HIA and Sustainable Well-Being 9 th International HIA Conference, Liverpool, UK, 9-10 Oct 2008

Can Liverpool city development provide practice examples of ”urban planning and health”?

...

[email protected], [email protected], [email protected]

Institute of Health and Work North Rhine-Westphalia (LIGA.NRW) / WHO Collaborating Center for Regional Health Policy and Public Health,

www.liga.nrw.de

9.-10.10.08 [08-40] RF, RW, OM

Overview

1.

2.

3.

4.

5.

Background, context Study questions, methods Search results: Key topics Contact results Conclusions

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1. Background, context

Urban development and planning procedures:  offer multiple opportunities for health protection and promotion  are underutilized opportunities, deserving more attention Therefore, a series of (mini-)case studies was initiated in several European countries in order to:  illustrate the status of “healthy local planning”  stimulate discussion within Public Health Approach:  using the locations of current professional meetings as examples  intended format: workshops providing informative dialogue among city/region representatives and other (local) actors

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2. Study questions, methods

Study questions

:   What practice examples to draw from Liverpool?

How is “health” reflected in the debate on Liverpool development? incl. ”integrated programs”  What relevant documents and processes can be identified?

Approach

:  Using the cities of professional meetings as examples

Methods

:   Searches of internet information Intended to be complemented by informative dialogue with city representatives and other (local) actors This exploratory analysis follows the format of a series of similar local (mini-)studies

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3. Search results: Key topics

Internet search identified 4 strands of interest: 3.1 Liverpool city planning 3.2 WHO’s Healthy Cities network, Local Agenda 21 3.3 Participation 3.4 HIA of Liverpool housing strategy Limited contact results, cf. 3.5

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3.1 Liverpool city planning

Liverpool city planning

: aims at making Liverpool a “premier European city”

Local development framework

: includes health-related topics such as housing capacity and flood risk assessment

Unitary development plan

(UDP):  statutory document playing a major role in shaping the future of the city   shows what every piece of land in the city can be used for under the new planning system, the UDP will be gradually re  placed by new Development Plan Documents (DPDs) and Supple mentary Planning Documents (SPDs) 13 chapters + appendices + proposals map

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Unitary development plan (UDP) 2002: Chapters

Explanatory Note & Contents Chapter 1: Introduction Chapter 2: National & regional planning context Chapter 3: Corporate policy context Chapter 4: Environmental context & appraisal of the UDP policies Chapter 5: Strategic objectives & policies Chapter 6: Economic regeneration Chapter 7: Heritage & design in the built environment Chapter 8: Open environment Chapter 9: Housing Chapter 10: Shopping Chapter 11: Transport

Chapter 12: Community facilities

Charter 13: Environment protection

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Unitary development plan (UDP): Chapter 12: Community facilities

HEALTH CARE

1. The City Council will support development proposals which con tribute to the health and well being of the City’s residents...

2. The City Council will assist the Liverpool Health Authority and the NHS Trusts in the rationalisation of health services in the City by: i. supporting, in principle, the xxx Hospital Trust in their proposals for expansion within their existing site boundary... iv. granting planning permission for the establishment of health centres ... provided that: · they are sited in locations accessible by public transport; · exclusive on-site parking facilities are provided, ... which enable vehicles to enter and leave in forward gear ...

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3.2

WHO’s Healthy Cities network, Local Agenda 21

Healthy City network: member since 1987 Local Agenda 21, Sustainable Development plan, re-issued in 2006, incl. education, social affairs, planning, housing, and transport     Key environmental actions for 2006-2009 put in order of priority...:  assess the feasibility of ... environmental management systems  waste minimisation; waste recycling (internal and external) sustainable procurement Green Transport Plan energy and water conservation; increased use of renewable energy internal staff training and awareness

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3.3 Participation

The City council and Primary care trust work with multiple partners to optimize services, using

Joint Commissioning Groups

, e.g. for older people Health education and promotion services support “

Health improvement initiatives

”

Local Involvement Networks

(LINks), currently replacing exist    ing local patient forums: The Government recognises that health and social care services will only get better if we listen and respond to the needs of the people who use them... LINks will: Provide everyone in the community ... with the chance to say what they think about local health and social care services Give local people the chance to influence how services are planned and run Provide feedback to services about what's working and what's not

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3.4 HIA of Liverpool City Council’s housing strategy

Final HIA report 2003

, 45 pp.

plus 9 appendices Contents re-arranged: (1) City Council’s housing strategy (2) Health and housing (3) This HIA (4) Nine sub-projects (5) Conclusions

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(1) City Council’s housing strategy

(p.3)   ... a city of 439,000 residents in some 200,000 dwellings. The city’s population has fallen from 856,000 in 1931 to its present level...

Poor stock condition characterises much of the city’s housing...

 ... low and falling property values in relation to much of its stock, together with rising vacancy levels  ... significant housing market restructuring will be required in future years

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(2) Health and housing

Topics (pp. 4-10):

Heating conditions

and health, incl. hypothermia, non-specific mort ality, asthma and respiratory symptoms, poor mental health

Fuel poverty

: “... inability to afford adequate warmth because of the energy inefficiency of the home “

Hazards

: Carbon monoxide poisoning, burns, house fires; lead in drinking water

Security

, incl. f ear of crime

Environment

, incl. health impacts of global warming

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(3) This HIA

  

Objectives

(p. 4, 13), incl. “To identify where the Housing Strategy Statement ... can make a difference to the health of the population”, “To improve the decision making process ...”

Process

(p. 11): The PH Department at the former Liverpool Health Authority and the Housing Strategy Team from Liverpool City Council were tasked by the Strategic Housing Partnership

Method

(p. 11), incl. initial “Rapid HIA”, then “Full HIA” ; Merseyside Guidelines

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This HIA (2)

   Budget (p. 18): £ 20K Steering group (p13, 36): 10 members, each leading on a particular area of research to ensure ownership by the group of the HIA External reference group (p. 13, 36): 15 members

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Nine HIA sub-projects (2)

Sub-projects (pp. 19-33) were selected from the original (more comprehensive) workplan. Each sub-project -> separate report

Substantive:

1. Occupational health for construction workers 2. [Community ... involvement on] Stock clearance policies 3. Greener housing, 4. Lead in water, 5. Travel plans 6. Healthcare facilities, 8. Houses in multiple occupation

Procedural:

2. Community ... involvement [on Stock clearance policies] 7. Involving children and young people 9. Development of a health and advice note

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(5) HIA Recommendations

(pp. 1-2)

Human capital

 Health and safety and occupational health training for all new  workers should be introduced ...

Community consultation and involvement in stock clearance and redevelopment ...

Natural resources

 ... location of lead piping, and where it is found, replacement  ... to inform households of the health impact of lead piping

Environmental protection

 ... development of a Travel Plan

Social capital

 Strengthen the outreach activities of health centres, GP practices, community-based health initiatives

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(6) HIA Conclusions and lessons learnt

Quotations (pp. 34):  ... the first experience of the HIA process for the majority of people involved in the study, ... all participated ... with enthusiasm and embraced the holistic model of health...

 One of the strengths ... was the allocation of responsibility for project management to members of the steering group which engendered   a sense of ownership of the study by the steering group members ... little community involvement, ... a very officer led process We had no representation from the private rented/private sector involvement despite our best efforts

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4. Contact results

Compared to the search results, th econtact results were much more limited:  HIA of Liverpool housing development: City representatives regar ded the document as “now quite out of date” and not appropriate to be presented at the meeting. No success in establishing workshop  Attempts to link with presentation by Haigh et al. on development of the town of Kirkby in the borogh of Knowsley, adjacent to Liver pool; possibly others

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5. Conclusions

(1) Re main study question: Yes, the Liverpool development offers a range of useful practice examples, deserving more detailed discussion (2) Links between local development and health in Liverpool    include the following: Involvement in integrated programs Participation: apparently, some major efforts are taken – but difficult to appraise from outside perspective City planning including the Unitary development plan: invites a comparison with current spatial planning elsewhere in Europe, e.g. Ruhr area (D) – also shrinking population

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Conclusions (2)

Comments on Housing strategy HIA. from outside perspective where “explicit” HIA not strongly established (D):    a range of informative details, incl. procedures and methods plausible combination of rapid & full HIA somewhat surprising to see the “capital approach” (with rather  limited reference to health) used for structuring the results / recommendations risk of “consultation fatigue” to be considered (p.21)

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Conclusions (3)

   This exploratory mini-case study identifies a number of practice examples, but does not allow assessing the effective ness of efforts to cross-link regional development and health Rather limited dialogue with local government and other actors Comparison of results from “mini” case studies, involving: Bad Kissingen (D) pop 22K, Graz (A) pop 290K, Bielefeld (D) pop 326K, Liverpool (UK) 435K: to be completed

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Finis

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