Environments: Developing a Whole Systems Approach to Obesity Leeds - - PowerPoint PPT Presentation

Creating Healthier Environments:

Developing a Whole Systems Approach to Obesity Leeds Beckett University 18 October 2016

• Prof. Tim G Townshend

Aim of today’s presentation

Part 1

• Briefly overview the impact of the built environment in supporting or

inhibiting healthy lifestyle choices

• Consider both sides of the energy equation that leads to
• verweight/obesity and the built environment
• Think about the ways in which planning might intervene

Part 2

• Interactive workshop on planning issues

Socio-ecological model of health

… so how is the built environment implicated in the obesity crisis?

Car dominated urban fabric…

…at the expense of ‘active travel’ – walking and cycling

Metrocentre, Gateshead

…plus

• A proliferation of

energy dense food/low nutrient outlets

• N.B. easier and easier

to order form home

• So, built environment

implicated on both sides of the energy (im)balance

This also links directly to health inequalities

• If you live in a deprived area

compared to the least deprived areas

• More likely to live near multiple

fastfood outlets

• More likely to feel unsafe
• Children 2 x as likely to be obese
• Etc. etc.

• Q. If its so obvious – aren’t the solutions

also?

• A. Well of course it’s a little more

complex! Moreover, reversing these trends is not straightforward – however…

Food Environments

• Impact of neighbourhood food

environments complex – but again multiple environments are important to consider

• Some suggestions of deprivation

amplification – linking poorer food access to scarcer/poorer

• pportunities to be active
• Fast food has been a focus of

planning policy for some time – with some success (not that much research on impact)

Walkable Neighbourhoods

• Some aspects of neighbourhoods

more important than others in supporting walking for transport

• Residential density
• Land-use mix
• Street connectivity
• Aesthetics
• Safety
• Some factors associated with BMI
• Know more about the thresholds
• f some of these issue than others

– e.g. residential density

Overall Physical Activity

• Key issues:
• Access to mixed used shops and

services

• High residential density
• Pavements and public transport

Help meet minimum guidelines

• ‘Activity supportive’ e.g. cycling

infrastructure = highest levels of activity

• Adams et al, 2013 (11 countries)

Copenhagen

Green Environments

• Studies have associated

greenspace proximity with increased recreational activity and inversely with BMI esp. in children

• There are contradictory results –

lot of unresolved issues e.g. around quality vs quantity – e.g. 40% rule of thumb

• Also broader health benefits, than

just providing places for exercise – i.e. we need to think about these things more holistically

Parkrun

Potential of blue

• Research has started to investigate the

benefits of blue infrastructure

• Research suggests urban blue

infrastructure may have important links to wellbeing -

• One study also suggested living far

from usable green areas or waterfronts increase the risk of

• verweight
• Finnish study – 2000-2008 (Halonen et al., 2014)

Emergent issues i in PA/Built Env focussed research

• Multiple Environments –
• Both PA and food environment research
• Combined exposure is important – but

more influential with some groups than

• thers

(e.g. Burgoine, et al 2016)

• Importance of journeys – particularly

active travel to school (e.g. Cooper, 2012)

Work Home Play

Healthy alternatives…

• Lots of research on allotments/community

gardens etc (v positive – particularly for

• verall wellbeing)
• They are associated with higher fruit and

veg consumption

• However - impact on overweight/obesity

not generally measured –

• Nor the impact of their shortage - Or

possible cost savings to NHS with increased availability?

Positive examples…

Vauban Malmo Edinburgh Gateshead

Discussion

• The evidence base is far from perfect but we do know some key pieces of

the jigsaw (e.g. density) – and have a good pointers about others (greenspace)

• However – there is inertia in the built environment and currently there is

little incentive for developers to do things differently (they go with routes

• f least resistance)
• Moreover post-2008 some developers seem to have retreated from more

progressive design

• Planning policy can be developed to intervene (and has been around fast

food proliferation) – but national planning policy (NPPF, 2012) is vague and much useful guidance was swept away by current government

• So its all a huge challenge – but all the more reason for public health and

planning to work together!

Planning Dilemmas – or ‘your mission

should you choose to accept it’!

• On your table you will find an envelope – in this there is a card entitled ‘planning

dilemma’ – please nominate one person to read this out to the rest of the group (some are based on real situations)

• There are also character cards – please take one
• Now among your tables please debate the situation that has been outlined – you may go

completely into your ‘character’ - if your are brave! Or simply bear in mind how this person might view the issues and reflect these in your comments

• Try and allow/encourage everyone to contribute!
• Try and reach a consensus agreement as to the correct way forward – you will feed this

back to the whole room

• The exercise shows that trying to deliver healthier places through the planning system

are not always straightforward!

• Please note – there is not necessarily a right or wrong answer

Many thanks for taking part – hope you enjoyed it!

Developing a Whole Systems Approach to Obesity Leeds Beckett University 18 October 2016

• Prof. Tim G Townshend

Tim.Townshend@ncl.ac.uk