Insights

Monday, 5th August 2019

Getting on Board the ‘Healthy Streets Approach’

What would make you get out of your nice cosy car or home to instead spend more time outdoors, walking or cycling more? This is the rather ambitious question that the Healthy Streets Approach seeks to answer and encourage.

One year on from the publication of the London Environmental Strategy (LES) and Temple’s work on the Integrated Impact Assessment of it, in a series of articles, we are exploring four themes that the LES introduced to seek to make the most of environmental opportunities and identify clear win/win outcomes that benefits everyone across the capital – namely:

  • Healthy Streets
  • Low Carbon Circular Economy
  • Smart Digital City
  • Green Infrastructure & Natural Capital Accounting

So, what are ‘healthy streets’ and why are they here to stay?

The Healthy Streets Approach is a framework which puts human health, and people’s experience of places, at the heart of urban planning and place making. In doing so it seeks to encouraging people to walk and cycle more, and providing safe, welcoming and unpolluted routes they can take will help lead to a range of important and beneficial outcomes.

The economic value of the ecosystem services delivered via healthy streets is significant. It has been calculated that the 8 million existing trees in London provide at least £133m of economic benefit per year through improving air quality, storing carbon, providing shade and shelter, and reducing surface water flooding. The health benefits include reducing preventable disease, helping to improve mental health, and tackling depression and anxiety. The Natural Capital Accounts for Public Green Space in London (2017) estimates that London’s parks save health services a total of £370 million each year as a result of improved mental health alone.

What did the LES Propose?
The LES sets out the following 10 mutually reinforcing evidence-based indicators of a ‘healthy street’ with the aim of improving air quality, reducing congestion and helping to make London’s diverse communities greener, healthier and more attractive places to live, work, play and do business.

Source: Healthy Streets Guidance

In support this initiative in March 2019 the Mayor of London and TfL announced they were increasing the funding for the ‘Liveable Neighbourhood Programme’ from £33m to £53.4m.
However, this does not mean that only schemes with Mayoral funding can become healthy streets and the LES encourages developers and local authorities to work together to ensure that the ‘healthy streets thinking’ forms a central part of the design of public realm and route improvement programmes as well as new development proposals.
How can we work together to make this happen?
There are many ways people and organisations can get involved in improving the 10 indicators. This ranges all the way from developing new policies, to encouraging volunteers to do a bit of gardening in their lunch breaks!

For example, implementation of LES Policy 4.2.1 will reduce emissions from London’s roads by gradually phasing out the use of fossil fuelled vehicles and promoting more sustainable forms of transport. By 2020, all TFL buses will meet the Euro VI diesel standard for NO and PM. The Ultra Low Emissions Zone (ULEZ) came into force in April 2019 to replace the T-charge. These measures will go a long way to reducing the use of fossil fuelled vehicles which will benefit one of the 10 indicators. In this way, healthy streets also links in with other objectives from the LES, such as transitioning to a low carbon circular economy and tackling poor air quality.

LES Policy 8.4.5 seeks to reduce the impact of a hotter climate on people’s health, and the Mayor will increase street planting to provide additional areas of shade, to provide refuge for Londoners during high temperatures, and lead to an overall cooling of the urban environment (through evapotranspiration). In doing so, it will also create places for people to stop and rest, encourage walking and cycling, reduce air pollution and create an improved visual environment.
‘Urban Greening Interventions’ are also considered part of the Healthy Streets Approach. These interventions include greener public realms, street planting and green roofs/walls. In the LES, the Mayor commits to working with a range of stakeholders to “champion and promote urban greening good practice”. The primary aim of urban greening interventions is generally to improve biodiversity (green roofs) but they can also make important contributions to creating healthy streets across London. Additional green infrastructure enhances local biodiversity and can protect priority species.

To summarise, the Healthy Streets Approach seeks to set out an interlinked framework of indicators which, if achieved, will lead to the creation of healthy streets. In addition to the indicators, it sets out policies which will direct plan-making and decision-taking to ensure that the indicators are achieved. Adopting the Healthy Streets Approach across all Boroughs will ensure that London becomes a fairer, healthier and more sustainable city.

There are three different levels of change that are required to create healthy streets:

  • Street level changes include measures which seek to improve Londoner’s experience of streets and encourage them to live more active lives. These changes can include more street planting, to create more attractive streets with increased shade during periods of warmer weather, as well as cycle lanes, to make it more convenient and safer for cyclists
  • Network level changes involve planning and managing London’s network to create more efficient public transport, more effective traffic lights to relieve congestion, and create safe and convenient loading/unloading areas for delivery vehicles
  • Strategic changes involve the location of new housing, for example, locating new houses close to public transport hubs to reduce people’s dependency on cars and relieve commuter stress

The LES addresses the changes needed across London which fall into the ‘street level’ category including increased tree planting and encouraging walking and cycling over travelling by car. The thing to remember is that although each individual change may seem small and immaterial, as a whole these street level changes have the potential to significantly improve London’s streets and, as a result, the physical and mental health of those using them. See an example case study here.

Linking Health Impact Assessment (HIA) to Healthy-Placemaking

So as to understand how the sorts of measures described above can actually influence public health thinking, this section describes some of the fundamentals of health impact assessment, a tool or process to help plan for and demonstrate positive health outcomes.

A person’s health is made up of a number of determinants including: constitutional factors (age, gender etc.), individual lifestyle factors (exercise, smoking, drinking), social and community networks (friendship groups, relationships at work), socio-economic and cultural conditions (housing, education, access to jobs) and environmental factors (clear air, water, noise). Many of these aspects are controllable, and the greatest effect on health outcomes occurs when there is a combination of multiple aspects (e.g. increasing exercise whilst improving air quality). The range of health determinants is shown in the image below.


Health Impact Assessment (HIA) is a process of identifying baseline health characteristics amongst a population, and considering how a project or policy can affect them. The assessment should be proportionate, bring in the views of key stakeholders, and use appropriate qualitative or quantitative methods. The process allows the early identification of potentially sensitive members of the community and possible health effects that may otherwise not manifest themselves until it is too late. It can also lead to a range of enhancement measures that can further improve health benefits and achieve win-win outcomes, such as with healthy streets.

An example of one measure is the NHS Healthy Urban Development Unit ‘Rapid HIA tool’, which also contains a lot of information to explain the connections between urban planning and health outcomes.

‘Healthy placemaking’ involves designing an area so it brings together many aspects of healthy design, whilst designing out elements that have negative health outcomes. This can include, amongst other things, incorporating measures to target the 10 healthy streets indicators. However, the magic ingredients are:

  • Engaging local communities to understand their specific needs and ideas, and to enable them to take greater ownership
  • Recognising the need to balance multiple priorities (e.g. providing sustainable drainage, playable space, traffic flows, air quality, vegetation) and select those with the greatest social value to an area
  • Thinking strategically and collaboratively across areas and stakeholders, to allow our public realm to become a healthy, climate change resilient network that embeds green infrastructure into the future of our city

How can Temple help?
Temple is one of the UK’s leading independent environmental, planning and sustainability consultancies, with sister businesses including The Ecology Consultancy, Arbeco and The Green Infrastructure Consultancy. We advise both private developers and infrastructure providers, and public bodies, and so we are able to provide a balanced and holistic view to any proposals or outcomes you may have.

The following list highlights some of the most relevant specialisms we can provide to help bring forward the Healthy Streets Approach:

If you enjoyed this article and would like any further information on this please get in touch with LES@templegroup.co.uk or if you would like to find out about the full list of services Temple has to offer please visit our website.