Incorporating health and wellbeing into housing developments

• High-quality developments deliver positive public health outcomes, attract jobs and investment in neighbourhoods, and reduce our carbon footprint.
• Developers and local authorities should work together to incorporate health and well-being in new housing developments by removing barriers to healthier lifestyles, promoting good health behaviours, and redressing health inequalities.
• By setting robust design standards and including a requirement for health net gain in developments, local authorities can positively influence the design quality of homes.

The impact of housing on health and wellbeing is now widely recognised. Good quality, affordable housing improves personal and social wellbeing, creates sustainable communities that attract investment and jobs, and can reduce our carbon footprint and improve the environment. However, delivering healthy homes still remains a big challenge. It requires urgent action involving all sectors of the built environment, but how can we rise to the challenge and create homes and places where it is possible to live a happy, healthy life?

Housing and health inequalities

The COVID-19 pandemic has exposed how housing inequalities can inhibit the capacity of households to adequately respond to lockdowns and changed patterns of work and leisure. Overcrowded households, defined as having more than one person per room in a household excluding bathrooms and kitchens, is a major factor for the spread of COVID-19. Poor house ventilation, which is a major cause of indoor air pollution and already has a disproportionate impact on low-income households, is another major factor driving the virus’ spread. The quality of design and the built form as a determinant of health and wellbeing have a lot of potential to improve health and wellbeing if the quality of buildings and open spaces is high. Good housing is key, but the planning for the area must also allow better access to employment, leisure, and recreation opportunities to positively impact health and wellbeing.

Unhealthy homes and neighbourhoods

The UK doesn’t have the best track record of high-quality house and neighbourhood design conducive to healthier lifestyles. Far too many new housing developments are car-dependent, lacking sustainable modes of travel or adequate open and recreational space. They are often not walkable and have a poor sense of place, leading to unattractive and unfriendly environments that make it difficult to be physically and socially active, and that don’t support wellbeing and mental health. In fact, the Building Better, Building Beautiful Commission, which advised government on how to promote and increase the use of high-quality design for new build homes and neighbourhoods, found that housing developments of the last century were often less beautiful than that of Georgian, Victorian and Edwardian periods in terms of settlement pattern, place-making, and building design. The National Housing Audit revealed that there are also long-standing inequalities within the housing system, which have led to an uncomfortable trend towards delivering less healthy developments for less affluent communities.

What can housing developers do?

Both developers and local planning authorities need to work together to deliver healthy homes and neighbourhoods for everyone. Developers can incorporate health and wellbeing into housing developments by preventing bad health outcomes such as reducing air pollution and promoting good health outcomes such as encouraging active travel. By doing so, developers can also contribute to redressing long-standing health inequalities such as increasing accessibility for disabled people. Developers cannot dictate how people should live their lives, but can manipulate the shape of the built environment to remove barriers to healthier lifestyles, discourage unhealthier habits and encourage good behaviour towards happier and healthier lives.

The real estate consultancy Knight Frank found that high-quality housing that promotes health and wellbeing does not necessarily erode returns and, in fact, can provide up to 15% value at the upper end of the market. At the lower end, where financial viability of the project is compromised, long-term investment in the area and close collaboration with local authorities on the matters of planning risk, planning costs, and infrastructure costs can deliver positive public health outcomes. For example, a mixed-use development delivering strong place-making and retail environment can bring huge return on business rate and council tax revenues for the council, which could justify some level of public subsidies to deliver health benefits in challenging locations.

The role of local authorities

However, the onus is on local authorities to set high health and wellbeing aspirations for housing developments. Judging by the most recent large scale housing developments and when the demand for housing remains exceptionally high, developers have very little incentive to promote health with their schemes. The primary concern of most house builders is to deliver profits for their investors. However, local authorities can motivate and inspire developers to work together and create healthier places. For example, local authorities can ask all major developments to demonstrate a health net gain with their development, provided that local evidence substantiates such a requirement. If a development demonstrates health net gain, for example, the local authority can grant an accelerated planning permission, which would lead to huge cost savings and contribute positively to the viability of the proposal. Health net gain can be adaptable to locality and it could refer to any acute local health issues such as respiratory diseases or obesity.

Furthermore, local authorities can set robust design standards, which are now strongly supported by the National Planning Policy Framework, to positively influence design quality. These could include a well-connected network of attractive, safe, convenient transport corridors with separated pedestrian and cycle routes, high-quality open and recreational green spaces, and decent homes built to the highest standards, such as BREEAM of which health and wellbeing are part.

Delivering healthy homes and high-quality neighbourhoods requires a strong steer from local leaders, who are responsible for establishing a unifying vision for their area and helping planning departments and public health teams inside local authorities work together to implement the shared vision. At a minimum, local authorities’ corporate strategies should outline how they address local health and wellbeing needs with the help of their housing strategies.

This article was originally published in Building Utopia, a collection of thought leadership pieces and expert analysis on urban development, published by Policy@Manchester.