Call for health to be embedded at the heart of future towns and housing

That was the message from Max Farrell, chair of the Healthy City Design Congress and founder of LDN Collective, as he participated in a major Westminster debate on healthy homes last week.

Speaking at the Healthy Homes and Buildings APPG session at the House of Commons, Farrell said poor and insecure housing was directly linked to worsening physical and mental health outcomes, citing evidence showing life expectancy gaps of up to 19 years between deprived and affluent communities. He warned that the economic and social costs of poor housing were now impossible to ignore, pointing to estimates that homelessness costs the UK £7 billion annually and poor-quality housing costs the NHS £1.9 billion a year.

Farrell told delegates that while large-scale new towns were important, delivery times remained a challenge, and smaller-scale “garden city” style developments could provide faster solutions. He said the sector was no longer short of evidence but was still struggling with “integration and delivery”, arguing that health considerations remained secondary in major investment decisions. Calling for health to become a primary investment metric in housing and placemaking, alongside a greater focus on prevention rather than cure, he said: “We need to treat healthy homes and neighbourhood design as critical infrastructure.”

The debate brought together parliamentarians, architects, housing providers, researchers and public health experts to discuss how health and wellbeing can be embedded into the Government’s ‘Pride in Place’ agenda. Speakers warned that future housing policy risked repeating past mistakes unless health outcomes were built into planning and design from the outset. During the wider discussion, Farrell stressed the importance of long-term, cross-sector collaboration, saying the challenge was bringing together people with “different agendas who speak different languages”. He noted that healthy placemaking was becoming less of a “fringe issue” and increasingly central to investment and urban development conversations.

Other contributors echoed calls for systemic reform. Gideon Amos MP warned against removing garden city principles from planning policy. “If the post-war new towns that Labour built were successful, it wasn’t because of the design of the shopping centre, it was the quality of the housing that went above the quality of existing homes,” he said.

Kate Henderson, chief executive of the National Housing Federation, argued that development corporations must put health at the centre of new town delivery. She called for vision and ambition; a long-term delivery vehicle, such as development corporations; and long-term stewardship models that are service-oriented with affordable maintenance built into the health considerations.

Professor Sarah Ayres of Bristol University’s TRUUD programme highlighted research showing that urban decision-makers often lacked the tools and incentives to prioritise health outcomes. She pointed to the programme’s HAUS model, which links the health impacts of changes to the urban environment around the home. “This identifies 200 pathways linking features of the urban environment to health outcomes, with 70 of those pathways attached to an economic cost,” she explained.

As the session drew to a close, Farrell concluded that the most urgent priority was aligning NHS, housing and planning funding to recognise the long-term value of investing upstream in healthier homes and communities.