Chapter 6
Building a Healthier Liverpool – Policies and Places
Integrating health into city policies, planning, and infrastructure to create a healthier urban environment
Health in All Policies
Liverpool’s ambition is to be a healthier, happier, fairer city for all. We aim to tackle the social determinants of health through our Marmot Communities approach as outlined in the Merseyside and Cheshire All Together Fairer report and by using international frameworks to promote and protect the health of our city and residents.
However, Liverpool has notable health challenges. Poor housing, living environments, lower employment rates and low income are the main drivers of poor health locally, with many public health outcomes for Liverpool being significantly worse than for England.
Liverpool is the
3rd most deprived local authority in the country
63% of residents live in areas ranked among the most deprived quintile in England
10% of areas are among the most deprived one percent
27,400 (1 in 3) children aged under 16 live in poverty
Our innovative State of Health in the city: Liverpool 2040 report outlined health in the city now and for the first time looked to the future. It set out that unless we make changes now, health outcomes and inequalities are predicted to significantly worsen in Liverpool by 2040.
The report has been a call to action for the city. It has driven Liverpool City Council’s (LCC) commitment to and delivery of a health in all policies approach. It has gained senior level commitment from local elected members and our corporate management team. Ensuring that there is a understanding of health and health inequalities across the council. The approach fosters a commitment to maximising the positive health impact of all of these functions. It brings LCC functions together in a way that will reduce inequalities. We are maximising opportunities and levers to improve local health outcomes. Work to date has included embedding our health in all policies approach within;
- The Liverpool Housing Strategy 2025-2030 and Homelessness Strategy
- Inclusive Economic Growth Strategy: Liverpool 2040
- Planning Policy – The Liverpool Local Plan review, The Waterfront Plan and Liverpool’s Housing Design Guide
- LCC Advertising and sponsorship policy
Health in All Policy Case Study
Collaborative work between planning and public health
We know that the environments in which we live are linked to our health. The design and use of the built and natural environments, including housing quality and green infrastructure are major determinants of health and wellbeing. A memorandum of understanding (MOU) is agreed between the LCC public health and planning teams to strengthen and formalise working together. The MOU sets out how the teams will prioritise health in all future planning decisions. Collaborative work to date has included
Embedding health within the refreshed Liverpool Local Plan:
The Liverpool Local Plan is being updated to align with national and international sustainability standards, including the National Planning Policy Framework and the UN Sustainable Development Goals. An integrated impact assessment will be undertaken which encompasses;
- Sustainability Appraisal
- Strategic Environmental Assessment
- Equalities Impact Assessment
- Health Impact Assessment
- and Habitats Regulations Assessment
This holistic approach addresses sustainable economic, social, and environmental objectives. It will enable Liverpool to embed policy that facilitates the creation of environments that promote healthy lifestyles. For example, through active travel and play spaces. Working together will enable health outcomes to be embedded in the Local Plan from the outset. Together we can focus on;
- securing essential healthcare facilities,
- ensuring inclusive and affordable housing,
- fostering mixed, intergenerational communities,
- and enhancing access to natural open spaces for the benefit of physical and mental health.
Liverpool homes which prioritise health
Cities designed to prioritise health
Co-developing a health impact assessment framework and local approach:
- The planning and public health team have embedded Michael Marmot’s principles into a co-produced Health Impact Assessment (HIA). Ensuring that social determinants of health are effectively addressed at the earliest stage of the planning process. The development of the HIA has been supported by guidance from national experts the Town & Country Planners Association and colleagues at Public Health Wales HIA Support Unit. To strengthen the HIA process, making it fit for purpose.
Working together to undertake a health impact assessment of the housing design guide:
- Using the Marmot principles to assess and revise the draft housing design guide. Making sure we are maximising opportunities within the design and build of new houses and neighbourhoods to improve local health outcomes and reduce health inequalities.
The collaborative work between planning and public health teams was awarded first prize at the recent International Healthy Cities Design Conference in October 2024 in the Healthy City Planning & Design category. The award-winning approach is supporting:
- The creation of environments that support and encourage healthy lifestyles e.g. active travel; space to play; greener environments.
- Identifying and securing the facilities needed for primary, secondary and tertiary care, and the wider health and care system
- Inclusive design & accessible new homes
- High quality and affordable new homes
- The creation of mixed, inter-generational communities that facilitate social interaction
- Increasing access to natural open spaces
