Built and natural environment

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Background

The built and natural environment is a key determinant of health and wellbeing. It includes the characteristics (both observable and perceptions) of a physical environment in which people live, work and play, including: schools, workplaces, homes, communities, parks/recreation areas, green (ie visible grass, trees and other vegetation) and blue spaces (ie visible water).

The Bolton picture

How healthy is my street?

  • These tools allow you to assess various aspects of a street that contribute to how it impacts on health e.g. are there places to rest or shelter, how easy it is to walk/ cycle along, how safe and welcoming does it feel. There are surveys for whether you are a professional using equipment to get a precise result or a member of the public who wants to get a quick indication.
  • Healthy streets assessments - used particularly across London
  • Place standard assessment - developed in Scotland, OHID are looking into wider adoption across England
  • Right to the Streets from Trafford Council/ GM Moving including Community place review

Further useful links

Neighbourhood design

Neighbourhoods are places where people live, work, and play and have a sense of belonging. The design of a neighbourhood can contribute to the health and well-being of the people living there. Several aspects of neighbourhood design (walkability and mixed land use) can also maximise opportunities for social engagement and active travel.

Evidence based principles for building healthy neighbourhoods:

  • Enhance neighbourhood walkability
  • Build complete and compact neighbourhoods with diverse land use mixes, local amenities and greater residential densities
  • Enhance connectivity with safe and efficient infrastructure for walking and cycling and access to public transport

Further useful links

  • Creating age friendly developments - a practical guide for ensuring homes and communities suupport ageing in place, from GM Housing Planning and Ageing Group. Although mainly focussed on older people, this guide will also be useful when considering the needs of other underserved groups.
  • cities alive - series of reports from Arup on taking a human centred approach to urban design. Includes reports on young people and play; walking; green and thriving neighbourhoods
  • Healthy streets resources - human-centred framework for embedding public health in transport, public realm and planning.

Housing

Housing is an important social determinant of health, and the link between housing and health is widely acknowledged. Housing affordability affects where people live and work, and factors that influence health including the quality of housing available, poverty, community cohesion, and time spent commuting. There is increasing evidence of a direct association between unaffordable housing and poor mental health, over and above the effects of general financial hardship.

Homelessness is associated with severe poverty and is a social determinant of mental health. To be deemed statutorily homeless a household must have become unintentionally homeless and must be considered to be in priority need. As such, statutorily homeless households contain some of the most vulnerable and needy members of our communities. There are a number of risk factors associated with the likelihood of someone becoming homeless, ranging from drug and alcohol issues, bereavement, or experience of the criminal justice system, to the wider determinants of health such as inequality, unemployment, and housing supply and affordability. The majority of the people that are found to be homeless but not in priority need are single homeless people, who as a group have very high prevalence of mental and physical health issues.

Evidence based principles for healthy housing:

  • Improve quality of housing so it is warm, energy efficient and safe
  • Increase provision of affordable and diverse housing
  • Increase provision of affordable housing for vulnerable groups with specific needs, such as adults with intellectual disability, adult substance users, and those who are currently homeless

The Bolton picture

Further useful links

  • Housing and health: a reading list - from the House of Commons Library
  • Creating age friendly developments - a practical guide for ensuring homes and communities suupport ageing in place, from GM Housing Planning and Ageing Group. Although mainly focussed on older people, this guide will also be useful when considering the needs of other underserved groups.

Access to healthier food

The food environment plays an important role in promoting a healthy diet, but this is a complex system influenced and determined by a series of factors, including a person’s proximity to food retail outlets and the type of food available. Vulnerable groups, including those on a low income, children, young people, those who are overweight or obese, and those of certain ethnicities, are less likely to achieve a healthy and balanced diet. To date, there is relatively limited good quality review level evidence on the influence of the food environment on health and wellbeing outcomes. However, existing evidence indicates that making healthier foods more accessible and increasing provision of low cost healthier food could be effective interventions, but these are likely to be more effective as part of a whole system approach to diet and obesity.

Evidence based principles for healthier food environments

  • Healthy, affordable food for the general population
  • Enhance community food infrastructure – there is some initial evidence that urban agriculture (the practice of cultivating, processing and distributing food in or around urban areas) and growing food in gardens and allotments may improve attitudes towards healthier food, increased opportunities for physical activity and social connectivity, and increased fruit and vegetable consumption

Natural environment

Also see Bolton JSNA - climate emergency (natural environment)

Spending time in the natural environment – as a resident or a visitor – improves our mental health and feelings of wellbeing. It can reduce stress, fatigue, anxiety and depression. It can help boost immune systems, encourage physical activity and may reduce the risk of chronic diseases such as asthma. It can combat loneliness and bind communities together. DEFRA/ University of Exeter evidence statement on the links between natural environments and human health

Bolton contains a number of areas of particular natural focus (see links below to mapping). Other places where nature is incorporated in the urban envirionment include street trees and other decorative planting; private gardens; and highway areas such as verges, rain gardens and other sustainable drainage features.

Different types of urban nature can support different types and amounts of biodiversity. For example, a city park with wooded trails, a stream, and a pond may be rich in biodiversity because it is home to many types and large numbers of trees, birds, frogs, fish, and beneficial microbes. In contrast, another nearby city park that features predominantly grassed areas for sports fields and picnic areas is also an example of urban nature but supports little biodiversity.

  • Sites of Special Scientific Interest (SSIs): the West Pennine Moors are located to the north of the borough, Red Moss is adjacent to Middlebrook, Nob End and Ashclough are near Little Lever.
  • Woodland priority habitat and woodland improvement areas are located around the borough. There are some areas of ancient woodland. Greater Manchester as a whole is part of a community forest programme.
  • Bolton has a number of country parks and parks. The borough's country parks are: Smithills, Jumbles, Seven Acres, Moses Gate, and Smithills Country Park. Bolton has the following sites on the list of Registered Parks and Gardens - part of the National Heritage List for England: Queen's Park, Tonge Cemetary, Farnworth Park, and Hulton Estate.
  • There are a number of rivers and brooks running across the borough, which provide water based habitats. Some of these include: River Tonge (running North to South), Gale Brook/ Belmont Brook and Dean Brook/ Astley Brook feed into it. Bradshaw Brook also runs north to south. Middle Brook runs east to west, before becoming the river Croal which runs through Bolton town centre. The River Tonge joins the Croal south of Bolton town centre, further south it joins the river Irwell. The Manchester Bolton and Bury canal runs in the south-east of the borough. There are other watercourses, reservoirs and lodges.

The Bolton picture

  • Green infrastructure mapping & analysis - information and resources for planning, monitoring and evaluating the provision of green infrastructure - from Natural England
  • All our trees - Greater Manchester's tree and woodland strategy
  • Mapping GM - provides map views of a number of datasets relavent to the natural environment, under the 'environment & ecolgy' and 'Water network and water bodies' tabs
  • MAGIC mapping - geographic information about the natural environment from across government.
  • Access to gardens and public space in Great Britain - average distances to and sizes of various types of greenspace for local authorities and smaller areas

Further useful links

Transport

Also see Bolton JSNA - climate emergency (transport) and Bolton JSNA - physical activity (Active travel)

Transportation plays an important role in supporting daily activities. Active travel (walking, cycling, and wheeling) as all or part of a journey (e.g. to/ from a public transport stop) can increase physical activity levels and improve physical and mental wellbeing. Prioritisation of active and sustainable travel can also reduce over reliance on private motor vehicles, contributing to improved air quality and a reduction in road injuries

Evidence based principles for healthy transport

  • Provision of active travel infrastructure - there is a wealth of high quality evidence to show that investing in infrastructure to support walking can increase physical activity levels and improve mobility among children, adults and older adults. There is moderate to high quality evidence that indicates that prioritising active travel, through investment in cycling infrastructure, can lead to numerous health gains
  • Provision of public transport
  • Prioritise active travel and road safety
  • Enable mobility for all ages and activities

Greater Manchester has endorsed a Vision Zero approach for the city region. It aims to eliminate road death and life-changing injury by 2040, with a target to achieve a 50% reduction by 2030. The intention is to increase safe, healthy, equitable mobility for all, by adopting the 'safe systems' approach. A Safe System is one where people, vehicles and the road infrastructure interact in a way that secures a high level of safety for all. While it is inevitable that there will always be road traffic collisions, adopting the Safe System approach means that the impact of a collision can be minimal, saving lives and preventing life-changing injuries.

The Bolton picture

Further useful links

  • Move free - report from Create Streets exploring why and how making it easy to get about towns and cities in as many ways as possible boosts prosperity, high streets and freedom, happiness, health and house-building.
  • Public health and strategic transport objectives - The Transport Committee is inquiring into how the Government sets its strategic transport objectives and how these objectives do or should influence decisions on investment in, and cross-government planning of, services, networks, and infrastructure. Consultation Response from the Association of Directors of Public Health (ADDPH)
  • Getting around Leigh: Social research with older and disabled people - from the University of Salford
  • Evidence review of Low Traffic Neighbourhoods (LTNs) - commissioned by Possible. LTNs use bollards, planters, and cameras (‘modal filters’) to remove through motor traffic from neighbourhoods, while retaining motor vehicle access to all properties. They share similarities with Greater Manchester's Active Neighbourhoods.
  • Cycling for everyone: A guide for inclusive cycling in cities and towns - from Arup and Sustrans

Commercial determinants of health

Commercial determinants of health - the ways in which companies and business activities designed to generate profits affect people’s health. These can act in positive or negative ways.

How do commercial determinants affect health?

  • Political practices - Practices to secure preferential treatment or prevent, shape, circumvent, or undermine public policies (or a combination of the above) in ways that further corporate interests
  • Scientific practices Practices involving the production and use of science to alter products or otherwise secure favourable outcomes (or both) for the industry
  • Marketing practices - Practices to promote sales of products or services, including: changing physical and information environments in ways that drive consumption; exaggerating inequalities by targeting specific populations; shaping norms to drive consumption
  • Supply chain and waste - Practices involved in the creation, distribution, retail, and waste management of products or services. E.g. waste, packaging and transport of tobacco products have their own health impacts wider than the product itself
  • Labour & employment - Practices to manage people employed directly within, or under contract to, the organisation within its supply chain. Work is an important determinant of health see Bolton JSNA - work
  • Financial - Practices to support financial position of the organisation For example tax avoidance and evasion or lobbying to avoid the introduction of policies that may adversely affect the organisation or industry’s financial position
  • Reputation - Efforts to shape legitimacy and credibility, reduce risk, and enhance corporate brand image Affecting underlying drivers & determinants
  • Individual responsibility - Frame and reframe discussion and debate Promote narratives of personal or individual responsibility, moderation, consumer freedoms, free markets, the nanny state, government intrusion, and businesses as part of the solution; lower regulation etc. 'Upstream' measures such as regulation and legislation can often be very effective e.g. ban on smoking in enclosed public places and workplaces;soft drinks indultry levy ('sugar tax').

Potential affected topics may include:

  • Food and drink
  • Tobacco
  • Alcohol
  • Gambling
  • Fossil fuels/ air pollution
  • Formula milk
  • Working conditions and benefits

Further useful links