To make progress do we now need urban planners and public health to share responsibility for tackling obesity?
Take note: Public health practitioners and planners who work with or in local authorities and academics in this field.
City planning impacts on people’s wellbeing and health. It can do this through affecting people’s access to food and the degree to which their local environment encourages physical activity. Both of these have been shown to be linked to obesity. Using planning policy to tackle health problems such as obesity could help tackle this global problem. Obesity is a complex international health and social problem and its solution calls for transdisciplinary approaches and innovative thinking.
Obesity is an international complex health and social issue. In April 2013, the restructuring of Public Health in England resulted in a move from within the National Health Service (NHS) to local government. This research explored the views of individuals working in public health and those working in spatial planning within local governments on their responsibilities for addressing obesity using spatial planning. Our interviews identified a range of barriers to engaging with planners, including an insufficient understanding of the causes of obesity and the primacy of addressing obesity via multiagency approaches, fragmentation in the health system and conflicting priorities. Planners could be better engaged in the obesity agenda via formal incentives (e.g. written within planners’ job descriptions or regulations), and aligning priorities via ‘soft approaches’ (e.g. public health leadership roles and training).
We already know: There have been attempts to reunite health with planning. Evidence has highlighted the transdisciplinary effort required to tackle obesity due to its multifactorial nature and underpinning health inequalities. However, there appears to be little evidence that English planners have engaged with the new public health agenda. No detailed investigation has attempted to fully understand the barriers to engaging planners in health issues.
What this study adds: The aim of this research was to understand the views of individuals working in public health in local authorities and those working in spatial planning within local government on their respective responsibilities for addressing obesity through spatial planning. Findings identified a range of barriers to engaging with planners, including an insufficient understanding of the causes of obesity and the primacy of addressing obesity via multiagency approaches, fragmentation in the health system and conflicting priorities. This adds to international findings about the need for political will and the requirement for ‘health-in-all-policies’.
Implications for city policy and practice: There needs to be a shift and clear leadership within local authorities to a shared model of responsibility for obesity and more broadly for wellbeing. Planners’ priorities need to be better aligned with public health. This means planners taking a more active role in tackling obesity. Such a shift could be supported both through formal incentives, for example written into planners’ job descriptions or regulations, and through ‘soft approaches’, for example with a stronger public health leadership role and improved training about the causes of obesity.