ON WORLD HEALTH DAY, LET’S BUILD BETTER NEIGHBOURHOODS TO TACKLE HEALTH INEQUALITY 

By Azul Castañeda, ICC Consultant

Friday, April 7 is World Health Day, and marks 75 years since countries together founded the World Health Organisation so everyone, everywhere could attain the highest level of health. The UK marks this day after more than a decade of austerity and the impact of a global pandemic diminished the life expectancy and wellness of many people, and a solution seems out of sight.

Last month the Journal of the Royal Society of Medicine published research showing that life expectancy in the UK lagged every other G7 country apart from the US, as a result of a decade of lower incomes and stagnating health and economy since 2012. But the situation was already dire in 2012, when research by University College London – a “Lives on the Line” map – displayed health inequalities so stark that there was an 11-year difference in life expectancy between London’s Hackney and the West End, the same gap as between England and Guatemala. We have known for a while that where we are born, grow up, and work matters to our health.

WHO’s 75th anniversary year is an opportunity to motivate action to tackle the health challenges of today before they become even bigger challenges of tomorrow.  At ICC, we’re embarking on a plan with three local authorities to develop neighbourhood models that as well as informing services delivery, placemaking projects and planning, can promote well-being, protect the environment, and foster social cohesion – all essential to tackling health inequality and addressing the fact that the people who live in the most vulnerable communities are often the hardest hit. Poor health isn’t just a matter of life expectancy but also quality of life and health – and councils have it in their power to make clear, positive differences here.

Working at local level is a great opportunity to identify and challenge health disparities. Neighbourhoods give local authorities the chance to address physical issues that contribute to poorliness, whether it’s by creating more green space or building safe and affordable housing, or by delivering walkable communities with immediate access to shops and amenities, including healthcare and pharmacies. All these build healthier, happier neighbourhoods.

Some of these steps may seem obvious. Others are less apparent, such as avoiding large monocultures of housing or physical barriers that segregate communities or deploying the time and expertise necessary to creating child and age-friendly cities. Neighbourhood models can also help identify where affordable housing initiatives are most needed, and thus protect vulnerable populations from eviction. They can promote policies that make accessing healthcare, jobs, and healthy food options easier through public transportation systems, and community gardens. Local authorities can also invest in clinics and hospitals in underserved areas, making sure healthcare is affordable, accessible, and culturally appropriate for all.

Vitally, these actions can only happen when everyone works together. Neighbourhood models work when they are inclusive and involve and co-ordinate key stakeholders like urban planners, civic institutions, investors, employers, and residents to address social determinants of health in a localized, culturally appropriate way. Community organisations, too often an afterthought, must sit at the heart of such plans. They can provide education and resources to promote healthy lifestyles such as walking groups, healthy cooking classes, and support groups – often vital support to ensure no-one in vulnerable and marginalized populations is left behind.

There’s not a lot here that’s new – apart, crucially, from the need for a new mindset that has the ambition to use different ways of working, planning and imagining to tackle inequalities that belong to the last century. Local authorities have at their fingertips the means to understand cause and impact of health inequality and to design different futures for all, so the future is better for everyone.

At ICC, we firmly believe that health and health equity must be at the heart of the work councils do within their neighbourhoods and that neighbourhood models can play a significant role in making progress to a more sustainable, healthier and equal future for all.

But of course, enabling health equity it is everyone’s responsibility and depends on comprehensive action at every level, from city-wide to regional to the most local neighbourhoods. Let’s work together to build healthier and fairer neighbourhoods, that can pave the way to a healthier and fairer future.