The Marmot Review showed that poor health does not arise by chance and is not simply attributable to genetic make-up, unhealthy lifestyles and a lack of access to medical care, important as these factors are.

Differences in health reflect the differing social, environmental and economic conditions of local communities.

The influence of these “wider determinants” on health requires preventative policy interventions focused on the root causes of ill health; this needs action well beyond the influence of the NHS and health services.

Each area’s Local Plan takes account of social, economic and environmental issues. The important link between how places are planned and developed and the health of the communities who live in them is increasingly recognised by planners. However the links between the wider determinants of health, health outcomes and health inequalities are not always explicitly and fully addressed in planning documents.

By working with health professionals to understand more about the health needs of communities, the wider determinants of health and the evidential links with planning and the built environment, planners can ensure that changes to physical infrastructure facilitate the conditions and the lifestyles that lead to improved health outcomes and reduced health inequalities.

This joint working should draw on local health data and evidence of the impacts of different wider determinants on priority health issues. A key source of local health evidence is the Joint Strategic Needs Assessment and associated maps.

Practical advice on how planners, health and sustainability could collaborate to address important local wider determinants of health, such as air quality, are provided in the Joint working section.

Closer engagement between planners and health could also involve carrying out health impact assessments of policies and/or large scale development proposals to explore in greater depth impacts on people’s well-being and health. Recommendations can then be made to enhance the positive effects and reduce the negatives. Guidance on how to carry out HIAs and examples of best practice can be found at the HIA Gateway.

Source: Barton, H. and Grant, M. (2006) A health map for the local human habitat. The Journal for the Royal Society for the Promotion of Health, 126 (6). pp. 252-253. ISSN 1466-4240 developed from the model by Dahlgren and Whitehead, 1991.Dahlgren G, Whitehead M (1991). “The main determinants of health” model, version accessible in: Dahlgren G, and Whitehead M. (2007) European strategies for tackling social inequities in health: Levelling up Part 2. Copenhagen: WHO Regional Office for Europe.