Influencing urban environments for health: NSW Health’s response

The burden of preventable chronic disease is rapidly increasing in New South Wales.¹ If the potential for preventing chronic diseases is not fully harnessed, it is projected that treatment costs alone for people with diabetes, cardiovascular disease, cancers and musculoskeletal conditions in NSW will rise from approximately $3.3 billion in 2000–01 to $6.1 billion by 2020–21.² Addressing this challenge will require a multifactorial approach and there is a growing body of evidence around the links between risk factors apportioned to increasing urbanisation and, more broadly, to the built environment.^3–5 Creating environments that promote health can play a significant role in reducing rates of death and disability from chronic disease.⁶ Compounding the challenge of addressing potentially avoidable chronic diseases is the sustainability of our urban communities, with increasing populations in and around Sydney and coastal NSW in particular. For example, over the next 20 years, population increases of over 50% are expected in several coastal townships.⁷

The importance of urban planning for health has been identified as a key priority for the NSW Government as described in the: NSW State Plan,⁸ NSW State Health Plan,⁹ Healthy People NSW,¹⁰ and the NSW Population Health Priority Taskforce. In particular, Healthy People NSW identifies health impact assessment (HIA) as a key tool for affecting change and to strengthen health input into planning decisions.¹⁰

While in NSW it is local government planners and urban designers who have the ability to directly influence and shape the urban environment, NSW Health is increasing its engagement at both a state and regional level. This issue of the Bulletin reflects the increased level of activity and innovation by Health Services across NSW to influence the shape of the urban environment, through the use of HIA in projects from housing regeneration to population growth to capital works, in line with the growing body of evidence.

For a number of years, NSW Health has invested in and worked towards creating a more cohesive partnership approach to urban planning projects with state and regional planning bodies including the NSW Local Government and Shires Associations, through the NSW Health Impact Assessment Project, and health risk assessment work. The learning-by-doing approach to HIA outlined in this issue highlights the practical impacts on planning that such a tool can have. HIA has emerged as a good mechanism through which to engage with the urban planning sector, as evidenced by the successful implementation of several joint Area Health Services and local government HIA projects in NSW in recent years. An acknowledged leader in this has been the Greater Southern Area Health Service, whose active engagement with the planning sector recently earned them an award from the University of NSW and the NSW HIA Steering Committee.

The coming year sees several activities being conducted in this domain including a statewide review of the activities being undertaken. This review will identify opportunities to build on the successes of recent years and to maximise NSW Health’s impact on urban planning and regeneration frameworks. Another highlight will be the 7–9 November 2007 South East Asia and Oceania Regional Health Impact Assessment Conference to be held in Sydney. This will be jointly hosted by NSW Health and the University of NSW Research Centre for Primary Health Care and Equity. The conference will be an important vehicle to facilitate greater engagement between the health and planning sectors, as well as academia, both in NSW and the South East Asia and Oceania regions.