In the age of austerity, short termism usually wins out. Which is why I was so taken with the new Health Towns idea from the NHS and Public Health England. It’s all about investing in wellbeing for the long term. But can designing in fitness facilities and taking away fast food outlets really put health at the heart of new neighbourhoods – for good?
There’s a lot to love about Health Towns. They’ll bring together local councils and others with the NHS and PHE to develop new town partnerships. Partnerships that will shape places to improve health, prevent illness and keep people independent. Think walkable neighbourhoods. Cycle paths. Outdoor gyms. Play parks. More accessible public transport. Integrated and digital health and care services. And the banning of junk food shops near schools.
With eight out of 10 of us still failing to meet the government’s target of 12 sessions of moderate exercise a month, and diseases caused by obesity threatening to financially cripple the NHS, any new idea that encourages people to get active and eat healthily has got to be good news. Particularly when there’s a great return on investment. As there can be: research shows for instance that for every pound a city invests in walking and cycling projects, the returns average £13 and could be as high as £19 in the UK.
And yet, I can’t help feeling we’ve been here before. In 2008, nine UK ‘healthy towns’ were given a £30m pot under a government initiative to combat obesity. They developed a range of very nice ideas: signs to help runners time their progress, keep fit gardens, mountain bike maintenance classes…. But we’re not entirely sure how successful – or not – the scheme really was. Because, as a study led by Queen Mary University of London subsequently showed, its underpinning evidence base was poorly developed.
If we’re not identifying what works and what doesn’t, how do we know what to do differently next time around? If we’re not measuring today’s outputs how can we input into tomorrow’s big ideas? It’s never been easier to generate the kind of evidence we need to evaluate innovative interventions. If we build in smart technologies from the outset we will give ourselves a much better chance of generating meaningful data that we can learn from and use to guide and support the development of bright ideas like Health Towns.
When he launched Health Towns, NHS chief Simon Stevens said, ”Obesogenic’ environments are a choice not an inevitability’. As well as introducing me to a word I didn’t realise existed, Mr Stevens highlighted another potential pitfall: choice. We can’t force people to choose to lead healthier lives. You can lead a child to a cycle path, but you can’t make it cycle. Well, you probably can if it’s a sporty child who loves the outdoors. But what about the child wedded to its computer – the one who really needs to exercise more than their thumbs on a games console?
We need to think smartly about how we can encourage and enable people to choose to change. How can we tap into their motivations? What would inspire them to break old habits? How can we reward them for embracing healthier ones? It’s a challenge for sure, but I believe it’s one we must explore and rise to if innovative ideas like Health Towns are to stand the test of time.