Planning and health: defining the limitations of regulation and the discretionary context at the micro/site scale

Planning, at its most basic, is about making better places. In recent years, there has been a positive renewed focus on strengthening the links between planning and the promotion of well-being and good health outcomes. This is a welcome emphasis with origins relatable to the health narrative in the 1909 Housing and Town Planning Etc. Act. Within the post-1947 Town and Country Planning Act context, planning in some respects regressed to a land-use and infrastructure focus, with health considerations limited to physical-health infrastructure provisions and environmental/amenity considerations. This relatively recent ‘reuniting’ of planning and health is one way in which planning has been expressly identified as central to the ability of the state to improve the quality of life of the people. This is based on two implicit assumptions. First, that the characteristics of the built environment have an impact on the health of the population, and second, that planning, via its current policy, regulatory and legislative provisions, has the right tools to achieve positive on-the-ground changes in relation to this. The first aspect of this is well established through a public-health evidence base; the second, however, remains substantively under-researched as part of a broader lack of attention paid to the regulatory or development management aspect of planning. This article begins to address this deficit by examining the manner in which issues of health are or are not encompassed in decision making on the site scale by looking at appeal decisions into the location of fast-food outlets. By so doing, it challenges some of the assumptions inherent in policy aspirations and calls for a renewed and detailed investigation of the tools needed to achieve such good intentions on the ground.