Questions on possible changes to health determinants

Does the plan or programme involve provision of health facilities, e.g. general practitioner surgeries, health centres or hospitals?

Population

Higher rates of general practitioner consultation are associated with greater social and economic deprivation, yet communities most at risk of ill health tend to experience the least satisfactory access to preventative services.

Does the plan or programme involve leisure facilities, e.g. sports centres?

Population

A lack of exercise is associated with increased cardiovascular risk.

Does the plan or programme affect access to health or leisure facilities?

Population

Lack of access to services (e.g. by foot or affordable transport) is experienced disproportionately by women, schoolchildren, the elderly and disabled people.

Poor access to services is a significant factor in social exclusion, which is associated with health problems.

Will the plan or programme give rise to developments involving emissions to air or water?

Soil, water, air

Air pollution has both short- and long-term damaging effects on health, can worsen the condition of those with lung or heart disease, and may reduce average life expectancy.

Is the plan or programme concerned with contaminated land or waste management or disposal?

Soil, water, air

Contaminants such as heavy metals, oil, asbestos and landfill gases are injurious to health.

Waste disposal can be a major generator of road transport, noise and dust, with potential adverse effects on safety and air quality.

Could the plan or programme lead to other types of impacts on people, e.g. from noisy or disruptive activities?

Population

Environmental noise causes annoyance and sleep disturbance to many people.

There is evidence of a causal relationship between noise and hypertension and heart disease. [12]

Does the plan or programme encourage the use of public transport or alternative means of transport other than private cars?

Air, climatic factors

Reduced car use lowers direct exposure to exhaust pollutants.

Reduction in traffic congestion and noise can be expected to improve quality of life and well-being.

Any reduction in carbon emissions, however small, contributes to the achievement of climate change objectives.

Does the plan or programme encourage walking and cycling?

Air, population

Physical activity is one of the best ways of improving overall health and reducing obesity.

Neighbourhoods with mixed land use, high population and employment density, street connectivity, pedestrian-oriented design and safety encourage more physical activity and have a lower obesity prevalence.

These features are particularly helpful to older people to reduce social isolation.

Does the plan or programme involve greater provision of access to the countryside and coast?

Population, landscape, biodiversity

Greater opportunities for walking and cycling are beneficial to physical health.

Greater contact with nature is beneficial to mental health

Will plans or programmes for housing take into account energy efficiency, warmth, ventilation and flexibility?

Population, climatic factors

Cold, damp homes are associated with cardiovascular and circulatory diseases.

Fuel poverty affects mental health and contributes to health inequalities.

Housing needs to be suitable for people with disabilities, families and the ageing population.

Does the plan or programme promote easy and sustainable access to services such as workplaces, shops, schools, healthcare facilities and social activities?

Population

Poor transport contributes to social exclusion as it restricts access to activities that enhance people’s life chances, such as work, learning, health care, food shopping, and other key activities.

Community severance by physical barriers (e.g. transport infrastructure) and psychological barriers (e.g. road safety fears) limits travel horizons and can affect access to services such as employment, education and health facilities.

Lack of access to services (e.g. by foot or affordable transport) is experienced disproportionately by women, schoolchildren, the elderly and disabled people.

Poor access to services is a significant factor in social exclusion, which is associated with health problems.

Does the plan or programme encourage a sense of community safety, identity and social cohesion?

Population, cultural heritage, landscape, biodiversity

Good design encourages greater community ownership of the environment and reduces negative effects such as vandalism and under-use of facilities. A sense of community identity and belonging is known to foster health and the sense of well-being.

Fear of crime reduces social solidarity, and has an adverse psychological impact. Fear of leaving home exposes older people in particular to isolation and vulnerability. Good urban design can help to “design out crime” and enhance community safety.

Will the plan or programme provide for locally accessible green spaces?

Population, biodiversity, fauna and flora, cultural heritage, landscape

Safe green space encourages social contact and exercise, and is associated with lower crime rates.

People who can see trees or green space from their homes report higher levels of health and well-being.

Does the plan or programme have employment implications relevant to the social groups concerned?

Population

Isolated developments can lead to the exclusion of vulnerable groups.

Local job opportunities enable walking and cycling options.

Unemployed people have a higher risk of poor physical and mental health and shorter life expectancy.

Low-paid insecure employment carries greater risks of accidents, infections and heart disease and increase health-damaging behaviour such as smoking.