Obesity rates have tripled in the UK since the 1980s, even as national dietary surveys over the same period show that people are consuming fewer calories. This suggests that solving the obesity crisis is going to be more involved than simply changing what we eat. How much energy we use in our daily lives is also an important part of the mix.
A focus on being more active is enthusiastically embraced by the latest government obesity strategy (actually, a ‘call to action’), which the Department of Health published on 13 October.
It highlights spatial planning as being one of the key ways to help increase the amount of exercise people get. In fact, in contrast to the strident criticism of planners during the many debates on the national planning policy framework (NPPF), the strategy might almost make some planners blush, such are the overtures it makes to the profession:
"At community level, the planning system is increasingly recognised as a vital tool for influencing the environment in a way that builds and supports strong, vibrant and healthy communities", it says.
This isn’t the first time that the health sector has courted planning. In the last few years the National Heart Forum, the Healthy Urban Development Unit (HUDU) and the King’s Fund have all had something to say about how planners can and should address health concerns.
However, when it comes to tackling obesity, gathering evidence about the success of planning interventions is in its early days.
There is strong evidence that open space that is safe and easy to get to increases the amount that people exercise (and that it improves mental health). But we know less about some of the other interventions that planners are being encouraged to make to reduce obesity levels.
For example, the health impacts of restricting hot food takeaways – a policy suggestion highlighted in the government’s call to action – are not yet clear. Only a handful of local planning authorities have adopted this approach: the London Borough of Waltham Forest was the first and planners there freely acknowledge that it won’t work in isolation, but needs to be part of a multi-pronged approach to tackling obesity.
Hugh Barton, Professor of Planning, Health and Sustainability at University of the West of England, thinks that the scale of health problems such as obesity will mean that research into the links between health and spatial planning will only increase and progressively "leave little excuse for inaction".
But where does that leave planners now? To complement the strategy the government has commissioned the Healthy Places resource, an online tool put together by a team from the National Heart Forum. A distinctive aspect of this tool is that it highlights how local authorities can use existing laws "that have the potential to change local environments and encourage more active lifestyles and better diets".
The tool utilises a pretty clunky web design, and the case studies are too few to give confidence that a planner will find a situation that matches their own circumstances – hopefully this is the beginning rather than the end of gathering good examples. Much better are the sections on the legal avenues available to a local planning authority. Each section – such as development control, or planning and licensing – takes users through the options and limitations available.
This is important practical information for planners and, put with the call to action, is a package that provides a policy framework and specific, if limited, ideas for how to put this into practice.
The question is, will planners feel able to implement it?
Inevitably, part of the answer comes back to the NPPF and some of the as yet unresolved tensions that the draft raised. The obesity strategy cites the NPPF as supporting health and wellbeing. But in practice this is vague, and would be strengthened by a clear definition of sustainable development that gave equal weight to social, economic and environmental considerations, given that health is influenced both positively and negatively by all three.
In the meantime, planners may take heart from the health and social care reforms – like the NPPF, another controversial area of government policy – which will see public health responsibilities transferred to local authorities.
From April 2013, these new responsibilities will come with ring-fenced cash. While this may seem a fairly distant date, local authorities are currently working on the transition. Now is the time for local authority planning teams to proactively make the case with directors of public health, health and wellbeing boards and corporate directors for why they deserve a slice of the funding. Given the role the health sector thinks planning should have for tackling obesity, planners might just be pushing at an open door.
Andrew Ross writes on planning and public health, www.fdconsult.co.uk, and is the author of Plugging health into planning: evidence and practice published by LG Improvement and Development in June 2011.