UK Healthy Cities Network- Stephen Woods / Jennie Cawood, RTPI CPD June 2013
1. UK Healthy Cities Network
STEPHEN WOODS/ JENNIE CAWOOD
UK HEALTHY CITIES NETWORK CO-ORDINATORS
SMWOODS2@UCLAN.AC.UK
JLCAWOOD@UCLAN.AC.UK
WWW.HEALTHYCITIES.ORG.UK
2. The Healthy Cities Movement
Initiated by WHO in the mid-1980s as a small-scale project that
aimed ‘to put health on the agenda of decision-makers in the
cities of Europe’, Healthy Cities quickly fired the imagination of
politicians, professionals and citizens worldwide.
It is now a global movement for public health and sustainable
development with over 25 years’ experience of incubating new
ideas and developing creative solutions to old and new
challenges.
3. Wider determinants of Health - Equity
wider determinants of health
vulnerable and disadvantaged groups
equity, solidarity, sustainability, empowerment, intersectoral
collaboration,
community development and participatory governance.
Change agent
4. Primary Goal
The primary goal of WHO Healthy Cities is to put health high on the social,
economic and political agenda of local government.
•Its aims are to:
enhance learning and build capacity through sharing ideas, experience
and best practice
widen participation in the Healthy Cities movement and support
member towns and cities to develop and test innovative approaches to
emerging public health issues
become a strong collective voice for health, wellbeing, equity and
sustainable development – informing and influencing local, regional,
country and national policy.
5. UK Healthy Cities Network
Membership
Belfast*
East Staffordshire
Portsmouth
Brighton and Hove*
Glasgow*
Preston*
Bristol
Lancaster
Sandwell
Cardiff*
Leeds
Sheffield*
Carlisle*
Liverpool*
Stoke-on-Trent*
Chorley
Manchester*
Sunderland*
Cumbria
Newcastle*
Swansea*
Norwich
Wakefield
Nottingham
Warrington
Derry*
*Denotes cities with WHO designated status
7. What is a Network / Benefits?
“An interconnected system of things or people.”
“Something resembling an openwork fabric or structure in form
or concept, especially: a system of lines or channels that cross
or interconnect; a complex, interconnected group or system; or
an extended group of people with similar interests or concerns
who interact and remain in informal contact for mutual
assistance or support.”
Being part of a values-based movement
Being part of an active and dynamic network
www.freedictionary.com
8. Phase V of the WHO European
Healthy Cities Network runs from
2009-2013
Overarching theme - Health and Health
Equity in All Local Policies
Caring and supportive environments.
Healthy living.
Healthy urban environment and design.
A healthy city offers a physical and built
environment that supports health,
recreation and well-being, safety, social
interaction, easy mobility, a sense of
pride and cultural identity and that is
accessible to the needs of all its citizens.
9. “significantly improve the health and
wellbeing of populations, reduce health
inequalities, strengthen public health
and ensure people-centred health
systems that are universal, equitable,
sustainable and of high quality.”
Working together: adding value through
partnerships
Health 2020 – a common purpose and a
shared responsibility
Phase VI - City Health profiles, integrated
planning for health and sustainable
development - remain at the heart of
the work – creating community resilience
10. “Healthy urban environment and
design”
Important issues:
•Healthy urban planning.
•Housing and regeneration.
•Healthy transport.
•Climate change and public health emergencies.
•Safety and security.
•Exposure to noise and pollution.
•Healthy urban design.
•Creativity and liveability.
11. “Where people live affects their health and chances of leading
flourishing lives. Communities and neighbourhoods that
ensure access to basic goods, that are socially cohesive, that
are designed to promote good physical and psychological
wellbeing, and that are protective of the natural
environment are essential for health equity.”
Closing the gap in a generation, WHO (2008)
“The planning system can play an important role in facilitating
social interaction and creating healthy, inclusive
communities.”
National Planning Policy Framework, DCLG (March 2012)
12. SPATIAL PLANNING, HEALTH AND
INEQUALITIES – THE EVIDENCE
‘Evidence shows that a disproportionate burden of ill-health
associated with the built environment is borne by poorer
people living in low quality built environments. This includes
adverse conditions related to transport including lack of
access, pollutions, and injury; deteriorating features such as
vandalism and litter leading to insecurity, isolation and
obesity; poor housing and lack of good green spaces. Land
use, transport and development policies determining urban
form are key to tackling these inequalities and securing
healthy built environments for all. ‘
Caroline Bird, Research Fellow Planning and Architecture, WHO
Collaborating Centre for Healthy Urban Environments, UWE
13. “Healthy urban environment and
design – city links”
● the National Planning Policy Framework (NPPF) and local plans;
● neighbourhood planning and community involvement; and
● housing growth, quality and affordability.
● health and wellbeing boards;
● Joint Strategic Needs Assessments (JSNAs) and Joint Health and
Wellbeing Strategies (JHWSs);
● clinical commissioning groups (CCGs); and
● the Public Health Outcomes Framework.
14. National Planning Policy
Framework
‘The planning system can
play an important role in
facilitating social
interaction and creating
healthy, inclusive
Communities’
NPPF Published March 2012
Purpose of planning –
‘contribute to the
achievement of
sustainable development’
15. ‘contribute to the achievement of
sustainable development’
Making it easier for job
to be created in cities,
towns and villages
Replacing poor design
with better design
Improving the conditions
in which people live,
work, travel and take
leisure
Widening the choice of
high quality homes
Social / Economic /
Environmental objectives
Health cuts across all
these
Section on promoting
healthy communities
……. role in facilitating
social interaction and
creating healthy inclusive
communities
16. Measures aimed at reducing
health inequalities
Improving access to
healthy food and
reducing obesity
Encouraging physical
activity,
improving mental health
and wellbeing,
and improving air quality
to reduce incidence of
respiratory diseases
Other hooks:Promoting sustainable
transport
Choice of high quality
housing
Good design
17. Health and Health Equity in All Local Policies
‘health in all policies is not confined to the public health
community or to the national level. It is relevant and has a
tremendous potential for positive health outcomes at the local
level, strengthening the public health leadership role of municipal
governments. Health in all policies is a horizontal approach that
seeks to engage all sectors of society in integrating health and
well-being considerations as central values in their strategies and
plans’
18. Ageing Populations the
challenges - an example
guide to global age
friendly cities 2007
demystifyng
the myths of
ageing
WHO Strategy and Action
Plan for Healthy Ageing in
Europe 2012 - 16
19. Age-Friendly Cities:
the WHO Global initiative
VALUING OLDER PEOPLE – ASSET BASED
INSPIRATIONAL; SPREADING LIKE
WILDFIRE TO CITIES ACROSS GLOBE
COMPREHENSIVE: 8 DOMAINS
SILO’S OF WORK
TASK TO HARMONISE WITH HEALTHY
AGEING SUB-NETWORK
UK AGEING WELL NETWORK
HEALTH IN ALL LOCAL
POLICIES
Global age-friendly cities: a guide (WHO, Geneva, 2007)
20. DEMOGRAPHICS – POPULATION
CHANGES/CHALLENGES
• At aggregate level across the
North, the population will
continue to grow throughout the
period 2011- 2036, but will also
age considerably.
• The numbers of people with
Limiting Long Term Illnesses
(LLTI) will rise
• The labour force (as currently
defined) will fall
• The Old Age Support Ratio (OSR)
will increase.
21. DEMOGRAPHICS – POPULATION CHANGES – THE NEED TO
RESPOND
Area
Lancashire
Preston
Population
2011
Population
2036
Population
75+ 2011
1,521,651 1,706,457 132,644
143,063
169,394
12,472
Population
75+ 2036
Population
90+ Male
2011
Population
90+ Male
2036
Population
90+ Female
2011
Population
90+ Female
2036
225,180
4,237
20,419
9,769
19,924
22,248
683
3,238
576
1,191
Source N8 Research Partnership
www.n8research.org.uk/research-themes/demographic-change/research-reports
22. DEMOGRAPHICS – POPULATION CHANGES – LOCAL
INFORMATION
Area
Lancashire
Dementia
65+ 2011
Dementia Health Not Health Not Health Not Health Not
65+ 2036 good 75+
good 75+
good 90+
good 90+
2011
2036
2011
2036
19,642
35,095
29,761
53,145
3,628
11,064
Preston
1,756
3,405
3,947
6,894
522
1,385
Area
LLTI 75+
2011
LLTI 75+
2036
LLTI 90+
2011
LLTI 90+
2036
Lancashire
74,840
133,099
9,748
28,978
Preston
10,182
17,992
1,587
4,188
LLTI –
Projected
population with
limiting long-term
illness, 2011 and
2036
The UK Healthy Cities Network is part of a global movement for urban health that is led and supported by the World Health Organization (WHO). Its vision is to develop a creative, supportive and motivating network for UK cities and towns that are tackling health inequalities and striving to put health improvement and health equity at the core of all local policies. Established with funding from the Department of Health for England, the UK Network is one of 30 national Healthy Cities networks across Europe, and we are proud that it is one of 20 accredited by WHO as a member of the Network of European Healthy Cities Networks. It is co-ordinated by the Healthy Settings Unit at the University of Central Lancashire and overseen by a high-level steering group representing all four countries within the UK.
Committed to tackling the wider determinants of health and addressing the needs of vulnerable and disadvantaged groups, Healthy Cities prioritises equity, solidarity, sustainability, empowerment, intersectoral collaboration, community development and participatory governance. Concerned to translate rhetoric into tangible action, it recognises that success requires experimentation, learning, adaptation and change.
Within England, the changes heralded by the Health & Social Care Act 2012 provide an important context for the Network’s future development. As Local Government prepares to take on the responsibility for Public Health, the Network is uniquely placed to support sector-led improvement by local authorities in promoting health and tackling inequalities through action on the wider determinants of health – drawing on the long history of Healthy Cities and the rich experience of member authorities in advocating and implementing ‘health through local government’. Furthermore, the life course approach and the five core domains of the Public Health Outcomes Framework resonate with the Network’s aims and activities.
Healthy Cities is a global movement that engages local authorities and their partners in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects. Within Europe, there are around 90 cities that are designated as members of the WHO European Healthy Cities Network – including 14 in the UK:
In addition, there are approximately 30 national Healthy Cities networks involving more than 1400 cities and towns as members.
SW
‘25’ the number of additional Cities, Towns, Boroughs and Local Authorities who have expressed an interest in becoming Network members. Throughout 2012 we have continued to support cities and towns from across the UK who have expressed an interest in applying to become members by offering one-to-one guidance, attending regional and thematic meeting and supporting discussions at a local and county level. We are currently exploring the potential for a County Council level membership option with Cumbria, Lancashire and Derbyshire and are working with those areas to establish how this might work at an operational level.
That might sound as if I’m stating the obvious – but it’s important to reflect on what it means. Not surprisingly, the term Network has many definitions, but perhaps the most resonant is:
“An interconnected system of things or people.”
Delving further, the dictionary defines Network as:
“Something resembling an openwork fabric or structure in form or concept, especially: a system of lines or channels that cross or interconnect; a complex, interconnected group or system; or an extended group of people with similar interests or concerns who interact and remain in informal contact for mutual assistance or support.”
Benefits in summary – full list on the website
Not just about planning in a traditional sense – all local policies
The focus on planning and health is important and timely. Historically, the town and country planning system developed at least partly in response to the unhealthy environments and unsanitary conditions that existed in the early 19th century – and planning and public health were understood to be closely interwoven. Whilst the relationship between planning and health drifted somewhat during the 20th century, there has in recent years been increased recognition of the need to bring them back together. There’s an accumulating evidence base that shows how important the physical, social and economic environments are in determining our health and quality of life. It’s also clear that many of the issues for which spatial planners are responsible interact with human health and have the potential to improve physical and mental wellbeing and help reduce health inequalities. Viewed in this way, planners are public health strategists and practitioners.
Optimising population health outcomes requires effective multi-disciplinary and intersectoral health-promoting strategies, which give access to safe, clean and sustainable environments, ensure good housing and living conditions, and support social inclusion.
Before moving into the main programme, I want to highlight a few key ways in which planners can make a difference and impact positively on health and wellbeing:
Firstly, the form of the built environment and patterns land use impact levels of physical activity – and thus levels of obesity and patterns of non-communicable diseases – through whether (or not) people want to, are able to and/or choose to walk and cycle.
Secondly, planning decisions influence access to healthy, sustainable and locally-produced food and to fast-food outlets – likewise having the potential to impact levels of obesity and patterns of non-communicable diseases.
Thirdly, research has shown that access to nature and green space is important for physical and mental health and development – highlighting the centrality of the planning role.
Fourthly, the design of our cities, towns and neighbourhoods influence levels of social interaction, which in turn affects social capital, community cohesion and wellbeing.
And lastly, planning as a discipline and profession provides an obvious ‘bridge’ between public health, sustainable development and equity agendas – for example, through contributing to community resilience to climate change.
With the health reforms taking shape and the transition of the public health function to local government, the time is right to debate how public health and planners can work together across county and district tiers, to bring about sustainable health improvement.
From reuniting health with planning – healthier homes, healthier communities
WHO – European activity has included the production of key document –
There are a number of complementary and competing frameworks for developing Age-Friendly Cities. The WHO team will map and analyse them for consideration by AF-SN member cities.
The main frameworks are;
The draft WHO European Strategy and Action Plan for Healthy Ageing (2012-2016)
the Guide to WHO Global Age-Friendly Cities (2007) developed via the
the Vancouver Protocol and forming the basis for
the planning cycle for WHO Global Network of Age-Friendly Cities (2009).
Two Products of the Phase IV AF-SN are Demystifying the Myths of Ageing (WHO, 2008) and Healthy Ageing Profiles: Guidance for producing local health profiles of older people (WHO, 2008).
Valuing older people – asset based approach
Intergenerational element
The old-age support ratio is an important indicator of the pressures that demographics pose for pension systems. It measures how many people there are of working age (16-64) relative to the number of retirement age (65+). At the moment, there are just over four people of working age for every one of pension age on average.
The N8 Research Partnership is a partnership of the 8 research intensive universities in the North of England - Durham, Lancaster, Leeds, Liverpool, Manchester, Newcastle, Sheffield and York.
The N8 Research Partnership aims to maximise the impact of this research base by identifying and co-ordinating powerful research teams and collaborations across the North of England. To support the collaborations, N8 Research Partnership creates teams with a critical mass of world class academics. These teams form a network of virtual centres of science and innovation excellence.
Population - Population change, 2011-2036
LLTI - Projected population with limiting long-term illness, 2011 and 2036
NGH - Projected population with not good health, 2011 and 2036
Labour Force - Projected labour force, 2011 and 2036
Households - Projected households, 2011 and 2036
The rate of increase of the population with limiting long term illness and in not good health will be
greater than the population as a whole because the age structure will shift towards the ages at which people
have experience more illness Population ageing reflects improvement in survival and longevity
but at the expense of more time spent in illness and more people ill, unless illness onset can be delayed by
improved health behaviours (less smoking, moderate drinking, better diets, more exercise )