Regenerating Middleport: using health impact assessment to ‘health proof’ masterplans for deprived communities

Salim Vohra & Gifty Amo-Danso (IOM) Marcus Chilaka (University of Salford)Zafar Iqbal & Judy Kurth (Stoke NHS)

Health, Well Being and Healthy Lifestyle Conference 21st October 2009

Meaning of Health in HIA

“Health is a state of completephysical, mental and social wellbeingand not merely the absence of disease or infirmity…

…Health is therefore a resource foreveryday life, not the objective of living; it is a positive concept emphasizing social and personal resources, as well as physical capacities.”

World Health Organization, 1947 and 1984.

Environmental and Social Model of Health

Adapted by Salim Vohra and Dean Biddlecombe from Dahlgren, G. and Whitehead, M. (1991). Policies and strategies to promote social equity in health. Stockholm, Institute for Future Studies.

Classic Definition of Health Impact Assessment

HIA is:

a combination of procedures, methods and tools

by which a policy, program or project may be judged

as to its potential effects on the health of a population,

and the distribution of those effects within the population.

Gothenberg Consensus Document 1991

Fuller Definitions of Health Impact Assessment

HIA is the key systematic approach to predicting the differential health and wellbeing impacts of proposed and implemented plans, programmes and projects

within a value framework that is democratic, equitable, sustainable and ethical in its use of evidence

so that positive health impacts are maximised and negative health impacts minimised (within a given population).

It uses a range of structured and evaluated sources of qualitative and quantitative evidence that includes public and other stakeholders' perceptions and experiences as well as public health, epidemiological, toxicological and medical knowledge.

Steps in the HIA Process

Screening

Scoping

Baseline and community profile

Evidence review

Stakeholder engagement

Analysis

Mitigation and enhancement

HIA Report or Public Health Statement

Follow up (monitoring and evaluation)

Strengths:Weaknesses:

Flexible No standardapproach

OpenDepends on

Inclusive experience of the HIA

assessor

WHO 12 Healthy Urban Planning Principles

Healthy LifestylesDo planning policies and proposals encourage and promote healthy exercise?

Social Cohesionencourage and promote social cohesion?

Housing Qualityencourage and promote social cohesion?

Access to Workencourage and promote access to employment opportunities?

Accessibilityencourage and promote access accessibility?

Local low-input food productionencourage and promote local food production with low input food production?

WHO 12 Healthy Urban Planning Principles

Safetyencourage and promote safety and the feeling of safety in the community?

Equityencourage and promote equity and the development of social capital?

Air quality and aestheticsencourage and promote good air quality, protection from excessive noise and an attractive environment for living/working?

Water and sanitation qualityencourage and promote improved water and sanitation quality?

Quality of land and mineral resourcesencourage and promote the conservation and quality of land and mineral resources?

Climate Stabilityencourage and promote climate stability (and reduce the potential impacts of climate change)?

Stoke-on-Trent & Deprivation

Ariel View of Middleport

Satellite View of Middleport

Photos of Middleport

Vision and Objectives of the Masterplan Process

Vision“To create a truly sustainable community ... Working in partnership with local residents and businesses … create a vibrant community where people want to live, work ... Drawing on and improving the core physical, environmental and heritage assets of the area, … become an exemplar sustainable community … excellent standards of day to day living and strengthening community pride and ownership of the environment.”

Objectives1. Creating Sustainable Neighbourhoods2. Achieving a Better Housing Choice3. Strengthening Employment and Training Opportunities4. Addressing Community Needs5. Delivering Improved Access6. Creating a Good Quality Environment7. Protecting and Enhancing Heritage Assets8. Community Enhancement

Addressing the Health and Wellbeing Needs of the Community

Draft Masterplan Design 1

Draft Masterplan Design 2

Draft Masterplan Design 3

Where Does Reviewing Masterplans Fit In

Screening

Scoping

Baseline and community profile

Evidence review

Stakeholder engagement

Analysis

Mitigation and enhancement

HIA Report or Public Health Statement

Follow up (monitoring and evaluation)

Reviewing/ analysing the masterplan designs / drawings

Part of HIA or can be done seperately?

10 step process to ‘health proofing’ masterplans

Connecting with the masterplan design team

Obtaining masterplan design/s and background documents

Visiting the proposed site

Analysing the Masterplan Vision and Objectives

Identifying key professional and community stakeholders to help review

Looking at and analysing the draft masterplan design/s

Seeking clarification from the masterplan design team

Writing up the analysis

Making recommendations for modifying the final masterplan design

Following up on the changes made to the final masterplan design

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Step 9

Step 10

Rapid Review Table Masterplan Design Option No. & Name:

Design Review Questions Analysis

What is the relationship between the housing, greenspace, roads, shops/amenities and business areas? How do they fit together or don’t? Does it make holistic sense? Is it ‘legible’/understandable (easy to navigate through the streets)?

Do the blocks of new housing fit with the existing blocks of housing? Is there affordable/key worker housing?

Is greenspace maintained, increased and improved? Is it accessible? Is there an opportunity for allotments/communal gardening?

Do roads and routes connect residents or serve to cut them off (physical/community severance)?

Are pavements/footpaths, cycleways and public transport links developed? Do they form a coherent and connected linked set of routes? Do they have priority over cars?

Is there a public space, a service hub, a local centre that serves as the heart of the area?

What kinds of public services, amenities and facilities are planned? Are there any gaps in service?

Is there provision for a local community centre and/or space for community/voluntary/charity groups?

Are there good natural surveillance/ opportunities for people to pass by?

How do the commercial areas fit with each other and with the residential areas? Is it too big/too small?

How does the proposed development link with other adjacent neighbourhoods?

Is there any local art/distinctive landmark/ architecture planned to build and create a revived sense of place/community identity?

Overall

In-depth Review Table Masterplan Design Option No. & Name:

Healthy Urban Planning Themes

Regeneration/Development Objectives to Consider Potential positive health/ wellbeing impacts

Potential negative health/ wellbeing impacts

Suggestions for mitigation and enhancement/ Other Comments/Questions

Healthy Lifestyle

Does the development encourage and promote physical activity?Is the community walkable?

What type of amenities, facilities and public services are planned or exist already that are nearby?

What existing sports/leisure facilities are there and will they cope with any increase in population?

Social Cohesion (encouraging active community participation)

Is there one or more accessible outdoor public spaces e.g. plazas, central open spaces?

Is there provision for a local community centre or indoor public space where residents and community groups can meet and carry out activities e.g. mother and toddler groups, youth work groups, community development activities?

Do the new and/or existing commercial developments fit well with the residential developments and the wider neighbourhood?

Is there integration between existing housing and new housing?

How do new routes and roads affect the community setting? (physical and community severance)

Building quality (Housing and Employment Sites)

What sustainable and healthy building standards will be used for the residential and commercial developments?

What are the size of houses proposed in terms of number and size of rooms, private gardens, car parking space?

Has provision been made for affordable and key worker housing?

Will there be a mix of tenures e.g. private rental and owner occupied?

Access to employment opportunities

Are there local employers within walking/cycling distance or accessible by public transport?

Accessibility Is there provision of distinct and developed cycle and footpaths?

What provisions have been made for public transport e.g. new routes, bus stops/shelters, etc?

Are the different transportation modes linked/ integrated to encourage mixed use?

Is there identified space for local retail shops and other amenities?

Is there provision of key public services nearby e.g. health centre?

Local low-input food production or sale

Will there be any community allotments?

Will there be shops providing fresh fruit and vegetables and a fairly wide choice of foods?

Is there an opportunity for a food/farmer’s market?

Safety Is there natural surveillance and is there a good balance between through routes and closed off areas e.g. cul-de-sacs?

Are there enough safe pedestrian and cyclists crossing points on local roads?

Are there safe paths on local green and blue space (parks, and canals, waterways)?

Equity Does the development target an existing environmentally and socially deprived area?

Do existing residents gain as much as (if not more than) potential new residents?

Will there be broadband, telephony and cable access?

Air quality and good living and working environment

Will air pollution and/or exposure to air pollution be reduced?

What kinds of emissions do existing or new employments sites generate?

Is there an opportunity to have low emission vehicles e.g. buses and lorries?

Water and sanitation See Land and mineral resources and Climate stability below.

What provision has been made for access to mains water and sewerage services (other sustainable and low maintenance water and sewerage systems)?

Has the use of natural and manufactured permeable surfaces been maximised to reduce surface water run-offs and potential for flooding/ sewer overflows?

Land and mineral resources(Including green and blue spaces)See Water and sanitation above and Climate stability below.

Are the amounts of greenspace and bluespace protected and increased where possible?

Are private gardens and allotments encouraged?

Is there a variety of multi-purpose outdoor spaces?

Are the open, green and blue spaces easily accessible with allowances for natural surveillance?

Are there opportunities for allotments/communal gardening, fishing and seating areas?

Will there be street recycling bins or pods to encourage recycling?

Climate stability(mitigation of climate change impacts)

Will there be any renewable micro-generation or combined heat and power facility on the development?

Will there be trees planted on key routes and local parks to provide shade, a cooler micro-environment and reduce the risk of flooding?

Recommendations for Middleport

Health Themes: A walkable community A socially rich and cohesive communityA physically active community

General: Make parks as attractive, safe, accessible and well maintained. Make better use of canal towpath/footpaths and cycleways.

Ensure no fast food in any new retail spaces that are developed. Locate new industrial sites towards Steelite rather than adjacent to Grange Park and cluster employments sites together.

Support the greening/public realm and environmental improvements e.g. plant trees along the roads, improved street furniture, and removal of non-essential signs. Support the creation of Home Zone areas throughout the development and additional safe crossing points across Middleport. Improved lighting across the whole development

Recommendations for Middleport

Advantages of this approach

Flexible and quick input into the masterplan design process

Systematic and structured use of a health ‘lens’ to scrutinise a masterplan

Provide support for the masterplan from health agencies

Some aspects are likely to be covered by experienced planning officers and masterplan designers

Detailed assessment can be time consuming

May be confused with doing a health impact assessment