Environment, Sustainability and Health Consultant, URS Infrastructure & Environment, Birmingham, UK.
Perspect Public Health. 2013 Sep;133(5):254-62. doi: 10.1177/1757913913488331. Epub 2013 Jun 13.
There has been a welcome joining up of the rhetoric around health, the environment and land use or spatial planning in both the English public health white paper and the National Planning Policy Framework. However, this paper highlights a real concern that this is not being followed through into practical guidance needed by local authorities (LAs), health bodies and developers about how to deliver this at the local level. The role of Joint Strategic Needs Assessments (JSNAs) and Health and Wellbeing Strategies (HWSs) have the potential to provide a strong basis for integrated local policies for health improvement, to address the wider determinants of health and to reduce inequities. However, the draft JSNA guidance from the Department of Health falls short of providing a robust, comprehensive and practical guide to meeting these very significant challenges. The paper identifies some examples of good practice. It recommends that action should be taken to raise the standards of all JSNAs to meet the new challenges and that HWSs should be aligned spatially and temporally with local plans and other LA strategies. HWSs should also identify spatially targeted interventions that can be delivered through spatial planning or transport planning. Steps need to be taken to ensure that district councils are brought into the process.
在英国公共卫生白皮书中和国家规划政策框架中，健康、环境和土地使用或空间规划方面的言论已经可喜地结合在一起。然而，本文强调了一个真正令人担忧的问题，即这并没有转化为地方当局、卫生机构和开发商在地方一级实施这一目标所需的实际指导。联合战略需求评估（JSNAs）和健康与福利战略（HWSs）有可能为改善健康的综合地方政策提供强有力的基础，以解决更广泛的健康决定因素，并减少不平等。然而，卫生部发布的 JSNA 指南草案在为应对这些重大挑战提供强有力、全面和实用的指导方面做得还不够。本文还确定了一些良好实践的例子。它建议应采取行动，提高所有 JSNAs 的标准，以迎接新的挑战，并且 HWSs 应在空间和时间上与地方规划和其他地方战略保持一致。HWSs 还应确定可以通过空间规划或交通规划来实施的有针对性的空间干预措施。需要采取措施确保区议会参与这一进程。
