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Calls for local authorities to apply "health tests" on developments to set health and well-being standards

29 March 2022

In this article, we consider the proposal put forward by Dr Caglar Koksal, Research Associate and Lecturer in Planning at The University of Manchester, which would see health and well-being embedded as a key part of planning decisions for major developments. 

A researcher has proposed that property developers should face "health tests" to assess whether major building projects will contribute to healthier living in communities. Developers that are seeking planning permission for such projects would need to prove that they can deliver "net health gain" to the area.

The briefing, titled Incorporating health and wellbeing into housing developments, was first published in Building Utopia by Policy@Manchester and also features on the Social Market Foundation. Dr Koksal argues that planning authorities should consider fast-tracking planning applications where the developer has shown that the development will deliver a "health net gain".

The article contends that the "health tests" will allow local authorities to motivate and steer property developers towards making places healthier to live in, provided that evidence calls for such a requirement. The "net health gain" could be adapted to the specific community, and could cover issues ranging from respiratory health to obesity. It is thought that the accelerated planning permission could "lead to huge cost savings and contribute positively to the viability of the proposal".

The importance of health in built environment design

As the article mentions, "good quality, affordable housing improves personal and social wellbeing, creates sustainable communities that attract investment and jobs, and can reduce our carbon footprint and improve the environment". Our health and well-being is impacted by our surroundings, and the article explains how overcrowding, particularly during the COVID-19 pandemic, has magnified health inequalities.

Research published in 2015 (and cited in Building Utopia) found that by the end of this century approximately 9 billion people, representing 85% of the world's population, will live in urban areas (compared with less than 1 billion people in 1950). This marked increase underscores a clear need to consider good design, sustainability, mental health and well-being as well as a focus on improving air quality and the local environment at the forefront of planning and development.

Dr Koksal's briefing links to the proposals made by the Ministry of Housing, Communities & Local Government in its final report Living with Beauty: Promoting health, well-being and sustainable growth, published on 30 January 2020. The report found that "new developments should be regenerative, enhancing their environment and adding to the health, sustainability and biodiversity of their context".

The article also recognises that local authorities can implement "robust design standards" that mirror the National Planning Policy Framework. These standards can encourage "design quality, including making sure there are convenient transport corridors with separated pedestrian and cycle routes".

What does this mean for local authorities?

The article rounds off by claiming that "both developers and local planning authorities need to work together to deliver healthy homes and neighbourhoods for everyone".

"Health tests" could be a method for councils as well as developers demonstrating a real commitment to encouraging health and well-being, and "local authorities’ corporate strategies should outline how they address local health and wellbeing needs with the help of their housing strategies".

The proposal also reflects the statutory duty of local authorities in England to "take such steps as it considers appropriate for improving the health of the people in its area" (section 12 of the Health and Social Care Act 2012, as added to section 2A of the National Health Service Act 2006).


The proposal for councils to impose "health tests" on major developments reinforces that the onus is on local authorities and developers to integrate health aspirations into governance and housing decisions. It also supports the idea that planning policy should play an active role in shaping healthy cities and the built environment for future generations. It is expected that the suggestion will be welcomed by developers that demonstrate how their projects deliver long-term health and well-being standards.

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