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Healthy cities: It's time to focus on prevention rather than cure

Polluted city

I am a demographer by training and have worked in healthcare for most of my life. As a basic marker of how well we are living on this planet, I am most interested not in GDP, or even educational standards, but in life expectancy and years of healthy life.

Medical science made enormous progress in treating disease in the past century. But the main interventions that increased our life expectancy from just over 40 years to over 80 years were public health measures over 150 years ago. Clean water and sewers reduced infectious disease rates (from 11 per 1,000 to under 1 per 1,000) while medical breakthroughs did not, in general, contribute importantly to the early major decline in infectious disease mortality.
The death rate from causes other than infectious disease was 12 per 1,000 in 1850 and this has not declined markedly. Our main health problems are lifestyle diseases such as diabetes, heart disease, stroke and depression and our medical system is geared almost entirely to managing illnesses and not avoiding them. We no longer have the resources (financial or environmental) to continue in this way.
Climate change is almost undoubtedly the biggest threat to health this century and we have a critical need to control greenhouse gas emissions. We are legally committed to reducing C02 equivalents by 80 per cent by 2050. In the absence of any agreed mechanisms for reduction in the production or use of C02, it is up to planners and health professionals to work together to create systems and infrastructure that support much lower C02 use.

”The environmental and healthcare crises that confront us make it a matter of urgency that planners and public health professionals renew their working relationship”

Yet, despite wide acknowledgement of the relationship between planning and health, there seem now to be few ties between the two worlds. The environmental and health crises that confront us make it a matter of urgency that planners and health professionals find new ways to work together to develop a world where healthcare is combined with social science and behavioural economics to encourage prevention above cure. Achieving this change will require health and planning to work much more closely together in future.
How can we best do that? Through “big data” via Apple, Microsoft, with people being closely monitored by ubiquitous computers and rewarded for looking after their health? Or by redesigning our cities and communities to support people to live healthy and fulfilled lives? Answers on a postcard, please.
Rachel Stancliffe is director of The Centre for Sustainable Healthcare and will be a guest speaker at the RTPI Planning Convention in London on 24 June.

I would direct you to the national Spatial Planning & Health Group (www.spahg.org.uk) and point out that the Town & Country Planning Association are in the third year of running a healthy planning project: http://www.tcpa.org.uk/pages/health.html - that's before I even get on to the work of individual local authorities on health & planning, including Stockport Council who I work for as the Health & Environment Advisor (Planning) - a post co-funded by the Director of Public Health and the Planning Policy Team - www.stockport.gov.uk/planningsustainabledevelopment. Finally you may be interested in the work of Healthy Cities Network: www.healthycities.org.uk

Healthy low fat food at grocery stores, see prices and nutritional facts http://www.unmuteme.com


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