Why is it a priority?
People need healthy places to live healthy lives, the physical environments where people are born, live, grow, work and age have significant effects on mental and physical health and wellbeing. Planning, transport, housing, environmental and health services all have a key role to play. These social determinants of health impact on physical and mental health & wellbeing. There is strong evidence that mental ill health, cardiovascular disease, respiratory disease, excess seasonal deaths and accidental injuries are heavily influenced by these social determinants. Both the built and natural environment play a key role in improving physical and mental health, reducing segregation and isolation, and preventing long-term illness, such as obesity and associated diseases. The evidence based Marmot Strategic Review of health Inequalities (2010) recommended the full integration of planning, transport, housing, environmental and health systems to address the social determinants of health.
What could make a difference at a local level?
Key factors that can influence specific health issues at a local level are as follows:
- Mental health and wellbeing: housing density and escape (overcrowding; access to green spaces and opportunities for physical activity, social facilities, places to stop and chat; community facilities such as libraries); safe highway network; housing design (the look of the development); housing quality (e.g. damp, noise; fear of crime (feeling unsafe to go out)
- Obesity and cardiovascular disease: opportunities for active travel and recreational exercise outdoors; safe highway environment; damp homes; overcrowding
- Air quality: outdoor air quality, total volume of traffic and local congestion
- Excess seasonal mortality: ensuring buildings are sufficiently insulated and designed to not trap excess heat in summer
- Accidental injuries: traffic calming, pedestrian-friendly environments
What are the opportunities for improvement in Greenwich?
Planning – a joint public health and planning work programme to consider how health concerns can best be addressed through planning and how planning can support the Greenwich Health and Wellbeing Strategy, particularly with respect to promoting good physical health and reducing obesity. Proposed work included: Health and Planning event facilitated by the Town and Country Planning Association; Greenwich planning and health document to include RBG expectations around health impact assessment; public health to develop its role in responding to planning applications.
Improving Housing Quality – Poor quality housing is housing that is poorly managed or dangerous. Living in poor quality housing particularly unsafe, cold, damp, noisy or overcrowded homes, has both direct and indirect health impacts. Badly managed homes or homes in poor physical condition put their occupants at risk of deteriorating health, particularly for young, old, disabled or vulnerable residents. Key issues for Royal Greenwich include: the quality of the private rented sector; levels of overcrowding; fuel poverty; demand for social housing and provision of a suitable mix of housing tenure including family housing. Actions include: a focus on improving the private sector through supporting responsible landlords and taking action to identify poor quality landlords; focus on homelessness prevention; supported work with residents to encourage participation in decision making and planning, maximising opportunities to work with registered providers; healthy lifestyle choices and access to training and support services.
Environment – The environment impacts on health through the amount and quality of green and open space; cleanliness; encouraging and facilitating physical activity; access to areas suitable for growing food; and air and noise pollution. Good-quality communities and neighbourhoods that enable healthy lifestyles where people feel safe are essential to ensure health equity. Actions include: Investments in safe highways and opportunities for walking and cycling, promoting quality food environments and food growing; play streets; proactive air quality management; encouraging and promoting play streets; proactive noise management; open and green space management; promotion of Greenwich Get Active physical activity programme.