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 need when they need it. So far, so boring, yes?

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.

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 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.

This is an abridged version of my blog post for the Health Foundation in May 2018, you can read the full version here.