Urban health

16 experts on how place-based approaches can improve future health

14 May 2019
8 min read
Rosa Vaquero
Rosa Vaquero
Head of Communications

In our work addressing complex health issues prevalent in inner-city London, we take a place-based approach. For us, this involves combining data, evidence and people’s lived experience to guide our work. We build partnerships and work at different scales to drive impact.

We’re interested in exploring how others view place-based approaches and their value in helping to improve people’s health in the long term. So we reached out to 16 thought leaders from the worlds of health, community-building, design and more.

Here, they share some of the opportunities and challenges they see for place-based approaches to make a difference in people’s health at home and abroad in the next ten years.


Seeing health through the lens of life

“Places are where life happens in all its complexity, messiness and glory. Outside interventions need to operate more through the lens of life and join up in the places where people live to be more successful. By thinking of place we can reframe many approaches to public health and leap further forward and faster than existing alternatives.”

Tony Burton, Vice Chair of The National Lottery Community Fund who was awarded his CBE for services to planning, local government and community.


Unlocking the potential in neighbourhoods

“The challenge for place-based approaches to continue playing a crucial role in shaping health is to realise the potential of neighbourhoods that are not currently fully health producing. These neighbourhoods are not backwaters of pathologies; they are places with a huge reservoir of health creating capacity, requiring appropriate support and community building.”

Cormac Russell is Managing Director of community development organisation Nurture Development and his work spans over 30 countries.


Designing inclusive places

“Changes to the built environment through new development or refurbishment projects offer a great opportunity to improve physical and mental health and quality of life using existing assets. Place-based approaches recognise that there are diverse needs within local communities and respond to these needs by designing and maintaining inclusive places. This could be about providing places to rest, drinking fountains or accessible toilets in public spaces. Enabling everyone to participate in their local area strengthens health, wellbeing and social cohesion.”

Helen Pineo, Lecturer in Healthy and Sustainable Built Environments at University College London.


Shifting power to local people

“By taking a place-based approach, we can look at health on a more human scale and in neighbourhoods and surroundings which are ‘natural’ to people. Through deeper engagement, we have an opportunity to use the wisdom and insight of local people to look at what change really needs to look like locally, to radically alter our take on health and, critically, to head ‘up-stream’ and address some of the fundamental structural inequalities – the wider social, economic, cultural and environmental factors, which cause major (and widening) health inequity in the UK. This is a power shift which starts locally and ten years is needed to make this happen.”

John Hume, Chief Executive of People’s Health Trust, an independent charity addressing health inequalities in Great Britain.


Helping people see how their environment affects their health

“What most excites me is the possibility of opening the eyes of ordinary people to how their surroundings are constantly shaping their health and wellbeing, and in turn those people taking an active role in shaping their surroundings. To my mind that feels like at least a two-part journey; firstly giving people new and interesting ways of interacting with their local area (such as getting involved in their local GoodGym), and secondly giving them the tools to improve the positive things and challenge the negative.”

Alex Kenmure, Head of Business Development at GoodGym, a charity that helps people get fit while helping their community.


Tackling health in a joined-up way

“A place-based approach allows us to tackle many health issues in a joined-up way. It prompts us to find ways to get better results from the aspirations, energy, money and time that are already running through an area. Over the next 10 years, place-based approaches could be one of the main ways that we help people live in good health – and potentially nurture the local environment and economy in the process.”

Rachel Toms, who is a healthy place-making specialist and runs Public Health England’s housing and health programme.


Integrating social and economic interventions

“Acknowledgment of the powerful health effects of social and economic forces is becoming widespread, but we have much to learn about how to integrate social and economic interventions at the individual, institutional and community level and about how to align financial and professional interests to achieve success. The next ten years of work in this area will be redefined by a new paradigm, centered around our growing understanding of how this ecosystem of forces and behaviors and environments shapes the health of communities and individuals.”

Raymond J. Baxter, PhD, President and CEO of Blue Shield of California Foundation, an American health foundation. 


Helping identify and measure health 

“The development of our proposals for Bermondsey demonstrated the importance of identifying the specific needs and aspirations of a place and its community. This detailed understanding of ‘place’ will enable us to deliver relevant social value, which we believe is crucial to improving the health of a community. In doing so, we recognise the various measures of a ‘healthy community’ that can include obvious indicators such as people being active or eating healthy, as well as things such as a thriving local economy, high levels of social integration and access to good quality education or secure employment.”

Nicola Wood, who is working on the development of a new urban neighbourhood in Bermondsey, South East London as Community Insight and Engagement Manager at privately owned property company Grosvenor.

Shaping the future of the NHS

“The NHS was a place-based service, designed by patient citizens. That was its founding narrative and its place in the nation’s affections is the lasting impact of its design – it was designed by people for people. The future of the NHS is equally dependant on our ability to re-learn and re-apply in the modern context what we know works in relation to place-based health and care. One of the key tools in place-based health and care making is that of community engagement.”

Lord Victor Adebowale, who chaired the Place Based Health Commission and is Chief Executive of social enterprise Turning Point.


Rethinking the resources available

“Tinkering at the margins of health services alone is not enough. Place-based approaches enable us to rethink how we use resources in the system and reorient health and care models to reflect the reality of people’s lives; shifting the conversation from ‘what can this service do better?’ to ‘what would help you live well?’ Place-based working offers a new model; one that moves the focus from organisations to people; competition to collaboration; service silos to system outcomes.”

Anna Randle, Chief Executive at independent social business Collaborate CIC, publishers of Get Well Soon, a report on place-based health.


Collaborating more creatively

“There are so many areas where charities and funders can work more creatively with local government and the NHS. Sitting atop this list, together they can design and deliver services that address local social determinants of health and barriers to stronger, collective, community wellbeing. Achieving this won’t be easy. But more sustainable solutions, rooted in and tailored to the communities that need and use them, are a prize worth striving for.”

Nathan Yeowell, who leads the strategy on ‘Place’ at the think tank New Philanthropy Capital as Head of Policy and External Affairs.


Looking at public services beyond health

“Building healthy environments for the future means more than gyms and health food shops on every corner. It means creating living conditions in which everyone can achieve and remain in good health, no matter their background. Needless to say, this requires looking at more than just our health services. Embedding public health priorities in planning and licensing processes – as we are already seeing in some councils – is vital to progress in these areas.”

Shirley Cramer CBE, Chief Executive of the Royal Society for Public Health.


Giving new meaning to partnership working  

“We need to bring together our partners, including the NHS, police and emergency services, schools, colleges, businesses and community and voluntary services to support local communities to live better, healthier and more engaged lives. A clear sense of ‘place’ is vital to giving meaning to this level of partnership working. A lot of the administrative areas we use for the NHS and, to some extent, the local government may have absolutely no meaning for local communities.”

Cllr Ian Hudspeth, Chairman of the Community Wellbeing Board of the Local Government Association


Combining organisational efforts to design health-promoting places

“Gaining an awareness of the initiatives local to our projects is as important as the initiatives themselves… Through this, we will have the opportunity to explore how the internal and external environments we create can contribute more specifically to improving the wellbeing of the neighbouring community. We know we cannot operate alone in achieving this goal and that it will need a combined effort on the part of planning departments and the clients we work with too.”

Paul Monaghan, Director at architecture practice Allford Hall Monaghan Morris.


Addressing health inequalities by joining up

“The social and economic conditions of the places where we live, work and socialise are as important, if not more powerful determinants of our health and wellbeing. Southwark Council understands the vital importance of place on health, community empowerment and economic productivity. By bringing together planning, regeneration, public health and communities under one roof, the council is committed to promoting inclusive regeneration and asset-based community development, improving health and addressing inequalities.”

Professor Kevin Fenton, Strategic Director of Place and Wellbeing and Director of Public Health, Southwark Council.


Urging cities to lead the way

“Cities are drivers of change. They are unique places to act on the needs of their citizens. Today more than half the world’s population lives in cities, and that number is expected to grow. Cities are critical to improving public health – leading the way on policies like smoke-free public places, increasing access to healthy public food and creating safe, public spaces for all to enjoy. When mayors and leaders help their cities live healthier and safer lives, cities are more prosperous.”

Dr Kelly Henning who leads the Public Health Program at Bloomberg Philanthropies, an American philanthropic organisation.