Testing Time for Sustainability and Health the Spectrum Approach for Collaborative Refinement and Assessment of Built Environment Projects, Plans and Policies

There is a widespread recognition that cities, towns and villages have become increasingly dependent on motorised transport and a car-based land use pattern. This has led to a series of unintended consequences – in particular lack of regular exercise, the decline of local communities and excessive greenhouse gas emissions – with huge long term impacts on health and well-being. Official policies are trying to change the trend, with much rhetoric about ‘sustainable development’ and ‘sustainable communities’. Yet many of the decision processes that control change in the built environment have not caught up with the new agenda. This paper is concerned with the way new development proposals are tested for their health and sustainability credentials. It reviews the theory and practice in this field, with a particular focus on Environmental Impact Analysis and Health Impact Assessment. It identifies the relative strengths and weaknesses of these tools, examining the degree to which they are systematic in their approach to health and sustainability, and include all those who have a legitimate interest in the outcomes. Then a new technique – Spectrum appraisal – is presented. Spectrum is a logical and very practical process that facilitates consensus-building and creativity in decision-making. Practical applications show how the technique can be used to help ensure a healthier, more sustainable urban environment. INTRODUCTION: HEALTH, SUSTAINABILITY AND PLANNING Concerns over public health in industrial cities led to the birth of modern planning in the nineteenth century. But during the twentieth century the umbilical link was severed. Town planners, environmental health officers and public health professionals went off in different directions. Planners’ priorities in the last part of that century have been dominated by the Thatcherite philosophies of economic development and narrowlyinterpreted environmental protection. Health and well-being have been sidelined. The result has been that we have built and are still building unhealthy conditions into our towns and cities. Examples of this can be found in everybody’s common experience. Recent housing estates have often been designed around the cul-de-sac principle, which provides a small safe area but increases the distance people have to walk to get to local facilities. New employment opportunities frequently take the form of low density edge-of-town ‘business parks’ predicated on high car use, while new retail, hospital and leisure facilities are of increasing scale and based on ‘campus’ development. The longer distances and poor adaptation to public transport leads to increasing car reliance and an overall reduction in ‘active travel’ (i.e. walking or cycling to get to somewhere), As a result the level of physical exercise for some groups in the population is falling, exacerbating obesity and health inequalities. The loss of local facilities which is part of this pattern leads to a decline in the local networks of friendship and support which are