Essay Sample on Relationship Between Urban Planning and Public Health

Over the last century, public health and urban planning have increasingly become interdependent. Contemporary urban planning models can be traced from unhealthy industries of the industrial revolution age. These cities were characterized by inadequate water supply, poor sanitation, insufficient lighting and poor ventilation in houses. These conditions led to revamping of the then urban design and infrastructure engineering (Barton et al., 2009). In fact, the building layout and street naming were developed to eradicate the poor housing conditions and air pollution (Barton et al., 2009). While many steps were taken to ensure that clean air and water supply were entrenched into the planning and building systems of the 19th century, it is worrying that these efforts have been neglected in the 20th century. As noted by Barton and Grant (2013), many urban planning organizations and policies have actively promoted the trends of car-dependency, sedentary lifestyles, and privatized lifestyles, all of which have significant adverse effects on health. Therefore, it is important to critically evaluate the United Kingdom governments urban policy agenda and the extent to which it promotes or suppresses public health.

Many studies have identified environment as one of the primary determinants of health (Marmot and Wilkinson, 1999; Lalonde, 1974). Health-based institutions also acknowledge that efforts that solely focus on changing the behaviours of a handful of individuals are not sufficiently effective as they only reach a small percentage of the total population and are hardly maintained in the long run. Rather, McCarthy (1999) and Lawlor et al. (2003) argue that fundamental changes in the economic, social, and environmental spheres are more effective. Undoubtedly, urban planning as a method of environmental regulation has significant impacts on public health in systematic ways. The figure shown below illustrates the different economic, environmental, and social aspects that are greatly affected by spatial planning (Barton and Grant, 2006; Barton, 2005).

(Barton and Grant, 2006)

Barton and Grant (2006) explain that the aspects of urban planning affect all other options that are available to an individual, group, government agencies, and businesses. For instance, the provision of appropriate space affects the events that can take place and the accessibility of those events to different people in the entire population. Whitehead and Dahlgren (1991); Lawlor et al. (2003) argue that the outer spheres influence the health of the population which is represented by the inmost sphere. For instance, the natural environment affects peoples health through the provision of clean water and air while the built environment affects the availability, accessibility, safety of amenities such as pedestrian paths, cycling lanes, parks, and public fields.

The Effects of Therapeutic Environments on Patients Experience

Many academic studies on therapeutic environments have revealed that their planning and design has a significant influence on the patients outcome as well as the staff performance. In particular, Ulrich (2000) revealed that the nature of views visible to a patient from a hospital bed affects the vulnerable state of the patient. Ulrich (2000) noted that healthcare environments without windows have negative impacts on patients. The results also showed that patients in intensive care unit with no windows have higher levels of anxiety, delirium, and depression than those in environments with windows. On the other hand, CABE (2002) established that healthcare workers in environments with high noise levels are associated with high stress levels. CABE (2002) also noted that high noise levels induced sleeplessness and increased anxiety in patients. In addition, natural light has been noted to have a profound impact on blood circulation. Simenova (2004) established that appropriate level of exposure and the daily rhythm of natural light is an effective regulative mechanism of the circadian system and enhances the productivity of the healthcare workers. Another study by CABE (2004) revealed that hospital environments with more privacy instilled dignity among patients. The study results also showed that sharing of rooms or wards is a major source of stressors in patients due to a perceived loss of privacy. The evidence presented by these studies indicates that design and planning of an environment have significant positive and negative impacts on the healthcare staff. A study by CABE (2004) that investigated the effect of work environment on the healthcare staff established that the nature of the work environment has considerable impacts on the staff and could influence a nurses decision on the organization to work.

Effects of Location of a Facility on Public Health

The location of a facility can be a barrier or promoter of the accessibility of services to the population. The Department of Health in the UK noted that more than 1.4 million people opt not to seek medical services due to transport problems (Department of Health & Neighbourhood Renewal Unit, 2005). The high number of people locked out of medical services illustrates the key role played by the planning and design of urban and suburban environments. Indeed, people in regions with poor plans and inaccessible facilities encounter many health challenges. It is important to note that the effects of poor plans and designs are only recognized after the completion of the project.

The location chosen for new services is vital to meeting the increasing patient expectations of better and accessible care. Arising issues such as ownership render the facility inaccessible hence expanding the health inequalities (Department of Health & Neighbourhood Renewal Unit, 2005). A survey by CABE (2008) revealed that many sites selected for erecting health facilities were expendable, unwanted for use by anyone, and inappropriate for the proposed use. The likelihood of selecting locations where facilities are accessible is dependent on the design and plan of the entire system ranging from individual buildings to geographical areas while integrating with other services. Importantly, there is the need to ensure communication between departments to ascertain that facilities are erected in their appropriate locations.

According to Department of Health (2009), health inequalities are among the most persistent and difficult to change problems. Despite the health inequities, most of the UKs major health problems such as obesity, asthma, and the aging population can be prevented by altering the quality of the built environment. In other words, efficient spatial design can eliminate and even prevent causes of poor health. The Commission on the Social Determinants of Health (2009) noted that the living environments in the urban areas are crucial because they can hinder or promote access to social cohesion, services, and physiological well-being. The commission concluded that health-related outcomes such as injury through accident and obesity can be associated with the way the people live. For instance, the fact that the living environments do not enable people to include physical activity into their daily routine has resulted in the decline of physical activity levels both in adults and children. Although many studies have been conducted in the United States, there are many lessons for the UK to learn (Lopez and Hynes, 2006). Lopez and Hynes (2006) link the declining levels of physical activity to the fact that many services are usually far and accessible only by car.

UK Governments Agenda of Promoting Public Health through Urban Planning

Statistics by the Department of Health (2009) show that more than 20% of the UKs population is obese and about 65% of the population is morbidly obese. Although the National Health Service is well equipped, it cannot offer services to all of them. This is exacerbated by the increasing levels of obesity that place UK as the leading nation with the highest obesity levels in Europe (House of Commons, 2004). It is estimated that about a third of the total population is currently obese and a continuation of similar trends would raise these levels to sixty percent by 2050. As a result, the government would be required to increase the cost of treating obesity-related illness four folds (Foresight, 2007). However, the government has recognized the need to prevent this disaster by proposing changes into the urban design and planning. The new changes would encourage using the means of accessing services, going to work, or school as avenues of increasing the physical activity in peoples lives hence reducing obesity levels.

On the other hand, Medical News Today (2009) presents data on global respiratory diseases which place the UK as the leading country with the highest incidences of childhood asthma. According to Medical News Today (2009), one out of eight children is diagnosed and treated for childhood asthma. The high incidences translate to high costs to the NHS. It is estimated that the NHS annual spending on asthma drugs is 115million, of which 8 million is spent on kids below five years (National Institute for Health and Clinical Excellence, 2008). Scientific studies have established a connection between asthma and increased levels of nitrogen oxide in the air that is emitted by vehicles near the place of residence (Edwards, Walters, and Griffiths, 1994). Increased dependence on the use of vehicles and living environments oriented toward car use are the major causes of increased air pollution hence the most cases of asthma globally.

With regard to age demographic, the UKs population comprises of more people aged above 65 years than those aged below 16 years. Importantly, the aged population is set to increase in the coming years (Office of National Statistics, 2008). These projections stress the need for improving the accessibility of services and enhance the ease of moving around the neighbourhood. As people get older, the neighbourhood significantly affects the quality of life. Recognizing this, the government acknowledged that many old people get trapped in their homes because of inaccessibility of local services such as shops and parks. Also, the elderly have difficulties in accessing medical care services (Communities and Local Government, 2008). However, health problems and a decline in mental ability increase with age.

Many studies have provided evidence that the design and planning of the built environment have significant effects on the health of the society. That evidence has led to an inquiry of the steps and policies that should be implemented to use urban planning to address health inequalities. One of the ways of addressing the health challenges is promoting physical exercise. As noted earlier, lack of physical exercise is the leading factor for the increased cases of obesity in the UK. Maintaining good levels of physical activity significantly prevents a decline in mental ability. WHO (2002) affirms this and illustrates that physical activity reduces the likelihood of psychological and social hazards that are accompanied by old age.

For many decades, the UK government has invested vast resources to facilitate a sedentary form of transport (Sustrans, 2009). However, the government must now change its policy and direct the resources into prioritizing active and healthy modes of transport such as cycling. That reform has been supported by more than one hundred organizations which have signed policy statement that advocates for health checks on all transport decisions and land-use decisions with the aim of creating safer cycling and walking paths (Sustrans, 2008).

On the other hand, Greenspace Scotland (2009) suggests that the government...