Using integrated placemaking to improve health

We must work together across multiple platforms when addressing health inequalities, write Jenny Coombs, Cheryl Davenport and Neil Webster.

There is a 19-year gap in healthy life expectancy between the least and most deprived places in England. This has been exacerbated by the covid pandemic. As integrated care systems (ICS) – involving local partnerships of the NHS, local authorities, voluntary and charity groups, and independent care providers – begin to get to grips with their new roles to plan and deliver joined-up health and care services, how can they use their combined property assets and place-making powers to reduce these health inequalities?

Only 20% of good health is influenced by clinical care. The rest is driven by behavioural, social, economic and environmental factors. It’s clear we need to treat the place, not just people, to improve lives. The way ICSs plan and use their combined estates (not all of which are in the ownership of the public sector) can make a significant difference to the wider determinants of health.

In doing so, and if targeted at areas where health is worst, inequality can be reduced. Use of community sites for health services can significantly increase footfall and take-up. Vaccinations at racecourses, village halls and shopping centres are good examples.

How organisations use and dispose of their assets can affect a range of factors influencing health

More broadly, how public sector organisations plan, use and dispose of their assets can affect a range of factors influencing health, from air quality to affordable housing, alleviating fuel poverty and creating opportunities for exercise. As ICSs develop their integrated asset strategies, they have opportunities to work with partners to prioritise their focus.

This could include siting planned facilities in high streets to ensure sustainable travel options, thinking creatively about renewable energy generation possibilities, accounting for a range of social value factors when disposing of surplus property, or greening the environment to improve residents’ mental health.

As capital is scarce, demand increasing and the external environment is bringing profound challenges, we must work together across multiple platforms when addressing health inequalities. The places in which people live and work have never been more important in helping improve the health and wellbeing of our communities.

Jenny Coombs, health and social care programme director, Local Partnerships
Cheryl Davenport, managing director, East of England LGA; previously director of health and care integration at Leicestershire CC
Neil Webster, chartered surveyor and head of engagement, Association of Chief Estates Surveyors

This article is also available on lgcplus.com