Planning is critical in promoting healthy places. Many of us are aware that the planning profession, as we know it today, emerged from the health concerns associated with the rapid industrialisation and urbanisation which occurred in the late 1800s and early 1900s. As aspects of health and wellbeing are being slowly ‘re-knitted’ together with planning, now is an exciting time to consider how taking place-based approaches can impact on and promote healthier ways of living.  For the purpose of this article an emphasis is placed on physical activity and the role planning has to facilitate ‘Active Living’ which can be defined as a way of life that integrates physical activity into daily routines.

Historical Context

The industrial revolution resulted in mass urbanisation, with cities growing exponentially to serve and house factory workers. Conditions were slum-like, housing was of poor quality and high in density, air was thick with smoke and smog, with little regard to sanitation and a lack of clean water. Communicable diseases like typhoid, cholera and dysentery thrived in such conditions which resulted in high rates of morbidity.

Advancements in health (such as the developments in germ theory) resulted in these diseases being almost entirely eradicated from society. Interestingly, around that same period, Town Planning had its own shift, formerly a function under the Department of Health, the Ministry of Town and Country Planning was formed, which arguably weakened the relationship between planning and health.  

A shift not only occurred amongst the planning profession but physical shift appeared in our built environments.  With rapid urbanisation came mass suburbanisation, and with it, suburban sprawl. Suburban sprawl can be identified by one common characteristic which impacts directly, and significantly, on health – these environments are all car dependent. A car is needed for almost every daily task, such as going to work, school, the local shop.  This encourages sedentary behaviour and physically inactive lifestyles. Now, with the rise of obesity, public health has also experienced a colossal shift from communicable diseases to non-communicable diseases such as cancers, chronic heart disease and diabetes.  

Active Environments

However, recently town centres have experienced yet another shift during the COVID-19 pandemic which has raised serious questions relating to our high streets, which are over saturated with retail units and office blocks.  The pandemic did not cause the problems we are now seeing in town centres, but it certainly exposed the concerns and issues related to ‘what we know’ and ‘how we think’ about our high streets.  As a result of remote working and online shopping we need to re-think town centres.  

The built environment, and built environment professions, can influence healthier lifestyles by making the daily routines, mentioned above, achievable through the use of physical activity.  This can be delivered through regeneration by applying active living principles; walkable neighbourhoods with high connectivity, permeability supported with green infrastructure, local amenities and rapid transit.  The table below illustrates the contrasting elements to urban sprawl and compact design, which are opposite in appearance, function and character - and how they affect how people live in different ways:

Compact design encourages walking suitable for all members of a community with priority being given to pedestrians. This opens up exciting opportunities, especially for Local Authorities who are now receiving government funding to regenerate their town centres and high streets.  Health should be integrated as much as possible to ensure that regeneration schemes contribute to individuals’ physical health and wellbeing, while also offering the potential for contributing to social cohesion, environmental protection and economic prosperity.  Bringing schools, housing, local shops, gyms and restaurants to the forefront of town centres can contribute to passively encourage physical activity.  With that, it is worth reminding ourselves of the core components which are enable active environments to be deliverable and broadly consist of:

• Active Travel – equitable access, encourage walking and cycling, appropriate infrastructure;
• Aesthetics – quality of the built environment, stimulating and attractive routes to destinations, lighting, active frontages, greenery;
• Connectivity – convenient travel links, compact densities, permeable street patterns, local amenities, mix of uses. 

Active lifestyles may appear to be a minor aspect of wider health debates, and of relatively low importance to the core operations of planning and regeneration, but placing an emphasis on it could have a significant role to play in creating healthier urban environments and a healthier society.  Furthermore, they not only promote health, but also stimulate social cohesion, higher footfall, perceptions of safety, natural surveillance, lower carbon emissions and sense of place within communities (and many more!).  Inner city regeneration schemes could have considerable influence in encouraging people to be more active by making healthier decisions within the built environment and therefore contributing to the prevention of non-communicable diseases which can even help in contributing to easing the burdens on the health system.  This calls for partnership working, to span across professional boundaries and collaborating effectively between planning and other stakeholders which is imperative in delivering physically active environments.  

Conclusion

Our cities, towns and high streets have been faced with many challenges throughout the century and now, we are again faced with unprecedented challenges to their vitality and prosperity.  The pandemic, housing and climate crisis, technological advancements and planning reforms are all changing the way or societies lives, works, shops and plays.  Successful town centres will likely need to value more than just their shops and services but rather promote health and wellbeing which will act as a catalyst to unlocking the social, environmental and economic value of places and property assets for the benefit of all.   

There is ‘no one-size-fits all’ approach to the regeneration, repurposing and renaissance of our town centres and this is why harnessing place-based approaches is so important, to meet local needs and to gain local knowledge and insight.  I hope this article provides a simple reminder to all those working in shaping our town centres that our professional behaviours, cultures and systems for designing and coordinating tailored place-based approaches can promote healthy living.

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