Why healthy streets matter for health: a local GP’s perspective

The way our streets are designed has an important influence on our health.

Streets that are difficult or unsafe to walk, wheel or cycle can discourage everyday physical activity. Heavy traffic can also contribute to air pollution, noise and road danger, with some of the greatest impacts falling on children, older people and those already experiencing poorer health.

We spoke to Dr Duncan Wallace, GP Partner at Higham Hill Medical Centre, about what this means for patients and why the design of our local streets matters for public health. Key points: 

• Street design matters because it influences whether walking and cycling are realistic, attractive everyday choices. From a GP perspective, the consequences of physical inactivity are not abstract public health issues. They are reflected in many of the conditions we see every day.

• Physical inactivity costs the NHS hundreds of millions of pounds each year, before considering the wider economic and social costs. Environments that make routine physical activity easier have the potential to improve health and reduce future demand on health services.

• Physical inactivity and long-term illness are more common in more deprived communities. Good street design can help make healthier choices accessible to everybody, rather than something dependent on having spare time, money or access to a gym.

• Higham Hill Medical Centre sits directly on Higham Hill Road, so the challenges created by heavy traffic are very visible to us. Making walking, cycling and crossing the road safer and easier would have a genuine public health benefit for the area.

Full Q&A: What kinds of health conditions are caused or made worse by unhealthy street design and inactivity?

Quite a wide range. Physical inactivity increases the risk of cardiovascular disease, stroke, type 2 diabetes, obesity, some cancers, musculoskeletal problems and premature death. It also affects mental health, with regular physical activity associated with lower rates of depression and better overall wellbeing.

Street design matters because it influences whether walking and cycling are realistic, attractive everyday choices. Traffic-heavy streets can also increase exposure to air pollution and noise, while busy or unsafe roads can discourage people from walking, cycling or allowing children to travel independently.

From a GP perspective, these aren't abstract public health issues. They are conditions we see every day.

How much money do these conditions cost the NHS?

The costs are substantial. Physical inactivity alone is estimated to cost the NHS hundreds of millions of pounds each year, before considering the wider economic and social costs.

Prevention is therefore not just about improving people's quality of life. Creating environments that make routine physical activity easier can also reduce future pressure on NHS services.

What kinds of people do these conditions usually affect?

Everyone can benefit from being more active, but the effects are not evenly distributed.

Children benefit from being able to walk, cycle, play and travel independently. Older people benefit from staying active, maintaining strength and mobility and reducing social isolation. People with long-term conditions can also gain a great deal from incorporating regular activity into daily life.

There is also an important issue of health inequality. Physical inactivity and long-term illness are both more common in more deprived communities. Good street design can help make healthy choices accessible to everybody, rather than something which depends on having spare time, money or access to a gym.

What changes to street design in Higham Hill and Lloyd Park would have a positive impact on public health?

Our practice is on Higham Hill Road, so we see the effects of heavy traffic every day. High traffic volumes, limited crossing points and poor pedestrian access can make even short local journeys feel difficult or unsafe, particularly for older people, parents with young children and people with mobility problems.

From a health perspective, changes that make walking, cycling and crossing the road safer and easier would have a genuine public health benefit for the area. That could include safer crossings, lower traffic speeds and volumes, better pedestrian access, safer cycling routes and measures that make school and local journeys easier without relying on a car.

Why is good public health important to the NHS?

A huge proportion of what we deal with in general practice is long-term illness rather than isolated episodes of disease. Treating diabetes, cardiovascular disease, respiratory illness, poor mental health and mobility problems is essential, but preventing or delaying those conditions in the first place is even better.

The NHS cannot achieve that through consultations and prescriptions alone. Where people live, the air they breathe and whether their neighbourhood makes it easy to walk, cycle, meet other people and stay active all have an enormous influence on health.

Traffic reduction also makes it safer for those who may have to drive to the clinic and reduces parking pressure locally. A huge thank you to Dr Wallace and the team at Higham Hill Road Medical Centre for all the work they do looking after residents. 

We are pleased to work in partnership with local services, community organisations and residents to create healthier, safer and better streets for all. If you are a local organisation and want to collaborate and take part in a Q&A,  as part of a coalition on reducing danger and making the area healthier and more equitable, please do get in touch!  highamhillhealthystreets@gmail.com  Healthy streets and active travel in Higham Hill | Higham Hill Medical Centre