Healthy Places: creating better environments that support healthy behaviours for children and families in deprived areas

The Healthy Places theme of ActEarly aims to deepen the understanding of the importance of environments in the prevention of non-communicable diseases and poor mental health and wellbeing.

Our focus is understanding how changes to the built and natural environments – which make them safer, less polluted and more attractive – can support healthier lifestyles among children, young people and families by encouraging more physical activity and by connecting people to each other and activities in their community.

We are working with both the local authority highway and public health teams in Bradford and Tower Hamlets and with key stakeholders like Transport for London. With our ActEarly co-production team, we are also listening to residents so that we can understand how best to change places to create more liveable environments.

Our planned research has been affected by the pandemic, which has seen a dramatic change in the way people use streets and parks in both London and Bradford – including the many street space changes made to accommodate more walking and cycling.

However, our first task has been to understand the evidence on the relationship between the built environment and physical and mental wellbeing for children, especially from deprived backgrounds. In our review we are seeking evidence of interventions that have been effective in supporting the health of children and intend to summarise this to inform the work of local authorities.

We are working to help evaluate several initiatives including:

Healthy School Streets

We will be evaluating the Healthy School Streets programme in Bradford and London. The programme aims to encourage physical activity and reduce pollution by creating more greenery, and support learning and development. It involves consulting with children and parents, schools, local residents and businesses. The approach is based on the flagship policy of Transport for London that was developed by public health consultant Lucy Saunders.

The changes can include restricting traffic at the start and end of school days, widening pavements and making road crossings safer, tree planting to offer shelter and extra greenery, green walls to filter air and create attractive spaces, and gardens to learn about nature and improve the environment.

Some surveys of school children have been carried out and when restrictions are lifted, we hope to explore the lived experience of parents and children and the importance of the quality of their streets in supporting health and wellbeing.

Liveable Neighbourhoods

The aim of the Liveable Neighbourhoods programme is to change the built environment to bring more activities to streets and encourage walking, cycling and the use of public transport. The London Borough of Tower Hamlets has funding to cover Liveable Streets covering 60 per cent of its area, and the programme is being implemented in phases over four years.

The evaluation framework will be structured around data routinely collected by the council and Transport for London. Importantly we will be exploring whether the engagement represents all the voices of the community and will be exploring ways of adapting the intervention to meet the needs of children and families.

Regenerating parks: Horton Park Bradford

Our evaluation will explore the impact of regenerating a large park in Bradford on families living in nearby deprived neighbourhoods. The intervention is supported by an EU project called Life Critical. The objectives are to explore the potential of parks to improve citizens’ quality of life and encourage their participation in implementing measures in the park that can help reduce the impact of climate change.

Ensuring health is considered in new developments: Health Impact Assessments

Tower Hamlets has introduced a health impact policy for new developments to make sure that they are designed to encourage healthy lifestyles and promote sustainable behaviours. The policy places the local community (people and organisations) at the core of master planning decision-making by valuing and validating local knowledge as a key aspect of the planning application process.

The theory is that the community and developers co-create the scope and systematically judge the potential and sometimes unintended effects of their urban development scheme on the health of the local population and the distribution of those effects within the population.  We will help the local authority understand whether this aim has been met by reviewing the assessments and judging whether developers have genuinely engaged with the community. We will  also gain qualitative insights into the facilitators and barriers of such engagement and of undertaking the assessment itself.

The impact of housing quality on health and wellbeing

Our team is involved in looking at housing quality data in the Families in Tower Hamlets: impacts of Covid-19 study led by the healthy livelihoods team. This will include gaining a qualitative understanding how the physical characteristics of their living space has affected families during lockdown.

We are also developing proposals on how digital tools can be used to reach out to communities and support their wellbeing and resilience in a time of lockdown in London and carrying out further work to explore the lived experience of overcrowded homes in London and Bradford.

New tools to evaluate place-based interventions

We have developed the Health And Place Intervention Evaluation (HAPIE) tool which incorporates standard measure of wellbeing, physical activity, play and street perception surveys combined with measures of housing such as overcrowding. The tool aims to collect data to study the interrelationship between the quality of indoor and outdoor space affects family health and wellbeing.

For more information please contact Professor Nicola Christie or Professor Laura Vaughan Theme Leads, Healthy Places