Health obligations and the built environment: analysis of health impact assessment policies in English local plans

Despite serious health inequalities in England, and the prevalence of non-communicable diseases, health outcomes are rarely prioritised in national urban development policies. Local Planning Authorities (LPAs) can incorporate health into the planning requirements for new developments by requiring a Health Impact Assessment (HIA) as part of planning consent. To date, there has been no comprehensive review of HIA policy content in England. We conducted a census of in England to investigate health-related parameters, finding that only two-fifths of LPAs had an HIA policy and there was wide variety in the policies which do exist. Our analysis concludes that challenges to making HIA effective include a lack of national government support and guidance. This includes defining acceptable trigger points for HIAs to be requested by LPAs would offer certainty to the planning system. National guidance is required on: the value of including metrics in HIA requirements; evidence of the expertise of the person undertaking the assessment; explicitly setting out factors to be considered as part of the HIA, and the value of public participation in the assessment process, would all help to ensure HIAs are more effective in bringing health into the decision-making process.