Regenerating Middleport:
using health impact assessment to ‘health proof’ masterplans
for deprived communities
Health, Well Being and Healthy Lifestyle Conference 21st October 2009
Salim Vohra & Gifty Amo-Danso (IOM)
Marcus Chilaka
(University of Salford)
Zafar Iqbal & Judy Kurth (Stoke NHS)
Meaning of Health in HIA
“Health is a state of complete
physical, mental and social wellbeing
and not merely the absence of
disease or infirmity…
…Health is therefore a resource for
everyday life, not the objective of
living; it is a positive concept
emphasizing social and personal
resources, as well as physical
capacities.”
World Health Organization, 1947 and 1984.
Environmental and Social Model of Health
Adapted by Salim Vohra and Dean Biddlecombe from Dahlgren, G. and Whitehead, M. (1991).
Policies and strategies to promote social equity in health. Stockholm, Institute for Future Studies.
Classic Definition of Health Impact Assessment
HIA is:

a combination of procedures, methods and
tools
 by which a policy, program or project may be
judged
 as to its potential effects on the health of a
population,
 and the distribution of those effects within the
population.
Gothenberg Consensus Document 1991
Fuller Definitions of Health Impact Assessment
 HIA is the key systematic approach to predicting the
differential health and wellbeing impacts of proposed and
implemented plans, programmes and projects
 within a value framework that is democratic, equitable,
sustainable and ethical in its use of evidence
 so that positive health impacts are maximised and
negative health impacts minimised (within a given
population).
 It uses a range of structured and evaluated sources of
qualitative and quantitative evidence that includes public
and other stakeholders' perceptions and experiences as
well as public health, epidemiological, toxicological and
medical knowledge.
Steps in the HIA Process
Screening

Scoping

Baseline and community profile

Evidence review

Stakeholder engagement

Analysis

Mitigation and enhancement

HIA Report or Public Health Statement

Follow up (monitoring and evaluation)
Strengths:
Weaknesses:
Flexible
No standard
approach
Open
Inclusive
Depends on
experience of
the HIA
assessor
WHO 12 Healthy Urban Planning Principles
Healthy Lifestyles
Do planning policies and proposals encourage and promote healthy exercise?
Social Cohesion
encourage and promote social cohesion?
Housing Quality
encourage and promote social cohesion?
Access to Work
encourage and promote access to employment opportunities?
Accessibility
encourage and promote access accessibility?
Local low-input food production
encourage and promote local food production with low input food production?
WHO 12 Healthy Urban Planning Principles
Safety
encourage and promote safety and the feeling of safety in the community?
Equity
encourage and promote equity and the development of social capital?
Air quality and aesthetics
encourage and promote good air quality, protection from excessive noise and
an attractive environment for living/working?
Water and sanitation quality
encourage and promote improved water and sanitation quality?
Quality of land and mineral resources
encourage and promote the conservation and quality of land and mineral
resources?
Climate Stability
encourage and promote climate stability (and reduce the potential impacts of
climate change)?
Stoke-on-Trent & Deprivation
Ariel View of Middleport
Satellite View of Middleport
Photos of Middleport
Vision and Objectives of the Masterplan Process
Vision
“To create a truly sustainable community ... Working in partnership with
local residents and businesses … create a vibrant community where
people want to live, work ... Drawing on and improving the core physical,
environmental and heritage assets of the area, … become an exemplar
sustainable community … excellent standards of day to day living and
strengthening community pride and ownership of the environment.”
Objectives
1. Creating Sustainable Neighbourhoods
2. Achieving a Better Housing Choice
3. Strengthening Employment and Training Opportunities
4. Addressing Community Needs
5. Delivering Improved Access
6. Creating
a Good
Quality
Environment
Addressing
the Health
and
Wellbeing Needs of the Community
7. Protecting and Enhancing Heritage Assets
8. Community Enhancement
Draft Masterplan Design 1
Draft Masterplan Design 2
Draft Masterplan Design 3
Where Does Reviewing Masterplans Fit In
Screening

Scoping

Baseline and community profile

Evidence review

Stakeholder engagement

Analysis

Mitigation and enhancement

HIA Report or Public Health Statement

Follow up (monitoring and evaluation)
Reviewing/
analysing the
masterplan
designs /
drawings
Part of HIA or
can be done
seperately?
10 step process to ‘health proofing’ masterplans
Step 1
Connecting with the masterplan design team

Step 2
Obtaining masterplan design/s and background documents

Step 3
Visiting the proposed site

Step 4
Analysing the Masterplan Vision and Objectives

Step 5 Identifying key professional and community stakeholders to help review

Step 6
Looking at and analysing the draft masterplan design/s

Step 7
Seeking clarification from the masterplan design team

Step 8
Writing up the analysis

Step 9 Making recommendations for modifying the final masterplan design

Step 10 Following up on the changes made to the final masterplan design
Rapid Review Table
Masterplan Design Option No. & Name:
Design Review Questions
What is the relationship between the housing, greenspace, roads, shops/amenities and business areas? How do they fit together
or don’t? Does it make holistic sense? Is it ‘legible’/understandable (easy to navigate through the streets)?
Do the blocks of new housing fit with the existing blocks of housing? Is there affordable/key worker housing?
Is greenspace maintained, increased and improved? Is it accessible? Is there an opportunity for allotments/communal
gardening?
Do roads and routes connect residents or serve to cut them off (physical/community severance)?
Are pavements/footpaths, cycleways and public transport links developed? Do they form a coherent and connected linked set of
routes? Do they have priority over cars?
Is there a public space, a service hub, a local centre that serves as the heart of the area?
What kinds of public services, amenities and facilities are planned? Are there any gaps in service?
Is there provision for a local community centre and/or space for community/voluntary/charity groups?
Are there good natural surveillance/ opportunities for people to pass by?
How do the commercial areas fit with each other and with the residential areas? Is it too big/too small?
How does the proposed development link with other adjacent neighbourhoods?
Is there any local art/distinctive landmark/ architecture planned to build and create a revived sense of place/community identity?
Analysis
In-depth Review Table
Masterplan Design Option No. & Name:
Healthy Urban
Planning
Themes
Regeneration/Development Objectives to Consider
Healthy
Lifestyle
Does the development encourage and promote
physical activity?
Is the community walkable?
What type of amenities, facilities and public
services are planned or exist already that are
nearby?
What existing sports/leisure facilities are there and
will they cope with any increase in population?
Social
Cohesion
(encouraging
active
community
participation)
Is there one or more accessible outdoor public
spaces e.g. plazas, central open spaces?
Is there provision for a local community centre or
indoor public space where residents and
community groups can meet and carry out
activities e.g. mother and toddler groups, youth
work groups, community development activities?
Do the new and/or existing commercial
developments fit well with the residential
developments and the wider neighbourhood?
Is there integration between existing housing and
new housing?
How do new routes and roads affect the
community setting? (physical and community
severance)
Building quality
(Housing and
What sustainable and healthy building standards
will be used for the residential and commercial
Potential positive health/
wellbeing impacts
Potential negative health/
wellbeing impacts
Suggestions for
mitigation and
enhancement/
Other
Comments/Questions
Recommendations for Middleport
Health Themes:
 A walkable community
 A socially rich and cohesive community
A physically active community
General:
 Make parks as attractive, safe, accessible and well maintained.
 Make better use of canal towpath/footpaths and cycleways.
 Ensure no fast food in any new retail spaces that are developed.
 Locate new industrial sites towards Steelite rather than adjacent to
Grange Park and cluster employments sites together.
 Support the greening/public realm and environmental improvements e.g.
plant trees along the roads, improved street furniture, and removal of
non-essential signs.
 Support the creation of Home Zone areas throughout the development
 and additional safe crossing points across Middleport.
 Improved lighting across the whole development
Recommendations for Middleport
Advantages of this approach
 Flexible and quick input into the masterplan design process
 Systematic and structured use of a health ‘lens’ to scrutinise a
masterplan
 Provide support for the masterplan from health agencies
 Some aspects are likely to be covered by experienced planning officers
and masterplan designers
 Detailed assessment can be time consuming
 May be confused with doing a health impact assessment