Author: Michael Chang MRTPI, HonMFPH. Programme Manager for Planning and Health at the new Office for Health Improvement and Disparities*. Views are personal. 

The effects of our changing climate should concern us as an environmental justice and health inequalities issue, where joining up spatial planning and public health actions can be an effective intervention.

The 2010 Marmot Review of health inequalities identified climate change as a ‘fundamental threat’ to health. This is because the public health and social care systems are made up of people, buildings, infrastructure and service provision and multi-sectoral providers. The impacts of climate change, for example severe flooding in the community, are profound.

The statutory UK Climate Change Risk Assessment is a good starting point and highlights the following health and wellbeing risks which have environmental and land use implications requiring action and investigation:

  • vulnerable population groups from high temperatures associated with the urban heat island effect in public realm and overheating of homes,
  • people, communities, and buildings from all types of flooding,
  • pressures on health and social care infrastructure, and its provision and delivery from extreme weather,
  • changes to indoor and outdoor air quality,
  • poor water quality or supply interruptions.

Our understanding and surveillance of climate change impacts have improved, but how are policies and practice keeping up?

The Royal Commission on Environmental Pollution reports on Environmental Planning (2002), The Urban Environment (2006), Adapting Institutions to Climate Change (2010) and its final report on Demographic change and the environment (2011), had consistently highlighted the dynamic relationships between societal trends, demographic change, land use and the environment and effect of and from climate change. The use of health impact assessments and incorporating health into environmental assessments have been identified to ensure a more systematic assessment – not only of direct health exposures and risks – but also of the impacts on mental health and wellbeing to achieve healthy, resilient, urban developments. Public Health England’s HIA guidance* also supports this approach.

We already know what we need to do. For example, there has been demonstrable innovation in how authorities across the UK and Europe are turning the climate challenge to opportunity, such as London followed in the footsteps of Malmo in Sweden to adopt the Urban Green Factor approach to leverage the multiple benefits of green and blue spaces.

We should be constantly reminded that future generations will suffer if the issue is not taken seriously and action is not taken by current generations. Whole society needs to take action, from government down to the individual. Local government, in particular, is and will play an increasingly leading role given their wide-ranging statutory responsibilities including on land use planning, climate change mitigation and adaptation, and population health improvement. Many studies have reviewed how and whether local government is taking appropriate and urgent action (for example those conducted by the National Institute for Health Research Health Protection Research Unit in Environmental Change and Health and the Royal Town Planning Institute). The findings have been mixed but generally point to health-related risks of climate change not well-realised, and emphasise greater role and involvement of local public health teams.

A joined-up system between spatial planning and public health can be considered a high impact intervention and it will determine how towns and cities step up to the climate challenge for public health benefit. New housing developments must be designed to cope with future rather than historical climates, and seek to dramatically reduce or even eliminate emissions. They must address energy demand and efficiency in the residential and commercial built environments and shift supply chain and consumption behaviours of industry and households, while at the same time adapt the environment to the effects of extreme weather events, such as more green and blue infrastructure. Adapting the existing building stock, which is being replaced by as little as 1% a year in the UK by new housing, is needed to make existing communities and built environments more resilient to climate risks too.

So, as we take action to deal with the challenge of climate change and incorporate public health considerations, the demands on creating healthy, sustainable, and resilient places have never been greater. It is a journey that is shared between the built environment and public health professions against the backdrop of the Sustainable Development Goals. While we appreciate the challenges in financial, political and policy terms, there is no shortage of aspiration and professional will. From now on, actions will speak louder than words.

* Note that from 1st October 2021, Public Health England was replaced by the UK Health Security Agency and Office for Health Improvement and Disparities. All views in this blog are personal and do not reflect those of PHE, UKHSA or OHID.