Draft Regulation 18 Sandwell Local Plan

Ended on the 18 December 2023

6. Health and Wellbeing in Sandwell

Introduction

6.1 The purpose of the planning system in England is to contribute to the achievement of sustainable development. The built and natural environments are key determinants of health and wellbeing. The NPPF states that one of the three overarching objectives of the planning system is supporting strong, vibrant, and healthy communities. The Health and Social Care Act (2012) gave local authorities new duties and responsibilities for health improvement and requires every local authority to use all levers at its disposal to improve health and wellbeing; Local Plans are one such lever.

6.2 Sandwell Council recognises the important contribution that planning can make to improving public health and wellbeing and this is embedded throughout this Plan. Well-designed development proposals can support strong, vibrant and healthy communities and help create healthy living environments that encourage people to adopt healthier lifestyles. In some instances, however, a proposed development may have a direct impact on people's health and in other cases, it may contribute to poor health by encouraging or making it easy for individuals to make unhealthy choices. Particular issues prevalent within Sandwell are obesity and related illnesses, diseases related to smoking, and the effects of alcohol.

Linkages between health and the built and natural environment

6.3 The linkages between health and the built and natural environment are long-established and the role of the environment in shaping the social, economic, and environmental circumstances that determine health is increasingly recognised and understood. Climate change will have a negative impact on health and wellbeing and actions to eliminate emissions and adapt to climate change, such as promoting active travel and improving the energy efficiency of buildings, will also benefit public health through outcomes such as reduced obesity and fuel poverty.

6.4 An increasing body of research indicates that the environment in which people live is linked to health across their lifetime. For example, the design of neighbourhoods can influence physical activity levels, travel patterns, social connectivity, food consumption, mental and physical health, and wellbeing outcomes. These are illustrated below in the Barton and Grant (2010) Health Map.

Figure 4 - Determinants of health and wellbeing (Barton and Grant, 2010)

The determinants of health and well being in our settlements diagram, which shows various determinants of health from a personal to an environment level. Also including impacts of climate change and biodiversity.

Health and Wellbeing

6.5 Planning policies and decisions should make sufficient provision for facilities such as health infrastructure and aim to achieve healthy, inclusive, and safe places that support healthy lifestyles, especially where they address identified local health and well-being needs. Ongoing engagement between Sandwell Council and relevant organisations will help ensure that the SLP supports both these aims.

6.6 Sandwell's unique circumstances give rise to several challenges to health and well-being, which are reflected in its related strategies. Ensuring a healthy and safe environment that contributes to people's health and wellbeing is a key objective of the Council and its partners in the health, voluntary and other related sectors.

6.7 Sandwell has lower rates of both life expectancy and healthy life expectancy than the rest of England, meaning people not only die earlier but live more of their life with ill health, which has implications for their ability to be productive and for how they use the built and natural environment. According to a Local Authority Health Profile for the borough published in 2019 by Public Health England, Sandwell is one of the 20% most deprived districts / unitary authorities in England and about 25.5% (18,495) of its child population live in low-income families[109].

6.8 Life expectancy is 8.6 years lower for men and 8.0 years lower for women in the most deprived areas of Sandwell than in the least deprived areas. In Year 6, 28.3% (1,343) of children are classified as obese, worse than the average for England. The rate for alcohol-specific hospital admissions among those under 18 is 25[110]. This represents 20 admissions per year. Levels of teenage pregnancy, GCSE attainment (average attainment 8 score) and breastfeeding are worse than the England average[111]. Estimated levels of excess weight in adults (aged 18+) and physically active adults (aged 19+) are worse than the England average.

6.9 Previously, the four Black Country Councils and their public health partners worked together on the Black Country Plan to ensure it was aligned with the plans of the area's Sustainability and Transformation Partnership (STP), as well as with each borough's Health and Wellbeing Strategies. The STP recognised that reducing health inequalities would help reduce financial burdens on the NHS. It also recognised that residents of the Black Country, on average, suffer from poorer health outcomes than people in the rest of England.

6.10 The STP identified several key drivers that play a significant role in the development of future illness in the Black Country, and which directly link to demand for health provision. These are education, employment, wealth, housing, nutrition, family life, transport and social isolation. These are all influenced by the built and natural environment. The Black Country's Health and Wellbeing Strategies identified the following as key priorities for tackling health and wellbeing:

  1. Healthy lifestyles including physical activity, healthy eating, and addressing tobacco and alcohol consumption and obesity;
  2. Access to employment, education, and training;
  3. Quality, affordable homes that people can afford to heat;
  4. Mental health and wellbeing, including having social connections and feeling lonely or isolated;
  5. Air quality and the wider environment.

6.11 There is therefore a need for the Sandwell Local Plan to continue to support those initiatives aimed at encouraging healthier lifestyle choices and mental wellbeing and addressing socio-economic and environmental issues that contribute to poor health and inequalities.

(1) Health and Wellbeing

6.12 This policy provides the context for how health and wellbeing are influenced by planning decisions and contains links to other policies in the SLP. Sandwell Council intends to create an environment that protects and improves the physical, social and mental health and wellbeing of its residents, employees and visitors, including children, other young people and vulnerable adults, and which reduces health inequalities.

(4) Policy SHW1– Health Impact Assessments

  1. Sandwell Council will require the following forms of development to provide an assessment of its potential impacts on the health and wellbeing of adjacent communities, residents and businesses, and to mitigate any potential negative impacts, maximise potential positive impacts and help reduce health inequalities;
    1. housing developments of over 10 dwellings;
    2. non-residential developments of 1,000m2 or more floorspace.
    3. major new waste handling / processing development;
    4. any development that would have an adverse impact on locations with currently poor air quality;
    5. any other development that the Council considers has the potential to impact on public health.

      Such development will only be permitted where it is demonstrated that it will not, in isolation or in conjunction with other planned, committed or completed development, contribute to a negative impact on the health of the borough's population.
       
  2. To ensure that new developments have a positive impact on the health and wellbeing of new and existing residents the Council will require an HIA of development proposals to a level of detail appropriate to its scale and nature;
    1. For developments of 100 or more dwellings, or non-residential development that extends to 5,000m2 or more in area, a full Health Impact Assessment will be required;
    2. For developments of between 20 to 100 dwellings or non-residential development that extends from 1,000 - 5,000m2 in area, the Health Impact Assessment will take the form of an extended screening or rapid Health Impact Assessment;
    3. For developments of 10 – 19 dwellings, or other developments that the Council considers may have a potential impact on public health, either a Design and Access Statement, Planning Statement or an extended screening or rapid Health Impact Assessment should be provided.
       
  3. Sandwell Council will support vibrant centres and local facilities, which offer services and retail outlets that promote choice, and which enable and encourage healthy choices. This will include managing the location, concentration of and operation (including opening hours) of businesses that contain uses potentially in conflict with these aims, including:
    1. hot food takeaways (sui generis), or hybrid uses incorporating such uses (Policy SDM6);
    2. betting shops and amusement arcades (Policy SDM8);
    3. shisha cafes / lounges, where the balance of uses is such that the use of the premises is predominantly for shisha smoking.
       
  4. Where the development of a new shop is acceptable in principle under other policies, planning permission will only be granted where a condition can be imposed that prevents the subsequent establishment of a stand-alone off-licence without the need to apply for planning permission where there is evidence of existing alcohol drinking establishments contributing to existing negative health and wellbeing impacts and patterns of anti-social behaviour.

(1) Justification

6.13 Proposals for major development or others with the potential to have negative effects on the mental and physical health and wellbeing of communities should provide an assessment of their potential impacts through health impact assessments, as set out in the policy.

6.14 Such an assessment should consider, where relevant, how the proposed development demonstrates that:

  1. it is inclusive, safe, and attractive, with a strong sense of place, encourages social interaction and provides for all age groups and abilities;
  2. it is designed to enable active and healthy lives through prioritising access by inclusive, active, and environmentally sustainable forms of travel and through promoting road safety and managing the negative effects of road traffic as set out in Policies STR5, STR6 and STR9;
  3. it will provide a range of housing types and tenures that meet the needs of all sectors of the population including for older people and those with disabilities requiring varying degrees of care; extended families; low-income households; and those seeking to self-build as set out in Polices SHO3, SHO4 and SHO5;
  4. it is energy efficient and achieves affordable warmth; provide good standards of indoor air quality and ventilation; is low carbon; mitigates climate change; and is adapted to the effects of climate change as set out in Policies SCC1 – SCC6;
  5. it is designed and located to achieve acceptable impacts by developments on residential amenity and health and wellbeing arising from: noise; ground and water contamination; flood risk; vibration; and poor indoor and outdoor air quality as set out in Policies SCC4, SHW3, SCO1 – SCO3, SDM1;
  6. it will provide a range of quality employment opportunities for all skillsets and abilities along with the education and training facilities to enable residents to fulfil their potential and support initiatives to promote local employment and procurement during construction as set out in Policies SHO9 and SEC5;
  7. it will protect and include a range of social infrastructure such as social care, health, leisure, sport and recreation, retail and education facilities close to where people live, which are accessible by means of inclusive, active and environmentally sustainable forms of travel as set out in Policy SHW2, SHW4;
  8. it will protect, enhance, and provide new green and blue infrastructure, sports facilities, play and recreation opportunities to support access for all and meet identified needs as set out in Policies SDS7, SHW4 and SHW5;
  9. it will protect, enhance, and provide allotments and gardens for physical activity, mental wellbeing, recreation and for healthy locally-produced food as set out in Policy SHW6;
  10. it will provide high-quality broadband and other digital services to homes, educational facilities, employers, and social infrastructure, to support digital inclusion and the application of new technology to improved healthcare, as set out in Policy SID1.

6.15 Sandwell experiences significantly higher than average levels of poor health among its population. Issues include obesity and related illnesses, diseases related to smoking and the effects of alcohol. The Council and its partners are concerned about the health of children, other young people and vulnerable adults, both in terms of immediate term safeguarding and the potential long-term consequences that aspects of their lifestyles will have for their health.

6.16 The Council and its partners are engaged in a range of long-term actions to address these issues, as well as to encourage people to take greater responsibility for the choices they make themselves. Planning is one aspect of these actions. In some instances, a proposed development may have a direct impact on people's health and will need to be mitigated. In other cases, it may be that the planning process can contribute to improving health by supporting individuals to make healthy choices, through encouraging a suitable range and mix of shops, outlets and activities.

6.17 Making it easier for people to make these healthy choices will increase the likelihood that they will do so; and this change in behaviour will improve health outcomes over time. Policy SHW1 sets out an approach to assessing development to help influence these issues.

6.18 Proposals for hot food takeaways will be assessed in relation to a range of policies, including Policy SDM6. Betting shops, amusement arcades and similar uses will be considered in line with Policy SDM8.

6.19 Shop uses currently fall within Class E - Commercial, Business and Service of the Town and Country Planning (Use Classes) Order 1987 (as amended) and therefore any condition preventing the subsequent establishment of a stand-alone off-licence would apply to any permission within Class E or any successor use class should there be changes within the lifetime of the plan.


[110] Rate per 100,000 population (PHE Local Authority Health Profile 2019; link above)

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