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Public Health and Landscape:Creating Healthy Places

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Public Health and Landscape:Creating Healthy Places Public Health and Landscape Public Health Creating healthy places and Landscape Creating healthy places Landscape Institute Position Statement Landscape Landscape Institute Institute Inspiring great places Inspiring great places Introduction St. Andrew Square, The state of our health services is rarely out of the news. Edinburgh, Gillespies / John Our landscapes have an important role to play in Understandably, there is a huge concern about acute Cooper Photography provision and the treatment of ill health. Much has been improving public health – so let’s invest in them written about the increased incidence of obesity, the persistence of health inequalities and the best ways to care for an ageing population. We believe that much greater priority needs to be given to prevention of ill health in public health and social care. Much of the history of landscape Over the past 50 years, public spending on the NHS has risen from 3.4 per cent to 8.2 per cent of GDP1. If spending continues In April 2013, responsibility for public health moved from architecture can be traced back to the need on the same trajectory for the next 50 years, then by 2062 the UK the NHS in England to local authorities. The Landscape to create places that were beneficial for could be spending up to a fifth of its GDP on the NHS alone2. It is generally accepted that now is the time to think about how much Institute was inspired by this change to look at the people’s health and wellbeing. we spend on health, where we spend it and how it should be paid promotion of public health across the whole of the UK. for. Increasing concerns about the cost of treating conditions Victorian parks were established as places to seek fresh air and such as obesity, heart disease, diabetes and mental illness, Our challenge was to answer the question: can landscape respite for urban populations; the innovative tree-lined suburbs coupled with the ever-present need to demonstrate value for of Port Sunlight and Bourneville were planned so as to enhance money, make this debate more necessary than ever. help create healthy places? We believe that the evidence residents’ sense of wellbeing; while Frederick Law Olmsted’s in this publication and especially the projects that we ambitious Emerald Necklace Park in Boston, USA, was designed The potential impact that public health interventions can make to improve water quality and reduce the number of deaths from on reducing these costs is huge. According to a 2012 study by describe, provide a clear and positive answer. cholera. There is an honourable tradition that links landscape the Canadian Public Health Association, it costs 27 times more to architecture and public health. This Position Statement achieve a reduction in cardiovascular mortality through clinical All those concerned in creating healthy places – public continues that tradition. interventions than it does to achieve the same result through 3 health professionals, planners and landscape architects local public health spending . Interventions in the landscape can, How we plan, design and manage our landscapes should be and indeed should, play an important role in delivering these – need to recognise landscape as an asset that has guided as much by their importance for health as for all of their cost-effective improvements in health and wellbeing. enormous potential to improve our health and wellbeing. other functions. This Position Statement aims to give public health professionals, planners and landscape architects a better Landscapes have long been seen as places of delight and understanding of the contemporary role landscape plays in the relaxation. Today, these associations are becoming more Sue Illman creation of healthy places. explicit: an increasingly strong evidence base demonstrates President, Landscape Institute the positive effects that access to good-quality landscapes has A growing evidence base, reflected in national policy, on our health and wellbeing – and the negative effects when suggests that spending on health care could be reduced if we don’t. We also know that areas of social and economic greater investment was made in preventing ill health before it deprivation, which are often linked with poorer health and has a chance to occur. Based on an overview of the available reduced life expectancy, can also be associated with limited 4 evidence, the Landscape Institute sets out five principles that access to good-quality green space . capture the positive links between landscape and health. Some 22 projects then show how these principles can be applied. Finally, our recommendations aim to inspire greater collaboration between public health, planning and landscape professionals, so that landscape is fully integrated with the delivery of public health outcomes. 01 01 Olympic Park, London, LDA Design Public Health and Landscape: Creating healthy places Page 1 Introduction Expertise Introducing the five principles of healthy places The landscape architecture profession has expertise that can help deliver the public health agenda It is not only people’s physical We are under no illusion that spending cuts in the UK are The landscape architecture profession constraining public health budgets, as well as putting pressure What do we mean by ‘health’ and ‘landscape’? environment that affects their health on the NHS. But, if responded to imaginatively, this pressure has plans, designs and manages our land and wellbeing; there are many relevant the potential to generate both positive results for the health and resource in order to secure the best Before we explore the links between landscape and health, wellbeing of communities across all the UK’s administrations it’s important to establish exactly what we mean when we personal and social factors too. and, as a result, reduce NHS spending. possible outcomes for people, the refer to ‘health’ and to ‘landscape’ in this document: environment and the economy. In order to plan, design and manage places so that they In England, the Health and Social Care Act (2012) and the Health describes a state of complete physical, mental and positively influence the health and wellbeing of communities, 6 social wellbeing, and not merely the absence of illness adoption of the National Planning Policy Framework , for Our landscapes are the result of a complex set of natural we need to identify and work with all these factors. They are and infirmity9. example, have gone some way to refocusing the public health and manmade factors, which contribute towards both their called the ‘determinants of health’, and were first referred to agenda. There are now potentially greater opportunities for aesthetic and functional qualities. The profession is rooted in an by Dahlgren and Whitehead in 1991 in their landmark paper Public Health describes the science and art of promoting and planning departments and public health professionals to work understanding of how these complex relationships work. What can be done about inequalities in health? 5. On pages together, and to embed health and wellbeing in local policy. In protecting the physical and mental health and wellbeing of 4–11, we identify how landscape is important to many of populations in order to prevent illness, injury and disability10. Scotland, health policy is increasingly focused on community- Today, the landscape profession is using its skills to achieve these determinants. We use them to underpin the following based care, and is coupled with an ambitious programme positive outcomes for people’s health and wellbeing at all scales five principles that we believe are essential to the creation of 7 Landscape doesn’t just include the wider countryside and of preventative public health interventions . Similar policy and all stages of development. By designing for the community, healthy places: concerns exist in Wales and Northern Ireland8. green spaces, but urban spaces, such as civic squares and landscape architects understand how the aesthetic and public realm. It is an area, as perceived by people, whose functional qualities of a place can enhance quality of life: Policy support needs to be followed by resources. We propose character is the result of the action and interaction of cultural 1. Healthy places improve air, water and soil quality, that, nationally, public health should be granted the same long- and natural factors. This definition comes from the European incorporating measures that help us adapt to, and where — By working on strategies and policies with other term budgetary support that other public services receive. Landscape Convention. This is a valuable and inclusive possible mitigate, climate change professionals and agencies, aiming to protect the valuable This is a necessary step towards delivering primary prevention definition, covering outside spaces everywhere and at natural resources that are the foundation of our health and 11 and a more sustainable way to manage the health of the nation every scale . 2. Healthy places help overcome health inequalities and can wellbeing: air, water, and, soil. Landscape professionals and reduce the pressure on primary care services. At a local promote healthy lifestyles understand the natural and cultural elements that define an Some landscapes act as green infrastructure. The Landscape level, landscape should be recognised as an asset in promoting area’s special character and can integrate these into practical, health and wellbeing and should be a central consideration Institute defines green infrastructure as a network of natural
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