Amendments to the Levelling Up and Regeneration Bill (The Bill) in the House of Lords have the potential to benefit health, the climate crisis, nature, social justice and the economy. The Bill, introduced in the House of Commons in May 2022 is endorsed by the Department of Levelling up, Housing and Communities.1 It aims to empower communities and local authorities to work together to deliver beautiful and sustainably developed houses and neighbourhoods. It also aims to achieve better environmental outcomes through plans incorporating conservation and enhancement of nature and climate action (mitigation and adaptation). The proposed changes to the National Planning Policy Framework are currently under review. This is an opportunity to vertically integrate net-zero strategies that can help the government achieve the 2050 target of becoming a zero-carbon nation and gain significantly from the co-benefits.
The built environment, defined as the human-made space in which people live, work, and recreate, is responsible for 25% of the total carbon emissions in the UK.2 Currently, 84% of the nation’s population lives in towns and cities.3 This is projected to increase rapidly over the next few years. Scientific evidence and human experiences suggest that biodiverse nature is essential for human health.4,5 However, with rapid and large-scale urbanisation, there has been a massive loss in natural spaces and biodiversity. For example, there has been a 13% decline in the average number of different wildlife species in the UK since the 1970s.4 Climate change is further escalating biodiversity destruction and ecosystem degradation. The development of built environments needs to consider the health impacts of climate inaction.
The key health issues linked with poorly built environment include:
- Non-communicable diseases accounted for 88% of all deaths in England in 2019.6
- Mental health diseases burden in the UK in 2019 was 10.3 million cases and was associated with 1.4 million DALYs* (of which depression was 33% and anxiety was 21%)7
- Deaths due to extreme cold (around 63,000 additional deaths) and heat (3,271 extra deaths) in England and Wales in the winter of 2020-21.8,9
- Air pollution-related deaths in the UK are estimated to be between 28,000 to 36,000 annually. 10
The risk factors for the above health issues are largely preventable and require population-level interventions. For example, lower levels of physical activity increase the risk of obesity, diabetes, cardiovascular, and mental diseases. And vulnerable groups are disproportionately affected by these issues that further widen health inequalities.11 Similarly, fuel poverty and inefficient heating in homes are borne by poorer households. Evidence suggests 836,000 life-years gained in England and Wales by 2050 if homes have adequate insulation and ventilation.12
Amendments tabled in the House of Lords, which are set to be debated next week, could deliver benefits to both health and the environment as well as social justice and the economy:
- Everyone has access to a healthy environment, including an objective to maximise the number of people who live within 15 minutes of high-quality natural green or blue space.
- A duty to reduce health inequalities and improve well-being by ensuring development plans are consistent with achieving health and well-being through providing access to green and blue spaces, the 20-minute neighbourhood, and access to cycling, walking and wheeling routes and networks.
- A duty to promote healthy homes and neighbourhoods by designing national planning policies to ensure positive improvements in people’s physical and mental health and well-being.
- To strengthen local powers on new home standards and affordable housing such that all new houses built must meet or exceed the requirements of the Future Homes Standard, including significant reductions in carbon emissions.
The policy brief for the Levelling Up and Regeneration Bill can be accessed here.
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*DALYs (Disability-associated life years) = Total years of healthy life lost due to premature death or living with an injury or illness.
References:
1. Levelling-up and Regeneration Bill. https://bills.parliament.uk/bills/3155.
2. Climate change. UKGBC – UK Green Building Council https://www.ukgbc.org/climate-change-2/ (2017).
4. State of Nature Partnership. State of Nature 2019 UK Report. https://nbn.org.uk/wp-content/uploads/2019/09/State-of-Nature-2019-UK-full-report.pdf (2019).
5. The Lancet Countdown on Health and Climate Change – Policy brief for the UK. https://s41874.pcdn.co/wp-content/uploads/Lancet-Countdown-2022-UK-Policy-Brief_EN.pdf (2022).
6. Annex C: data on the distribution, determinants and burden of non-communicable diseases in England. GOV.UK https://www.gov.uk/government/publications/nhs-health-check-programme-review/annex-c-data-on-the-distribution-determinants-and-burden-of-non-communicable-diseases-in-england.
7. Mcdaid, D., Park, A.-L., Wilson, N., Davidson, G. & John, A. The economic case for investing in the prevention of mental health conditions in the UK (Summary). https://www.mentalhealth.org.uk/sites/default/files/2022-06/MHF-Investing-in-Prevention-Report-Summary.pdf.
8. Semple, L. Excess winter mortality in England and Wales – Office for National Statistics. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/excesswintermortalityinenglandandwales/2020to2021provisionaland2019to2020final (2021).
9. Excess mortality during heat-periods – Office for National Statistics. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessmortalityduringheatperiods/englandandwales1juneto31august2022 (2022).
10. Air pollution: applying All Our Health. GOV.UK https://www.gov.uk/government/publications/air-pollution-applying-all-our-health/air-pollution-applying-all-our-health.
11. Marmot, M. Health Equity in England: The Marmot Review 10 Years On. (2020).
12. Milner, J. et al. Impact on mortality of pathways to net zero greenhouse gas emissions in England and Wales: a multisectoral modelling study. Lancet Planet Health (2023) doi:10.1016/S2542-5196(22)00310-2.