What makes a healthy place? Some answers from the public

Once a week or so, I go for a run towards the river. Maintained by my local authority, the riverside has benches, toilets, a level path that provides access for wheelchairs and buggies, and a segregated bike lane. It is a lovely place to be on a weekend morning, with all walks of life enjoying the outdoors.

This stretch of river came to my mind as I was hearing answers to the question, ‘What makes a place a healthy place?’. The Health Foundation, through the research agency Public First, recently asked six groups of people from the Midlands and the North of England this, and other questions, to understand what they thought and felt should be done on health inequalities.

‘For me, it's open green spaces,’ said one participant from Wakefield, ‘so access to parks and green spaces where you can get fresh air and exercise.’ Another in the same area wanted ‘free exercise for the younger generation...some clubs [for them]’.

Along with outdoor space and greenery accessible to all, participants saw the importance of high quality, stable employment. ‘[Work] is good for your mental health,’ said a West Bromwich participant, ‘it provides routines and stability’. Other participants emphasised quality housing, a sense of community and activities for children.

We had explicitly asked about healthy places, and what we got back was a rich description of a place where wider determinants supported a healthy life. The topics the public linked to healthy places are the bread and butter of those trying to improve life in a particular area, including teams in local authorities.

However, this research shows that while local authorities are at the forefront of shaping healthy lives through the wider determinants, relatively few members of the public yet recognise this as happening in their place. More than half of those we polled said they had not seen their local council taking action to improve health of people in their area.

This shows a clear mismatch between the essential role local authorities play in our health, and the relatively low awareness among the public of what is being done in their local area to improve health. So how can we engage people more effectively in the conversation about what is needed – and what is being done – to improve health?

The Health Foundation has been working with FrameWorks UK to understand how people think about health. The research involved more than 7,500 people across the UK. It found that the public think health is mainly influenced by individuals’ behaviours and access to care, rather than the wider determinants. This means that when talking about solutions, attention too readily turns to the NHS, and to the willpower and discipline of individuals.

Can anything be done to address this misconception? Yes. Our recently published toolkit shows how it is possible to frame our communications to tell a more powerful story about health, building understanding about the wider determinants – the building blocks – of our health, leading to action and change.

‘Framing’ refers to the choices we make about what we say, and how we say it, including what we emphasise, how we explain an issue, and – equally importantly – what we leave unsaid.

Our toolkit sets out five recommendations, and provides tips and examples to apply to your own communications. To accompany this, we also have short explanatory videos and a webinar recording with practical insights from people who have used the toolkit in their work.

Heartening news from our polling is that where local authorities are seen to be taking action to improve health, people are satisfied. When asked, of those who said they noticed their local authority taking action to improve health, 63% were satisfied – many more than the 43% who had noticed and were satisfied with central government action for health.

Local authorities should be claiming credit for creating healthy places, making the connection with health, and the case for action that goes further still. Like the thriving weekend riverside close to me, once you notice all the hard work to make a place that supports health, using it becomes second nature.

Martina Kane is Policy and Engagement Manager in the Healthy Lives team at the Health Foundation.