We need to talk about healthy streets

Transport is one of those things that most people agree is important but struggle to get particularly excited about. If you ask an expert ‘what is transport?’ you will usually be given an answer about moving people and things around. If they are a particularly enlightened expert, instead of focusing on the arbitrary activity of movement, they may talk of purposeful movement enabling people to access what they when they need it. So far, so boring, yes?

Putting transport in context

This definition is boring because it describes transport as an isolated activity, suggesting that it happens in empty space. In reality, most transport happens on streets in urban areas – to think of it as an isolated activity misses the central impact it has on each of our daily lives. Transport is happening in the same places that billions of people live, grow, learn, work, play, share, laugh and cry.

In urban areas, streets typically make up 80% of public space, and the vast majority of transport happens in these public spaces. Considering transport in the urban context shows us that it is much more interesting and important than we might previously have thought. How this supposedly benign activity is conducted intimately affects our daily lives in many ways, including significantly impacting on our health.

In most urban areas, transport affects our ability to build physical activity into our daily routine, the quality of the air we breathe, our risk of being injured or killed in a collision, our exposure to the health impacts of noise and how we access the people, places and services we need. All of these are vitally important to being able to live well, so reducing transport’s negative impacts on our health is a clear priority.

Changing the language of health and transport

If we want to reduce or eliminate the negative impacts of transport on our health we need to involve a range of people who have a role in how streets look and feel. This includes residents, business owners and their employees, planners, police, architects and designers, engineers, entrepreneurs, politicians and artists, to name just a few.

It is therefore not especially helpful to talk in the language of health or transport in this context. Instead, we must engage people by talking in a way that we can all relate to. Most people don’t think of their lives as a collection of serious health risks to avoid. They also don’t think about their lives as a string of ‘transport choices’ or see themselves as a ‘motorist’, ‘pedestrian’ or ‘service user’.

The preferred languages of the health and transport communities are not likely to resonate with the wide range of people who have a stake in the issues. Most of us are thinking about the daily grind of our lives, getting things done, making life easier and finding pleasure wherever the opportunity arises. It follows that we should frame our approach to complex social determinants of health – like transport – in terms of creating an environment in which people can do what they need to do in an easy and pleasurable way.

The Healthy Streets Approach sets out 10 Healthy Streets Indicators, which describe the key ingredients for an environment in which people can do just this. I developed these indicators from an evidence base for the impacts of the built environment on health, inequalities and travel choices. This means that at the centre of this approach are the primary goals of the health community (healthy environment and healthy behaviours) and the transport community (using the most efficient mode of transport suited to each trip). The language, though, is focused on how the human experience can be made both easier and more pleasurable by changing the urban environment to put people and their wellbeing first.

The 10 Healthy Streets Indicators

• Everyone feels welcome – streets must be welcoming places for everyone to walk, spend time and engage with other people.
• People choose to walk and cycle – people will choose to walk and cycle if these are the most attractive options for them, which includes making driving and parking less convenient for some trips.
• People feel relaxed – being in the street should be pleasurable, not stressful.
• Easy to cross – our streets need to be easy to cross for everyone. It is not just physical barriers and lack of safe crossing points that cause problems, it’s fast moving traffic too.
• Clean air – reducing air pollution benefits us all and helps to reduce health inequalities.
• Not too noisy – reducing the noise from road traffic creates an environment in which people are willing to spend time and interact.
• Places to stop and rest – seating is essential for creating environments that are inclusive for everyone as well as being important for making streets welcoming places to dwell.
• People feel safe – feeling safe is a basic requirement that can be complex to deliver, it’s about managing motorised road transport but also personal safety.
• Things to see and do – street environments need to be visually appealing and to provide reasons for people to use them: for example, local shops and services, and opportunities to interact with art, nature, and other people.
• Shade and shelter – to ensure our streets are inclusive of everyone and welcoming to walk and cycle in no matter the weather, we must pay close attention to shade and shelter.

The success of this framework is that it is positive, relatable and achievable. We can all visualise how these Healthy Streets Indicators could improve our environment, making life tomorrow a little easier than it was today. To read more about how the Healthy Streets Approach is being implemented in London and to access tools for implementing it in your town or city, visit the Healthy Streets website.

Lucy Saunders (@LE_Saunders) is a public health specialist in the transport and public realm at Transport for London and the Greater London Authority