The rhetoric of social mobility continues… yet disadvantaged pupils continue to fall behind

skills gap

By Heather Cameron

Despite continued investment to improve social mobility, it has been estimated that at the current rate of progress it will take 50 years to close the attainment gap for disadvantaged pupils in England.

Recent analysis of government data shows the gap between the most disadvantaged pupils and their non-disadvantaged peers has actually worsened over the past decade.

The research, conducted by the Education Policy Institute (EPI), found that while there has been some progress in closing the gap for disadvantaged pupils (those eligible for the Pupil Premium), this has been slow and inconsistent. The gap has also been shown to vary between areas.

And, perhaps most worryingly, for pupils described as ‘persistently disadvantaged’ (i.e. those that have been eligible for free school meals for 80% or longer of their school lives), the gap has widened – leaving these pupils over a year behind their non-disadvantaged peers at the end of primary school and more than two years behind at the end of secondary school.

Widening gap

The attainment gap is evident in the early years, continuing to grow throughout school.

Pupils from disadvantaged backgrounds were found to be 19.2 months on average behind their peers at the end of Key Stage 4. While this represents a narrowing of the gap by 2.7 months since 2007, this is not consistent across the board. And the gap for ‘persistently disadvantaged’ pupils increased by 2.4 months over the same period.

The EPI analysis indicates that the disadvantage gap grows by five months between Key Stage 1 and 2, and by 10 months between Key Stage 2 and 4.

Persistently disadvantaged pupils are shown to fall even further behind at all phases. For them, the gap grows from six months at the end of Key Stage 1, to 12 months by the end of Key Stage 2 and 24 months by the end of Key Stage 4.

It is argued that the differential rates of progress pupils make need to be tackled to stop the gap from growing throughout the stages.

Indeed, the issue can’t be solved with a one size fits all approach, particularly as there is significant variation across the country.

Variation

The disadvantage gap between local authorities ranges from no gap to seven months in the early years, five to 13 months at the end of primary school and one month to over two years at the end of secondary.

The gap is generally smaller in London, the South and the East at around 16-18 months at the end of secondary. In comparison, the East Midlands and the Humber, the North and the South West experience a much larger gap of 22 months. The largest attainment gap was found on the Isle of Wight, where disadvantaged pupils were 29 months behind their peers on leaving secondary school.

The gap was also found to become worse in rural areas. In Cumbria and Northumberland, for example, the gap widens from nine months at the end of Key Stage 2 to over 25 months by the end of secondary.

But there is also evidence of particularly good performance and notable improvements made in recent years. In Newham, disadvantaged five year-olds perform as well as non-disadvantaged five year-olds nationally, on average. And in Richmond-upon-Thames and Windsor and Maidenhead, the gap for disadvantaged secondary school pupils has closed by over six months since 2012.

This would suggest that there is certainly potential for dramatic improvements in reducing the gap in other areas.

Government action

As an historic problem, successive governments have taken action to address it via investment and targeted interventions. The current government is also working to address the issue, including through Opportunity Areas.

The EPI suggests that while this may be a good start, there are other areas across the country that are not covered by these where “social mobility is stagnating or even worsening”. And it also highlights that the system continues to fail to meet the needs of certain vulnerable groups, including those with special educational needs and disabilities, those from Gypsy Roma or Traveller communities, and Black Caribbean children.

In addition, recent commentary from the Chief Inspector of Ofsted, Amanda Spielman, raised concerns over schools focusing on exam results at the expense of the curriculum, leading to many disadvantaged children being shut out from acquiring a rich and full knowledge:

“It is a risk to social mobility if pupils miss out on opportunities to study subjects and gain knowledge that could be valuable in subsequent stages of education or in later life.”

It has been suggested that government pressure to improve performance has led to a focus on exam and test results. But Spielman argues that this is a mistake on the part of school leaders as it should “not be taken as read that higher scores for the school always means a better deal for pupils”.

Final thoughts

Clearly, while it shouldn’t be forgotten that progress has been made, a lot more needs to be done if the disadvantage gap is to close any time soon.

As the EPI concluded: “If we carry on at this pace, we will lose at least a further three generations before equality of outcomes is realised through our education system.”


If you enjoyed reading this post, you may also like our previous blogs on education-related topics.

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Supporting markets to survive and thrive

For around a thousand years, the London Borough Market has existed in one form or another.  It has survived fire, flood, plague and war – and on the 3rd of June this year, a terrorist attack.  The market has since reopened, with traders determined to continue their work and serve the local community.

Although many markets are a historic part of their host towns and cities, they are far from being relics.  Indeed, in recent years markets have experienced something of a revival.  In London alone, since 2010, the number of street markets has grown from 162 to over 250.

There are clear reasons for this – markets offer consumers and traders a number of benefits, and they make significant contributions to the economic, social and political health of towns and cities.

Economic impact of markets

Indeed, in 2015, the Institute of Place Management (IPM) conducted a comprehensive review of the impact of markets and found that markets not only have a significant turnover, they also impact indirectly on the wider economy – meaning that the £3.5 billion turnover directly attributable to retail markets is actually worth around £10.5 billion to the UK economy.

The Portas review in 2011 hailed markets as a potential saviour of the high street.  Indeed, the IPM review supports this, reporting that markets can help to increase town centre footfall by up to 25%.  This has significant economic potential.  In London, market visitors spend around £752 million per annum in nearby shop-based retailers.

Markets were also found to:

  • act as a significant employer, both nationally and at the local level
  • support intergenerational economic mobility (through family-owned businesses)
  • support the development of entrepreneurial skills in young people through ‘youth markets’
  • act as business incubators and support business formation due to their low barriers to entry, for example, enabling migrants to set up their own businesses
  • enable small businesses to reach larger businesses whom they can supply, and support other local businesses, such as farmers.
  • encourage high street diversity and create a distinct ‘identity’ for high streets
  • promote high street resilience, as they are flexible and able to respond quickly to changing demands.
  • help to utilise vacant and underused spaces within high streets
  • attract tourists, who are drawn to them because they are “unique, quirky, unusual”

Wider benefits

Markets also have a number of social purposes.  They are important places of social interaction, which facilitate community cohesion and social inclusion.  Markets can also help to improve public health and quality of life through the provision of fresh, quality produce at lower price points, which may be particularly beneficial for low-income families.

From an environmental perspective, there are also a number of benefits arising from the sale and purchase of locally produced products, including reducing pollution associated with high ‘food miles’ and reducing the need for consumers to travel to out-of-town sites, such as large retail parks, in order to make their purchases.

Challenges

Although there is overwhelming evidence that almost every street, food and farmer’s market is an invaluable asset to its local community, markets still face a number of very real threats.  These include:

  • the rise of out-of-town shopping centres, the dominance of big supermarkets, and the popularity of online shopping
  • planning and regulatory regimes that do not allow for, or restrict, the expansion or establishment of markets
  • a lack of support for markets or poor management by local authorities
  • high land values making it difficult for markets to be established

As many markets are a lifeline for areas experiencing deprivation, it is important that they receive the support that they require to survive and flourish.

Promoting and supporting markets

So, what can be done to support markets?  Earlier this year, the Mayor of London, Sadiq Khan, announced plans to establish the London Markets Board – a team of experts tasked with delivering a London markets strategy, and work to preserve and promote London’s increasing number of markets.

On a wider scale, NABMA (National Association of British Market Authorities) and the National Market Traders Federation recently published a ‘five-year manifesto’, which made a number of recommendations for ways to support markets.

A key recommendation is that local authorities work to raise the profile of markets.  There are many market-focused national initiatives such as Love Your Local Market, the National Youth Market, and the Great British Market Awards, which local authorities can become involved in.

The Love Your Local Market campaign, for example, is an annual event, established in 2012, which brings together markets across the UK.  It aims to build affection and support for markets in local communities, and offers free or subsidised pitches to start-ups to test trading conditions.  In 2013, it increased footfall in participating town centres by 10%.

Other recommendations to support markets include:

  • greater recognition of the role of markets in local economies, jobs and growth, as well as in civic local society
  • ensuring that retail markets have a voice in policy making that affects them, including planning and town centre management
  • further lifting the current burden of business rates for SMEs
  • supporting greater awareness of the sector’s employment opportunities including apprenticeships, platforms for self-employment and training hubs
  • developing and supporting sector-led initiatives that aim to support entrepreneurship and increase the amount of businesses on markets, and support them digitally
  • encouraging schools and further education establishments to work with market operators to enable people entering the labour market to embrace markets as a possible career

There are some promising signs.  Around £90 million has been invested into improving markets since 2014, and an increasing number of local authorities are making them central to town centre plans and regeneration activity.

By promoting and supporting markets in this way, the economic, social and environmental benefits can be maximised. As the 2015 review of markets underlines: “markets are an important asset to a location, and their future cannot be left to chance.”

Europe’s housing time bomb: a new report highlights the millions affected by housing exclusion

The European Union has not had its troubles to seek in the years following the financial meltdown of 2008. Continuing concerns about the euro, the refugee crisis and Brexit are challenging Europe’s leaders as never before, leading to speculation about the very existence of the EU. But at the end of March, new research highlighted an additional challenge that threatens Europe’s social fabric.

The authors of the report described the current situation concerning housing exclusion and homelessness as “a state of emergency” affecting all European countries. Startling figures uncovered by the research show a continent-wide crisis in the making:

  • In France, the number of homeless people increased by 50% between 2001 and 2012
  • In Germany, 16% of people spend more than 40% of their income on housing
  • In Romania, one in every two people live in overcrowded conditions
  • In the league table of homelessness, the UK now ranks 20th out of 28
  • The number of families in temporary accommodation in London has increased by 50% since 2010
  • In Copenhagen, youth homelessness has increased by 75% since 2009
  • In Warsaw, the number of people sleeping rough or in emergency shelters has risen by 37% since 2013
  • One in 70 people in Athens are now homeless

Vulnerable groups

The report finds that young people across Europe are being hit especially hard by housing exclusion.

“In all EU countries, young people are more vulnerable to prohibitive housing costs, overcrowding and severe housing deprivation than the rest of the population. For poor young people across Europe, the situation is becoming unbearable, with 65% in Germany, 78% in Denmark and 58% in the UK spending more than 40% of their disposable income on housing. The average in the EU is 48%.”

The report also found that Europe’s poor are being side-lined at a time when housing expenditure has increased while incomes have fallen.

“In general, people living below the poverty threshold are increasingly marginalised by a private rental market that feeds off a systemic lack of affordable housing.”

Non-EU citizens are another vulnerable group experiencing housing difficulties:

“Two-thirds of non-EU citizens are overburdened by housing costs in Greece, almost half in Spain and Belgium, more than one third in Ireland and Portugal, and more than one quarter in the United Kingdom, Denmark, the Netherlands, Italy, and Slovenia.”

Unfit conditions

While homelessness and the rising cost of housing are proving to be growing problems across the EU, poor housing is are also a Europe-wide issue.  Across all European countries, a poor household is two to twelve times more likely to live in severe housing deprivation (leaking roof, dampness, poor sanitation) than other households, and in the European Union as a whole, one person in six lives in overcrowded housing.

Fuel poverty is another significant problem, affecting almost a quarter of poor households across the continent. In the UK, 9.4% of the population and 20.2% of poor households experience financial difficulty in maintaining adequate household temperatures.

Eviction: “a collective abandonment of other people”     

An entire chapter of the report is dedicated to eviction, which the authors describe as “…one of the worst forms of violence that can afflict someone.

The figures from national governments and Eurostat highlight significant variations in the pattern of evictions in each EU country, with surges in the number of evictions in Bulgaria, Cyprus, Ireland, Latvia and the Netherlands, while six countries – the Czech Republic, Denmark, Croatia, Lithuania, Portugal and Sweden saw substantial reductions in the number of evictions.

The figures also show varying trends within the UK and differences between the private and public sectors. In England and Wales, rental disputes rose in the social housing sector, but fell in private housing; in Northern Ireland, property foreclosures rose slightly, while tenant evictions rose dramatically by 75%; in Scotland, eviction procedures of all kinds fell by 17%.

Addressing the issue

The report argues that the tools for dealing with the challenges of housing exclusion in Europe already exist, including Europe-wide networks of local, regional and national governments, and EU initiatives, such as the Urban Agenda and the European Pillar of Social Rights. The authors note that there are many examples of good housing practice, notably in Finland, whose “housing first” strategy has achieved a reduction in homelessness – the only EU country to do so.

However, the authors contend that Europe’s leaders need to rapidly activate the political will to tackle the problem of housing exclusion:

“The EU and Member States should place the elimination of homelessness in the core of their social policy agendas. Responses to homelessness should be mainstreamed into the design and implementation of relevant sectoral policies including youth, gender, migration, and Roma inclusion. The EU and the Member States can and should act to enforce social rights.

Final thoughts

The report’s figures make sobering reading: more than 36 million households living in overcrowded conditions; almost 11 million households facing severe deprivation; more than 22 million households experiencing fuel poverty. Perhaps most worrying is the number of homeless people in Europe. This is an unknowable figure, but all the indications are that it is rising dramatically.

Published a week before the UK signalled its intention to leave the EU, the report received comparatively little media coverage. But if the problem of housing exclusion and homelessness continues to grow, it threatens to overwhelm political leaders at EU, national and local levels. It’s no exaggeration to suggest that homelessness could rival Brexit in its impact on the future of Europe.


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Talking to children about poverty: why education needs to get in on the act

boy with bear

1 in 5 children in poverty

Scotland has one of the highest rates of child poverty in the UK. The latest figures from the Joseph Rowntree Foundation estimate that 1 in 5 children in Scotland live in poverty, with the figure rising to 1 in 3 in the urban centre of Glasgow. With more and more families falling into relative poverty and the numbers of working poor rising, the newly branded “JAMs” (just about managing) are, in some cases not managing, having to decide between heating their house or feeding their families.

People are affected by poverty in many different ways. For adults it can lower self-esteem, increase levels of stress, and can have consequences for mental and physical health. However, it’s sometimes forgotten that many children can feel these same effects from growing up in a family living in poverty.

In the same way as adults, many children suffer from low self-esteem and feel the invisible burden of the stigma that the label of “poverty” places on them. In addition, children affected by poverty:

  • are more likely to be victims of bullying;
  • tend to have lower attainment at school;
  • have fewer social networks or groups of friends;
  • suffer from poorer physical and mental health;
  • have less chance of leaving school with a full set of qualifications and going on to further or higher education (despite the best efforts of various governments to change this); and
  • are more likely than “affluent children” to spend their adulthood in poverty too.

How children understand poverty

Many children have an understanding of poverty as meaning “poor” or lacking in money. Concepts such as heating a home, building personal debt or not being able to afford to travel to work are not things they yet associate as being part of the cost of living, despite many of them seeing their own parents face these struggles on a weekly basis.

They associate poverty with foreign, particularly third world nations, as well as with homelessness, loneliness, a lack of familial support and a reliance on donations. Many children, even from the poorest backgrounds do not recognise themselves as being in poverty. This is something highlighted in research conducted by the Scottish Universities Insight Institute (SUII), which looked at child perceptions of poverty, and expressing these through alternate methods such as art.

In the study, children from schools in less affluent areas of Glasgow and Aberdeen were surveyed and many regarded notions of poverty as a distant, “third world” concept. However, when they were engaged in more creative methods, such as drama, or art, expressions of their experiences of poverty became more acute.

School children raising hands. View from behind.

Engaging education professionals in the poverty discourse

In Scotland, the overarching framework of Getting it Right for Every Child (GIRFEC) is designed to bring services and professionals with whom children come into contact closer together to create a complete model of care for a child. It is interesting that in the latest commitment to tackling child poverty in Scotland there is no commitment to including teachers or education in general, in the same way as health professionals or social workers.

We know that poverty can have an adverse impact on wellbeing and on learning, and that children who live in poverty are more likely to be absent from school. However, education professionals are largely excluded from the discussions which child welfare officers, social workers, doctors and third sector colleagues are already having around the health and wellbeing of children who are living in poverty.

In a practical sense schools do, to a degree, already engage in reducing the impact of child poverty by providing financial and practical help. This could include subsidies for school meals or trips, the donation of free uniforms, breakfast clubs and tutoring after school classes. There have even been cases of individual teachers giving children clean clothes, meals or allowing them to sleep in the staff room at break and lunchtimes to allow them to catch up on sleep lost because of a disruptive lifestyle at home. However, talking about poverty with children is often neglected. This is something that academics are keen to see schools do more of – use their position to engage children in talking about poverty in order to help identify children at risk, but also to help raise the issue with other children who may not have experienced it or know what it is.

Using creative methods in schools to talk about poverty

Many academics argue that statistics on attainment can be misleading – while poverty has a significant impact, it does not correlate directly to cognitive ability. As one researcher at a seminar suggested, “just because you were born poor does not mean you were born without the ability to learn”. While there is evidence to suggest the slower development of children who live in poverty is acute in the early years, there is also evidence that the attainment gap is closing – what children in poverty miss out on is opportunity, variation and experience, and a chance to develop, rather than having lower overall cognitive function. This is one of the reasons, academics argue, it is so vital to engage teachers in wider discussions on child poverty.

For example, the vocabulary of children in poverty is often smaller in range than that of their more affluent peers. But, rather than this being the result of reduced cognitive function, researchers have found that this is primarily because they have not had the need to learn new words. Unlike children from more affluent backgrounds, they tend to remain within their community unit, using more colloquial language and a more limited number of words; they also often have less access to books or exposure to cultural experiences. That is not to say that they could not learn or have learnt all of the words that a child from a more affluent area knows; it’s just that they have not had the need or the opportunity to learn them yet. With this in mind, alternative methods of communication such as art, dance and storytelling could prove useful in explaining poverty to children, and helping them to discuss their experiences and understanding of what it means to be in poverty.

künstlermaterial

Using creative ways of communicating and engaging with children has already been found useful in helping them to talk about other issues personal to them, such as trauma or abuse. Researchers from the Scottish University Insight Institute-funded research team employed similar methods, using art, drama and play to help children express their feelings on poverty, and how it could be tackled in their communities. Children acted out scenarios, wrote poems, and created a number of pieces of tactile artwork, including sculptures and drawings. It was thought that these same methods could be used by teachers as a way to allow children to communicate their feelings about poverty and express issues relating to their own personal experiences without feeling stigmatised or singled out by other members of the class.

It is clear that the education profession has an important role, not only in helping to alleviate the effects of poverty on children through schemes like breakfast clubs, but also in a teaching and learning role. Many teachers and schools are averse to raise issues of money or poverty with children for fear of placing unnecessary distress onto children. However, sensitive and context-aware teaching on the issues around poverty should be seen as an opportunity, not a burden to teachers.

Effective discussion could go a long way to helping children to open up about experiences of poverty and also help them to be more understanding of other children who are living in poverty, reducing stigma and encouraging positive action within their local communities.


This blog reflects on research from the Scottish Universities Insight Institute and seminar participation at the Centre for Child Well-being and Protection at the University of Stirling.

Follow us on Twitter to see what developments in public and social policy are interesting our research team. If you found this article interesting, you may also like to read our other article on arts based practice with children.

Mobilising healthy communities: Bromley by Bow Health Partnership

Ian Jackson of the Bromley by Bow Health Partnership was the guest speaker at the first Glasgow Centre for Population Health (GCPH) seminar series of the year.

The Bromley by Bow Health Partnership (BBBHP) is a collaboration between three health centres and other non-primary care partners in the Tower Hamlets area of London. The aim of the partnership and the new primary care delivery model which comes with it is to transform the relationship between the public and primary health care. This means considering the wider determinants of health when the partners plan and deliver care, rather than treating healthcare in a purely biomedical way.

Edited image by Rebecca Jackson. Map via Google Earth

Edited image by Rebecca Jackson map via Google Earth

Effect of social determinants on health

In the 1890s Charles Booth created a map of London which categorized areas of the city of London depending on their levels of deprivation. The most recent Indices of Multiple Deprivation Report showed that those same areas considered deprived in the1890s are still facing the highest levels of multiple social deprivation and health inequality today. It is no secret that disadvantage has a negative impact on people’s ability to make the best choices when it comes to health. And disadvantage at a social level can have a significant influence on poor physical and mental health across a range of conditions.

More recent research conducted by Michael Marmot looked more closely at what determines health outcomes in populations, and the extent to which other factors influence people’s health, or rather their ability to be well.

He produced what is known as the 30/70 model: 30% of what determines your health is your genetics and improvements in pharmacology, the other 70% is related to other “external factors” including poverty, environment, culture, employment and housing. BBBHP has used this as the foundation for their primary care model, arguing that primary care providers are not just dispensers of medical products, but have a responsibility to contribute to people living healthier lives in their community.homeless

Social prescribing

One issue highlighted by the BBBHP was the significant number of people presenting at GP surgeries with “non-medical” ailments, or medical ailments triggered by “non-medical stimulus”. People were arriving at the practices and booking appointments because they were lonely and it gave them somewhere to go. Others were presenting with symptoms of depression, which on further investigation were found to have stemmed from issues around debt or domestic violence. A social prescribing service was set up by the partnership to try to tackle some of these non-medical conditions and improve the health of the general population by non-pharmacological means.

The social prescribing service, where GPs refer people to other local services for help, can be used as a replacement for pharmaceutical interventions, or be supplementary to them. GPs, or other primary care staff, may refer any adults over the age of 18 to one of over 40 partnership organisations. These range from walking groups to formal sessions with advisors in debt or domestic violence agencies, as well as art classes, community gardens and companionship services to combat loneliness. The organisations can provide help and advice on issues such as employment and training, emotional well being and mental health.Ölfarbe

The challenges of quality and funding

Maintaining quality in the provision of social prescribing is a particular challenge for BBBHP. They work regularly with trusted partners, particularly the Bromley by Bow Centre. However, there is no consistent quality check for many of the services from the health partners themselves. Evaluative studies and feedback sessions are used to assess quality and impact, and consider the scale of demand. And while it is acknowledged that more formal frameworks for assessing quality and impact of social prescribing services are preferred in formal assessments, in reality, word of mouth, participant feedback and uptake rates are used as a standard for quality as much as official feedback in a localised community setting.

A second issue is funding. BBBHP identified that finding long term funding was their main issue in providing security for providers and service users, as well as for GPs referring to services. Funding is vital not only to ensure the survival of the community groups who provide some of the referred services, but also to allow them to develop longer term partnerships and build capacity within the social prescribing service. The BBBHP works closely with the Bromley by Bow Centre, a key provider of support services for the local community, but like many services which rely on funding, they increasingly have to plan for tighter budgets.

blue toned, focus point on metal part of stethoscope

A final challenge for the staff at BBBHP was changing people’s expectations of primary care, and what it means to live well. Some patients were suspicious and reluctant to be recipients of “social prescription”, as this did not fit with the traditional expectation of what GPs should do to make people well. This can be a big change in mindset for some people, according to Ian Jackson, when people come expecting to be prescribed antidepressants but are instead “prescribed” a walking club or a debt advice service. He noted that the reaction from patients can sometimes be confused or hostile, and some patients do not even turn up for referrals.

Improving patients’ understanding of the benefits of social prescription, ensuring people attend referral appointments, and that social prescriptions have a long term impact is something which BBBHP are hoping to research further. They feel that looking at the long term impact of non-pharmaceutical interventions and how these feed back into the wider agenda of tackling inequalities is important to allow the partnership to continue to build healthy communities and save on primary care costs in the long term.

category-picture-community-development

Creating positive social connections to improve community health

Social prescribing and other associated projects have sparked new social connections. Members of the community have come together to form their own support groups. The Children’s Eczema support group run by local GPs and the DIY health scheme, which sought to educate and support parents who were anxious about minor ailments in children, have helped parents in the area to set up WhatsApp groups, organise coffee mornings and go to one another for support. Such initiatives are regarded by BBBHP as important in tackling wider, systemic social inequality in the area.

Currently, primary health care in communities is focused on illness. This needs to change, according to BBBHP, with local community-based health delivery based as much around social health as biomedical issues. Through its social prescribing and other services BBBHP has aimed to focus on supporting people in a holistic way, tackling health inequalities as well as biomedical illness, to allow them to make good choices to improve their health.


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Planning healthy cities … integration is key

Image from Flickr user Sebastian Niedlich, licensed for reuse under a Creative Commons License

Image from Flickr user Sebastian Niedlich, licensed for reuse under a Creative Commons License

By Dorothy Laing

“The environment in which we live, work and spend leisure time – both the physical nature of places and the social environment of communities – has an enormous impact on our health and wellbeing. Health problems such as obesity, chronic heart disease, stress and mental health issues are intricately linked to the environments in which people live and work”. (RTPI, 2014)

Earlier this month the RTPI published Promoting healthy cities: Why planning is critical to a healthy urban future, the third in a series of Planning Horizons papers launched to mark the RTPI’s centenary. The report looks at how planning can help to create healthy cities – one of its main arguments being that health and wellbeing need to be at the core of city design and development.

With a growing number of people living in urban areas, and health problems such obesity and diabetes on the rise, planning for healthy cities is vital. And interest in the links between planning and urban health is nothing new.

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