and North East Somerset – The place to live, work and visit
Water, sanitation and
flooding
(infections).
Water efficiency,
collection of rainwater,
use of grey water.
Building on flood plains
Concreting and over
draining natural carrying
capacity
Pesticide runoff Fracking.
Land and mineral
resources
(many health effects)
Maintaining green
space, use of brownfield,
use of recyclable
materials
Degradation, loss of
greenfield and green belt.
Deforestation, open cast
mining, toxic waste.
Climate stability
(many direct and
indirect health effects)
Energy efficient building
construction and use.
Limiting need for car
transport.
Poor control.

10. Bath and North East Somerset – The place to live, work and visit
And in Bath…
» Sense of community depends on the preservation
of heritage and uniqueness
» Future of community demands forward-looking use
of modern solutions
» Issues around transport, air pollution, affordable
housing.

11. Bath and North East Somerset – The place to live, work and visit
Most important areas of
cooperation
» Land use and transport planning, linking the location of
housing, employment and facilities with a strategy for transport
» Strategies for social services, embracing the forward planning
for social housing, health, education, open spaces
» Economic regeneration strategies, so that economic
development and urban regeneration programmes are
mechanisms for implementing a healthy planning strategy.
Riverside
» Integrated transport strategy, incorporating road policies, car
parking, public transport planning and operations, cycling and
walking. (bike-rail, park and ride, multiuse roads)
» Integrated resource planning for energy, water, food, waste etc

12. Bath and North East Somerset – The place to live, work and visit
Process is as important as
objectives
» Negotiate clear goals and purpose of the plan – agencies should
consult widely with partners, public and politicians. Putting the
health of the public as a central objective.
» Establish the baseline by creating a city health profile which
incorporates baseline social, health, economic and environmental
conditions. This will provide an opportunity to recognize problems
and obtain agreement on important issues. JSNA
» Scope and explore options – scoping and policy development is an
ongoing process. Alternative options. Health impact assessment of
options.
» Evaluate and refine policies – openly, explicitly and transparently
to maintain support. Balance the quantitative and qualitative, and
group interests.
» Coordinate implementation – using whatever powers are available.