Transport, planning and the environment are key issues in new public health vision

Prevention is a vital health topic for government and the health sector – and it’s now the focus of a new public health vision document

Prevention is a vital health topic for government and the health sector – and it’s also the focus of a new public health vision document, launched this week by Health Secretary Matt Hancock. The 'Prevention is better than cure' vision, which sets out how we can use policy, new technology, workplace strategies and the power of local communities to prevent worsening health, will also be a key focus for the Public Health & Sustainable Transport Summit to be held on 27 March 2019 in Bristol.

The vision specifically mentions the need to 'coordinate transport, housing, education, the workplace and the environment in the grand enterprise to improve our nation’s health 

The vision specifically mentions the need to 'coordinate transport, housing, education, the workplace and the environment in the grand enterprise to improve our nation’s health'.

This will involve employers, businesses, charities, the voluntary sector and local groups in creating safe, connected and healthy neighbourhoods and workplaces, says Hancock. The coordination message also highlights the evidence collected in a variety of recent reports, including Transport for New Homes (Foundation for Integrated Transport, 2018), Location of Development (RTPI, 2018), which highlight a typical lack of sustainable transport integrated into new housing developments, and the Transport Knowledge Hub, which published independent analysis on the issue, undertaken by KPMG for Greener Journeys.

Public Health England’s Chief Executive Duncan Selbie calls the new vision a 'transformative moment for public health'. 'National and local government must place prevention at the forefront of their policies. They must weave it into all of their plans and all of their policies, for everything from health and social care to town planning, housing and transport,' he says. 'Making this shift in favour of prevention requires additional funding and more staff in community services. That’s where the NHS Long Term Plan and the additional £20.5bn a year by the end of 2023-24 comes into play,' he adds. 'We expect this additional funding to support health and social care services to prioritise prevention.'

As Hancock notes, coordinating transport, housing, education, the workplace and the environment will be fundamental to delivering higher density housing in locations served by high-capacity rail and bus links, along with high quality public realm and pedestrian and cycle infrastructure. However, whilst the benefits of integrating sustainable transport and housing have for decades been the holy grail of urban planners, in reality planning and delivery operate in very distinct silos.  Recent policy developments – the National Planning Policy Framework revision of July 2018, the DfT’s updated appraisal guidance of May 2018 and the National Infrastructure Assessment published by the National Infrastructure Commission of July 2018 – all highlight the fact that transport must deliver benefits that reach much further than time savings to society as well as the Treasury. 

And speaking of the Treasury, Hancock notes that 'there is, of course, a cost benefit to all of this. Each year, we are spending £97 billion of public money on treating disease and only £8 billion preventing it across the UK – that’s an imbalance in urgent need of correction. We must get smarter about where we focus our efforts and spend our money, not least because preventative treatments cost less than retrograde treatments further down the line.'

When we think about staying healthy, says Hancock, it’s often within the narrow bandwidth of eating well, exercising regularly and avoiding smoking. 'These are important issues for us all to address of course, but there’s so much more to it than smoothies, park runs and vaping,' he says. 'This is not just about keeping well physically and mentally, or preventing ill health in the future – it’s about the environment around us, the lifestyle choices we make and how we manage existing health conditions, many of which – like some cancers – cannot currently be prevented.'