NHS England’s foray into town planning will not prevent obesity, says Paul Finch
‘Obesogenic’ is an ugly word, now in vogue as a way of describing environments that are ‘unhealthy’, though of course it is not towns as such that are unhealthy, but the people in them.
Our old friend architectural determinism is alive and well, at least in the minds of NHS England, which announced earlier this month that it would be promoting 10 ‘new towns’ across the country as places where it would try to ensure conditions which promote healthy living.
To be fair, the NHS is also going to pursue the opportunities digital technology presents in relation to healthcare, thus attempting to extend the independent living of the boomer generation. Nothing wrong with that – it sounds refreshingly like ‘predict and provide’, that is to say what we have not applied to the question of general housing provision in recent decades.
Just about in living memory, housing was the province of the Ministry of Health as it was then called, mainly because of the perils of 19th century slums to the health of those who lived in them. Disease, squalor and the unsanitary were the problems that needed to be addressed, not fatness. Times change, and the health problems we are now experiencing or predicting are those of prosperity and lifestyle. Obesity, like anorexia, is not generally associated with poor countries.
The health problems we are now experiencing are those of prosperity and lifestyle
Being overweight as such is not the problem – it is the consequences. Hence the belief that if only staircases are made more attractive (or available), office workers will flock to use them. My observation is that they will generally do so descending; going up is more of a problem, but it is good to have the choice.
Children are not office workers, of course, so they present a different challenge to those who believe that town planning is the answer to everything. It turns out that the public school ideal of ‘healthy body, healthy mind’ was no bad thing but, in an era when school pupils prefer to spend break-time sexting rather than running about in playgrounds, it is not obvious that the provision of activity-encouraging physical environments will do the trick.
This all reminds me of the strange belief that traditional architecture doesn’t produce criminals, whereas those horrible local authority high-rise flats do. I have pointed out before that the Kray twins were brought up in traditional terraced housing, but it didn’t have any restraining effect on their life of violent crime.
It is not difficult to become a controversialist on these issues. I once had an argument with an anti-car fanatic totally opposed to the location of car-parking … next to a sports complex serving a decent-sized town. It was wrong to allow people to drive before swimming or going to the gym ‘because it sends out the wrong message’. The real reason for limiting driving, he should have said, is the effect of emissions on air quality.
Ever since Greens forced London black cabs to become more polluting by making them switch from petrol to diesel, it has taken something of a back seat on the issue. However, it is right to say that we need a new Clean Air Act, which would probably do more to promote health than anything except a dementia cure. Hybrids and electric cars should help, along with driverless cars, so legislation could give a nudge to the evolutionary process.
NHS England might be better off addressing this sort of big-picture issue than getting involved in estate planning. Still, the fact that they have thought about the subject is welcome. Housing is far too important to be left to housebuilders.