How can we help to bring health into the development decision-making process, without placing yet another burden on already overstretched local government officers?
Health impact assessments (HIAs) can be a useful tool, and although there are no national requirements for them in development decision-making, they are increasingly used for planning applications.
However, we have come across many stories of HIAs being little more than a tick-box exercise – a hoop to be jumped through, with little attention to wider questions of health for the community.
As part of my research with TRUUD (Tackling the Root causes Upstream of Unhealthy Urban Development), we identified that just 38 per cent of local plans have an HIA policy, and that officers from across planning practice were looking for examples of their use and guidance from their peers.
In response to this gap, we commissioned a series of short films to help share experiences, including advice from five councils, the Office for Health Improvement and Disparities, two planning consultancies, and Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board.
Participants in the nine films look at their own experiences of embedding requirements for HIAs in their local plans and share where they have seen positive impacts, and what could be improved.
Contributions highlighted:
- creating usable green spaces rather than a ‘tick-box’ approach
- building confidence and buy-in between developers and planners
- future-proofing communities for generational living
- team working between public health and planning
- getting senior level buy-in to a health approach
- using HIAs to avoid technical language
- using HIAs to promote better community engagement.
In relation to local plans, we looked at 344 from 314 planning authorities across England, to see how HIAs were referenced and the triggers in place for their use. That research found a huge degree of variation in local plans where a HIA was required.
There will be published research from this work, but, in the meantime, I can offer the following tips for planners, public health officials and developers to improve HIA implementation:
- a clear statement of the HIA requirement in local-plan policy wording
- an unambiguous trigger for an HIA within policy wording
- a clear scope for an HIA within policy wording
- be explicit about proportionality, with precision about the scale of HIA required depending on the size and/or type of development proposed
- consider setting out the HIA process
- consider the outcomes of HIAs
- include explicit metrics.
The main goal of an HIA policy should be to ensure that developers incorporate health considerations into their proposed developments, maximising the potential health benefits of development, reducing inequalities, and mitigating potential harms.
An effective HIA process should frontload responsibility onto developers (working in partnership with the local authority) to get health right.
In contrast, ambiguity in HIA requirements and processes risks health considerations being missed, misunderstood, or challenged by developers, creating more work for local planning authorities and developers, and losing opportunities to improve the health and wellbeing of people and communities.
- For more, including tips for using health impact assessments, please see our briefing note and our online blog.