Nick Wright, Convenor RTPI Scotland, recounts his key message from BEFS Annual Lecture that planners have a vital role in delivering ‘healthier places’.

BEFS (Built Environment Forum Scotland) this week organised an evening seminar asking: How can the planning system contribute to wellbeing in a fairer Scotland? Alongside Alex Neil MSP, Cabinet Secretary for Social Justice, Communities and Pensioners’ Rights and Sir Harry Burns, Professor of Global Public Health, University of Strathclyde, I was delighted to represent RTPI Scotland on the panel. The evening was chaired by Petra Biberbach, Chief Executive of PAS.

Alex Neil began the evening by emphasising the absolute need for planning to create healthier places. Harry Burns then described how those healthier environments might look and feel. I felt it was then my turn, as the planner, to take up the vital challenge of explaining how we might deliver those healthier places.

This post recounts what I chose to say. My key message was that planners have a vital role in delivering the ‘healthier places’ that Alex Neil and Harry Burns rightly say are so important for our future. 

Back to our roots

Health and wellbeing shouldn’t be unfamiliar territory for the planning profession. Our roots lie in Victorian health and sanitation concerns. But planning moved away from those Victorian public health concerns in the 20th century, a reflection that cholera, typhoid and smallpox are no longer the issues in our towns and cities that they once were.

Health and wellbeing have, however, returned to the top of the UK planning agenda in the last decade. Not due to a re-emergence of deadly infectious diseases like cholera; but linked to pollution, lack of exercise, obesity and – as Sir Harry explained very articulately – a lack of empowerment over many of our lives and our communities.

Isolated examples

There are some excellent Scottish examples of planners trying to address health and wellbeing. For example, the nine Equally Well pilots promoted by the Scottish Government while Sir Harry was Chief Medical Officer, including one in Glasgow’s East End that I was was fortunate enough to work on with Glasgow City Council and Willie Miller Urban Design.   The East End pilot took forward Harry’s premise that planning for health and wellbeing (or wellness, to use Sir Harry’s preferred term that is more encompassing of mental and spiritual well-being) is not just about physical environment interventions – less air pollution,walkable neighbourhoods, access to greenspace for recreation and nature – but also greater empowerment for individual people over their lives and the future of their community. In other words, a more engaged and empowered community is likely to be a community with greater levels of individual wellness.

The trouble is, examples like the Equally Well pilots are relatively isolated.  Although physical interventions like more greenspace, less air pollution, more carbon reduction and more walkable neighbourhoods are now finding their way into planning policy, we are only slowly making Harry’s link between community empowerment and health/wellbeing.

But there is a big opportunity here. The Scottish Government’s clear focus on community empowerment and the Review of the Scottish Planning System means that planning is in an ideal position not only to support community engagement and empowerment, but to link it more explicitly with health and wellbeing.

I explained in the seminar that, from my perspective as a planner, there a number of ways of achieving that. For example:

  • Keep on mainstreaming the physical interventions about walkability, carbon reduction, pollution and greenspace in planning policy, masterplans and other plans.
  • Better integrating spatial planning and Community Planning – a much talked about but rarely achieved challenge, with a few local authorities including Angus, East Ayrshire, Fife and North Lanarkshire pioneering new approaches that can lead led to joint initiatives between town planners, community planning and the NHS.such as Motherwell town centre’s dementia-friendly garden.
  • Learn from excellent initiatives like Glasgow Centre for Population Health, which has for a number of years worked hard to link various public sector players around a central agenda of health and wellbeing.
  • Genuinely give more opportunities to empower communities to shape their places. This is one of the stated objectives of the current Planning Review – which is why RTPI Scotland’s response, alongside others, put forward suggestions to the Planning Review such as more community engagement early on in the formulation of plans (to give communities more influence) and more mediation (so the locus of control of a community’s future remains closer to them, rather than centralised to a distant ‘authority’).

Planners as brokers

There is another way that planners can support better health and wellbeing. It’s perhaps less obvious, but potentially very powerful. It’s by thinking of ourselves as brokers.

Let me illustrate this through an example.

I am currently working on Community Action Plans for three villages in South Lanarkshire: Coalburn, Douglas and Glespin. They have been with wave after wave of job losses and challenges of rural isolation (although they do also have wonderful levels of community activity and resilience). Just last week, I was speaking to a local GP who said that the most intractable problem for these communities, in his view, was disengaged young men causing misery in their communities.

Those words really struck me. What on earth, I thought, can land use planning possibly do to solve such a challenging social and economic issue?

At face value, I thought, nothing. Planning policy, planning applications and Local Development Plans can only fiddle at the edges. But, reflecting on it, I realised that there is actually a great deal that I can do – if I recognise that I am a broker.

I can organise a meeting or workshop to broker that GP meet with social enterprises, businesses, housing associations and local authorities who might never otherwise have met, but who all have a shared interest in making those communities better; who knows what collaborations might come out of those conversations to help the disengaged young men. Equally, the Community Action Plans that I will help produce can overtly support local employability initiatives or improved access to opportunities, increasing their ability to tap into community benefit money from windfarms or other sources of funding.

So – there are very real things that I, as a planner, can do to help those disengaged young men lead healthier and more fulfilled lives. Simply by realising the power that I have as a broker, I personally can do something very significant to deliver the built environment and improve people’s lives. All we need to do is make connections and get people talking.

Nick Wright, Convenor RTPI Scotland.

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Phil Prentice, Chief Officer of Scotland’s Towns Partnership, reflects on the correlations between health and place in Scotland’s towns.

What image does your mind conjure up when you think of Copenhagen, Vancouver, Melbourne, Amsterdam, Vienna or Monte Carlo? Modern city living, sustainable communities, engaging cultures. Yes, all of the above…and they are all also the same names that often feature in the top 10 healthiest cities to live in the world. These endless surveys measure intangibles such as Creativity, Liveability and Quality alongside tangibles such as Amenities, Cost and Pollution. But what do they tell us about the realities of living in Barrhead or Kirkcaldy? Aside from a luxury break or a once in a lifetime holiday, just how many of us will ever get the chance to live in these cities, and would it make a difference to our life chances or indeed life expectancy.

A recent report by the World Health Organisation stated that the average life expectancy for a male born in Calton, Glasgow was 54. In India the figure is 63 and in Lenzie, the figure is 82, which just happens to be the current UK average. Work by Sir Harry Burns over the last few years has shone an important light and drawn strong correlations between health and place; however these issues are complex and are still to be fully explored and understood.

However, that said, the evidence is sufficient and robust enough to suggest that nicer places tend to have healthier people and that the built and natural environment is a very important factor in the health of the surrounding resident population.

Define nicer.

Nice house, nice town centre, nice people, nice life. As opposed to damp and cramped tenement, a dirty and neglected town centre, sick unemployed neighbours and no hope.

The most powerful word in all of the preceding words and imagery….hope.

Sir Harry and others can talk much more eloquently than I about all of the above, but hopefully I can provide a few ideas around solutions.

At Scotland’s Towns Partnership we have spent the past year building new collaborations and trying to knit the whole towns agenda together. Scotland is a nation of towns, but the town narrative is less well articulated that cities. Towns have suffered and their transformation has stalled. The promise of a networked urban system, with choices, to support an increasingly diverse society has not yet been met. Yet our towns are a living legacy of our history and culture, even the most cynical amongst us will have an emotional attachment to their home town or village, a childhood memory, a sense of pride and identity, we acknowledge their famous sons and daughters, it’s who we are, part of our fabric and DNA.

Our towns are not homogenous and whilst some are doing well, many are at a crossroads. The continued drift of talent and youth to city economies, structural changes in retail where we use tablets, online, click and collect, out of town and destination shops, the ongoing impact of the economic recession, dysfunctional property and housing markets, welfare reform, less disposable local income and a fast shrinking public sector.

So if no one is coming Towns need to do most of this for themselves, whether through a BID, Development Trust or a loose collaborative of the willing. Get together and agree on what a nicer place could be, start believing in your combined strength. This is your problem and only you have the solutions. Base your investment decisions on evidence, make a plan that is achievable and realistic, be resilient but also ambitious, understand what your key assets are, your unique tale, embrace the town centre first principle and best practice and look at building the widest possible partnerships. Start talking to other towns to see how they are coping. Explore how tourism, digital, public services, retail, commercial, health and greenspace, housing, leisure, transport, museums and attractions, events and marketing can all help build better places. Success will come from better public-private-third sector working and more joined up community planning partnership decision making. It will also improve community and with that, our health.

Phil Prentice, Chief Officer of Scotland’s Towns Partnership.

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David Thompson, Director of DPT Urban Design, compares Wellbeing to quantum physics in response to BEFS Annual Lecture 2016.

Wellbeing is a little like quantum physics.

According to the latter’s principles, we don’t know the definite position of a particle until it’s measured by an observer.

So it goes with wellbeing. There’s only a particular state at a particular point in time. Wellbeing is dynamic and ever changing and it’s the key truth Sir Harry Burns explained within his presentation.

To get close to designing a wellbeing system that identifies actions, before thinking through the role of Development Planning within it, the system could:

  • Gather data very regularly – a highly engaging set of processes to understand ‘the now’;
  • Identify the ‘initial conditions’ – identify those aspects that lie behind what we see when we engage; and
  • Adapt to emerging needs – have an agility that affords changes in direction and purpose.

A system would need measures or indicators to know if changes or interventions are having an impact. This is where it starts to get very murky. I’ve viewed a recent presentation that identified over 2000 separate indicators in a literature review. 2000!!?? Room for debate then?

Perhaps not. We do know that Maslow’s Hierarchy of Needs provides much of the context for wellbeing and we also have a model for appreciating the Determinants of Health. The central tenant within this very complex landscape, one that was covered in the presentations, is that having a network of people you know really matters. Some people may call this a community. It turns out that if this network or community have a shared purpose that helps bring meaning and a degree of control to everyone’s lives then even better. Having an agreement on this approach or assertion seems a useful starting point.

How does the Development Planning system fit with this idea? This system is far more simple, in (very) short, it states where new development is built and what it looks like, how we manage changes in existing built and natural contexts and a process for making decisions. So in theory, this sounds interesting and useful to thinking about wellbeing.

Is it? Thinking about the need to gather data very regularly and respond very quickly, a Local Development Plan is 3 to 4 years in the making and has a shelf life of 5 years. At the extreme end, if an idea is missed at the Main Issues stage (right at the beginning), it may have to sit there for 8 years until it can become an action (reconsidered in the next Main Issues report (5 years later) and enforced in the subsequent Adopted Local Development Plan).

However, based on experience, many of the issues raised within the Development Plan making process by people, relate to aspects of their life in the context of how they live and interact with their place.  It’s highly unlikely that we are going to see protests outside Council offices with a banner saying ‘that street you’re proposing to be built in 7 years’ time isn’t conducive to social interaction and should be realigned to better connect with greenspace!!’.

Scotland’s Community Planning system is shaping up, alongside the integration of social and health services, so perhaps the main focus lies here, instead of ‘Main Issues’ exercises.  The collaborative processes happening across Scotland right now (of which I’m privileged to be part of two), within the Scottish Government’s Charrette mainstreaming programme, offer the chance to get data, asks questions, find out what matters and propose actions, regardless of a particular system.

I’m convinced the rules of how we design new places can be written on a side of A4 (by rules I mean the key aspects that shape new development, not window details!) so every new physical context we build in Scotland is consistent and helpful to those that live in it. Here’s a challenge to someone, what would a wellbeing diagram within a master plan look like? What would it show?

One insightful comment made the point that the focus of the Development Planning system keeps changing. There’s some truth in this. Place-making has replaced sustainability, resilience replaced it to some degree and now there’s a focus on wellbeing and health.

We know that our perception of the world we see is based on the information received through our senses and interpreted in our brain into a model of understanding. Without a consistent approach based around the aspects of wellbeing we do know, we’re stuck in the land of 2000+ measures and a huge range of opinions. This diversity of wellbeing understanding was evident during the evening as almost every subject we can think of was linked in some way to wellbeing. From a young planning lawyers question about “who pays for infrastructure” to an assertion “it’s about more cinemas son” to a debate on Edinburgh’s greenbelt.

The way I try and tackle information is the same way Kip Thorne wrote his book (the physicist behind the film Interstellar) by taking information and placing it into one of three categories 1) information we know is evidenced based 2) educated guesses extrapolated from some evidence 3) speculation. My experience of the built environment sector is that we’re generally in columns 2 and 3. This sector (and I place myself in this) have much to learn from the evidence based approach of the health sector.

David Thompson, Director of DPT Urban Design.

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Dr Fiona Stirling, Design Advisor at Architecture & Design Scotland, reflects on the BEFS’ Annual Lecture: Planning for wellbeing – How can the planning system contribute to wellbeing in a fairer Scotland?

The BEFS’ Annual Lecture asked ‘how can the planning system contribute to wellbeing in a fairer Scotland’. On the night we heard from Alex Neil MSP, Cabinet Secretary for Social Justice, Communities, and Pensioners’ Rights, Sir Harry Burns, Professor of Global Public Health, University of Strathclyde, and Nick Wright, Convenor of the Royal Town Planning Institute (RTPI) Scotland.

Alex Neil MSP emphasised that a good planning system is fundamental to supporting wellbeing. He spoke about the current housing shortage as an example: that good quality housing is fundamental to closing the educational attainment, inequality and health gaps, and to maximising sustainable economic growth. To be effective, he suggested that planning needs to take better account of all the services and facilities needed to create a community.  For planning to succeed, it needs to work with communities and ensure that they are properly engaged in the system of decision-making.

Sir Harry Burns told us that wellbeing or wellness is a dynamic thing; it’s a state that we can move into and out of within a single day. A sense of purpose and a sense of control are important factors that enable people to respond to, and deal with the challenges of everyday life, as are the conditions and opportunities presented by the built environment.

Nick Wright advocated the role of planners in delivering healthier places. He emphasised the importance of mainstreaming decisions that create healthier places, of the need to better link spatial planning and community planning, of the benefits of approaches that support more genuine community engagement, and of the potential for planners to act as brokers.

We heard about some good examples, and the need to mainstream good practice; to move away from the current focus on land use and numbers to a system that is more pro-active about the sorts of place we want to create, and one that engages people at the heart of decision-making.  As a landscape architect, employed in the public sector and involved in the planning system, I agreed with much of what I heard.  And arguably the current policy context in Scotland supports a system which enables good practice to happen. However as Scottish Planning Policy states, it’s ‘People [that] Make the System Work’ (paragraph 5).

Perhaps unsurprisingly – given the title – we heard a lot about planning and the role of planners in particular.  But it struck me that achieving places that promote well-being and wellness is much wider than can be delivered by planners and the planning system alone. Sir Harry Burns reminded us that it’s a complex world out there and that we often fail because we try to simplify it too much. Planning and planners have a key role to play, but so too do public sector service planning, ongoing management and ‘place-keeping’, and wider private sector investment and decisions.

Planning successfully for wellbeing is about all of us – not just those involved in the planning system – making choices and decisions that help support and promote wellness. Nick Wright encouraged us to think beyond our defined job descriptions in order to help bring people together, to connect and to make things happen. This seems crucial; good places – places that promote wellness – seem most likely to be achieved through collaborative, inter-disciplinary approaches rooted in a firm understanding of people and places. It’s about understanding what exists, what works and why, what needs to change and adapt, and where new elements are required. That’s wider than the planning system.

With the Community Empowerment Act, and discussions on Land Reform and the Independent Review of the Scottish Planning System ongoing, it’s a particularly interesting time for the built environment in Scotland. Whatever decisions and changes might be on the horizon, in the short term, the main message I took away from the evening’s discussions was to think on a day-to-day basis: ‘what can I do to help make this a place that supports wellness?’. As Sir Harry Burns pointed out, lots of small changes can add up to something big!

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