Health, wellbeing and regeneration in coastal resorts
Conclusion
Survey respondents demonstrate the breadth of the agenda that public health covers. They were clear that regeneration contributes to improved health.
Physical improvements to [the] built environment [have had an effect on the] wider determinants [of health]. Impact on mental health [and] community cohesion; improvement in access to training/life skills; access to affordable/improved accommodation, improved access to facilities eg leisure; working closer with faith sector to engage with communities (spiritual health)
... regeneration has been directly linked to the development of new health services and there are indications of improved perceptions of wellbeing among local people.
Local government and NHS colleagues have a range of mechanisms available to improve public health. For example:
- Local government has powers to promote the wellbeing of its citizens.47
- Local authorities lead a range of local partners through Local Strategic Partnerships.
- Joint Overview and Scrutiny Committees police health outcomes/services and the extent to which inequalities are being tackled.
- Local Area Agreements (LAAs) bring local authorities and the NHS together to develop and deliver health targets.
- Joint Strategic Needs Assessments are a responsibility of the directors of public health, adult social services and children’s services, designed to inform long-term planning and commissioning for health and wellbeing. These should draw on a wide range of information and drive the local vision for health improvement.
Planning and health are also beginning to develop closer links. The Royal Town Planning Institute and the NHS Healthy Urban Development Unit have each issued good practice guidance on delivering healthy communities.48 The National Heart Forum and the National Institute for Health and Clinical Excellence (NICE) have prepared guidance for physical activity and the environment.49 Health Impact Assessments are cited in several case studies as ways in which public health considers, and presents, the potential effects of planning and regeneration policy. Strategic Environmental Assessments (SEAs) apply to a range of strategic plans including Local Development Frameworks and Shoreline Management Plans. The Department of Health has issued draft guidance as SEAs are legally required to identify effects on human health.50 This is a big opportunity for health professionals to take on a greater role in influencing planning and regeneration policy. NHS colleagues and joint processes such as the JSNA can play a key role in enabling regeneration and planning colleagues to better understand the health needs of local communities and support appropriate planning to meet these.
The current economic situation is focusing attention on economic factors. The challenge will be to show how social and environmental factors, including health, contribute to economic security (see case study 6). How should planning and regeneration work with public health? We are not talking about full-time hand-in-hand work but about partnership work that might be time-specific and designed to achieve particular outcomes. Whitehead’s typology is useful for framing an agenda.51
A note of caution. Much of the work described above will contribute to improving health, but it is hard to link improved health outcomes directly to regeneration activities.52 If we are to see improvement in health and reduced health inequalities we must be clear about the aims and objectives of regeneration programmes and they must be properly monitored and evaluated.53 Local knowledge and the experience of health professionals, regeneration practitioners and community members are key to charting the best course in each coastal community.
There is much excellent work in coastal communities across England that is not cited in this chapter. This chapter could be the start of a dialogue and we look forward to continuing this discussion with readers via IDeA’s Health Community of Practice: this is an online community that brings together local government and public health colleagues from across the country to share activity and work collaboratively on improving health and reducing inequalities.54
We leave readers with some key questions for effective partnerships between local authorities and the NHS.
- What are the five or six key health issues in your area and how can regeneration and planning help to address them?
- Who is your local director of public health and his/her team? Have you met to discuss the health impact of regeneration and planning?
- Who, in your council, holds the portfolio for health services, health improvement and health inequalities?
- How can regeneration and planning contribute to meeting needs identified in the local Joint Strategic Needs Assessment (JSNA)?
- Can health impact assessment be used within regeneration and planning to ensure positive health outcomes?
