Health impact assessment – the role of planning in making places fit for the future

Public health and wellbeing has been increasingly under the spotlight in recent years. This was exacerbated by the covid-19 pandemic; a time during which a series of national and local lockdowns limited people leaving their homes and prevented social gatherings. For many, this highlighted the aspects of place they valued most, for example walkability, access to nature and space for social interaction. Prior to the pandemic the role of place in the health and wellbeing had been recognised by academics, planners and public health professionals. The ‘National Planning Policy Framework 2021’ places emphasis on the role of planning in enabling and supporting healthy lifestyles, especially where this would address identified local health and wellbeing needs. This is reflected in planning policy with many local planning authorities (LPA) requiring a health impact assessment (HIA) to be undertaken for a proposed scheme and submitted with a planning application.

HIA is a tool which looks at the existing health and wellbeing of a population and the implications on it as a result of a proposed development. Identifying potential negative impacts allows mitigation measures to be put in place. The positive impacts can also be maximised so that, wherever possible, development not only has a neutral impact but creates healthy places which contribute to addressing broader health inequalities. The HIA uses key health ‘determinants’ to consider the social, economic, cultural and environmental factors that influence health and wellbeing, many of which can be influenced by the design of people’s living and working environments.

There is no prescribed guidance for undertaking a HIA in England. However, HIAs should address the following:

• Does the project need a HIA and why?
• What does the HIA need to assess?
• What is the existing situation or baseline?
• What changes would occur as a result of the proposed development?
• What actions are recommended to mitigate negative impacts and maximise positive impacts?

Whether a HIA is required and what it needs to assess depends on the location, scale and nature of the proposed scheme. This may be determined through engagement with the LPA and stakeholders such as the local NHS trust.

An assessment of the baseline conditions should give an accurate picture of the current situation in terms of health and wellbeing. For example, it may set out statistics in relation to life expectancy, mental health and prominence of chronic illnesses such as heart disease. It may also include socio-economic factors such as employment rates and average income. In addition, environmental factors that impact on health such as air quality and access to green space can be illustrated.

The likely changes both positive and negative as a result of a proposed development can then be assessed in comparison to the baseline. This should consider any demolition, construction and operational impacts. Particular attention should be paid to the potential impacts on vulnerable groups in the community such as people with disabilities. Health inequalities and social exclusion should be considered and the potential for the project to affect them.

The HIA is presented as a report which details the implications of the proposed development and sets out recommendations including mitigation measures in relation to the impacts of the proposed development.

When used proactively HIAs can help create liveable and vibrant places which make a valuable contribution to the achievement of sustainability. They can be used to inform design and create high quality environments that allow people to access jobs, green space and social activity to facilitate the improved health and wellbeing of individuals and address wider health inequalities.

Cundall has undertaken HIAs on a range of projects of varying scales including housing schemes, healthcare facilities and mixed-use development of large city centre regeneration sites. Should you have any questions on HIA or a project which may benefit from the experience and expertise which Cundall have please get in touch.