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Health promotion must be at the heart of housing

Building quality homes will help close inequalities.

Last summer several local government representatives held an emergency meeting with parliamentarians to discuss how councils are haemorrhaging funds to house growing numbers of homeless individuals and families in, often unsuitable, temporary accommodation.

The government’s answer – building 1.5m homes by 2029 – appears to make sense at face value. But prioritising this national target, and fixating on numbers, misses much more fundamental questions. Questions about whether volume house builders are really going to deliver a sufficient supply of the right homes in the right places. Questions about genuine affordability, about standards, about the types of homes and connection – if employment and services will be accessible. Questions about what it will be like to grow up in these new homes and places – if they will support starting, living and ageing well.

This preoccupation with delivering housing numbers also ignores the reality that in many parts of the country, there is a greater urgency to address the poor condition of existing housing stock and neighbourhoods, and the lack of economic opportunities.

Referring to regulations and planning as “blockers” is simply unhelpful, pitting nature and communities against house building. The emphasis must be on setting a clear ambition to work with people and build trust – by investing in new and existing communities, enabling them to take ownership and improve their life chances.

We have seen a decline in healthy life expectancy in England – especially for those living in the most deprived areas. Women living in the most deprived areas have 18.2 years less healthy life compared to women in the least deprived areas – an increase in inequality of 17 per cent since 2011-2013. Men, on average, have 17.9 less healthy years in the most deprived areas (a 22 per cent increase compared to 2011-2013) (ONS, 2024). Growing health inequalities are preventing those people from living healthy, happy lives, engaging in learning, and contributing economically.

Those working in the built environment sector must prioritise the “upstream” causes of poor health and better target those determinants to support good health outcomes. This is because we know people living in poor quality homes are twice as likely to have poor health outcomes.

We can do better. The building blocks of a healthier, more equal society, and inclusive regenerative economy – good housing and neighbourhoods – are within our reach. The TCPA continue to call on the government and councils to not just prevent harms, but prioritise development, place-based ways of working and better health promotion through better planning. This includes work to ensure future New Towns and communities set inclusive health promotion as their central aim.

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The Campaign for Healthy Homes has been two-pronged. Firstly, at the national level, seeking comprehensive legislative reform to raise the standards of housing across all tenures – including new ‘homes’ produced under permitted development rights. Moving beyond the current fragmented, under-resourced and poorly enforced model that mainly focuses on preventing the worst harms of poor housing, towards a system that positively encourages health.

Secondly, we are supporting key groups – local authorities, housing associations, developers – to adopt and apply the Healthy Homes Principles through policy requirements and housing schemes. For example, last year the developer Wates adopted the Healthy Homes Pledge, and Lewes District Council’s new council housing policy applies the Healthy Homes Principles to all their future housing schemes. This year six housing schemes were shortlisted for the Health Homes category of The Pineapples award – with winners Hazelmead Community Land Trust in Bridport and Appleby Blue Almshouse in Bermondsey demonstrating it is possible to viably deliver all 12 principles and even go beyond them.

Where people live matters, and planning policies shape these places. Over the last decade the TCPA has worked with national and local government to embed consideration of health and well-being into local plans. In 2024, in collaboration with the TRUUD research consortium, we published planning for healthy places; a toolkit of practical evidence, guidance, and inspiration to help local authorities in England create healthier places for everyone. The toolkit, developed with seven local authorities, is designed to appeal to a range of audiences from different professional backgrounds and levels of understanding about planning and public health.

We can provide advice, training and act as a “critical friend” to support planning and public health elected members and officers seeking to embed healthy planning principles into Local Plans, design codes and supplementary planning documents, including developing approaches to health impact assessment.

There are many influences on children and young people’s health and happiness from the earliest years of life, but where they live – the built and natural environment around them – is crucial.

A child’s home, the street they live on, their neighbourhood and access to safe and inclusive outdoor and green spaces matters. Being able to be outside, to play, socialise, move and get around independently matters. Feeling welcome, having ownership, being seen and heard in their community, and having a voice in how spaces develop and change over time really matters.

The TCPA, alongside partners, are exploring what place-making and keeping looks like when it is re-centred to engage, support, and promote the rights of the child, and developing what this means for national and local planning policy. Later this year, we will be adding new UK case studies and a resource for councils, focusing on embedding the needs of children and young people in local plans.

Now is the time for the government and those involved in planning and delivering development to be more ambitious. Now is the time to create and steward places that are designed to improve over time, places where children and people of all ages and backgrounds can thrive.

Find out more and sign up to the Healthy Homes Pledge now.

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