How low can they go? Cities are taking action to reduce air pollution and save lives

Air pollution is a bigger killer in Europe than obesity or alcohol: nearly half a million Europeans die each year from its effects.

Particulate matter (a complex mixture of extremely small dust particles and liquid droplets) and nitrogen dioxide (an invisible, but foul smelling gas) are particularly harmful to health.  As the New Scientist has explained:

“…nitrogen dioxide lowers birthweight, stunts lung growth in children and increases the risk of respiratory infections and cardiovascular disease. Particulate pollutants like soot cause a wider range of problems, including lung cancer.”

Motor vehicles are the main source of these emissions in urban areas. For this reason, European Union regulations introduced in 2010 set down that nitrogen oxide should average no more than 40 micrograms per cubic metre over a year. These limits are regularly breached. By the end of January this year, London had reached its legal air pollution limit for the whole of 2018. Scientists say that even these limits are unsafe: the 30,000 deaths each year attributed to particulate pollution are due to exposure levels below the legal limit.

Getting into the zone

Many local authorities have been trying to tackle the issue by getting the most polluting vehicles out of their city centres.  As Traffic Technology International has noted:

“From Athens to Aberdeen, and from London to Ljubljana, there is an eclectic smorgasbord of initiatives with over 200 low emission zones (LEZ) around Europe excluding more polluting vehicles, and some cities employing road-user charging to deter vehicles from entering.”

In the UK, Glasgow is set to become Scotland’s first low emissions zone, while Oxford could become the world’s first zero emissions zone, which would exclude all non-electric vehicles from the city centre by 2035.

T Time in London

London has adopted especially ambitious goals to clean up the capital’s air. As of October 2017, older vehicles driving in London between 7am and 6pm have needed either to meet the minimum toxic emission standards (Euro 4/IV for both petrol and diesel vehicles and Euro 3 for motorised tricycles and quadricycles) or to pay an extra daily charge of £10.00 (in addition to the £11.50 Congestion Charge).

Air quality campaigners have welcomed this “T Charge”, but not everyone is happy. The Federation of Small Businesses has voiced concern that the charge will have a negative impact on small and micro-businesses that are already struggling with high property, employment and logistics costs. Shaun Bailey, a Conservative member of the Greater London Assembly, has described the T Charge – and the mayor’s plan to bring forward to 2019 the launch of London’s ultra-low emission zone (ULEZ) – as “vanity projects” that will have little effect on air quality.

National demands and local plans

London’s T Charge is one way of tackling air pollution, but there are other methods, such as retrofitting bus fleets, improving concessionary travel and supporting cyclists. Some UK cities are already taking action, while in Germany and Belgium, even more radical ideas are being mooted.

Last summer, the UK government set out its plan for tackling roadside nitrogen dioxide concentrations. The document made it clear that local authorities have a leading role to play in achieving improvements in air quality.

By the end of this month, local authorities were expected to submit their own initial schemes for tackling the issue, with final plans to be submitted by December. The government promised support for councils, including a £255m Implementation Fund to help them prepare and deliver their plans, and the opportunity to bid for additional money from a Clean Air Fund.

It was hoped that these measures would lower the poisonous emissions. However, last month the High Court ruled that the government’s approach to tackling pollution was not sufficient, and ordered urgent changes. Even if the subsequent plan is accepted, many feel that the only sure way to solve the problem is to eliminate traffic from our cities. Others counter that this will damage the economy.

The battle of Britain’s air quality has only just begun.

Our previous articles on air quality include:

‘Agent of Change’ protects music venues from noise complaints, but won’t stop them from closing

This guest blog was written by Marion Roberts, Professor of Urban Design, University of Westminster.

A Conservative minister for housing, a grey-haired Labour MP, ageing icons of rock and creative young people have formed an unlikely alliance in support of the Agent of Change (Planning) Bill. The proposed law, which will be discussed for the second time in the House of Commons on March 16, makes developers responsible for dealing with noise issues when they build new homes near music venues.

This all came about because people were worried about the high number of live music venues that were closing across the UK. The Greater London Authority (GLA) asked for a report on London’s grass roots music venues, only to find that 35% of them had been “lost” since 2007. Cities across the nation – from Glasgow to Manchester – have similar stories to tell, even though the government has recognised how important the music industry is for the economy.

So how did this happen? Many different governments since around the year 2000 have tried to get more flats and houses built in cities, because there aren’t enough for everyone who wants to live there. Many homes have been built on “brownfield” sites – where there used to be factories or warehouses, which are now used less or not at all. These types of places also offered spaces where creative entrepreneurs could set up new clubs, or take over existing venues and attract new customers with the offer of live music.

Buyer beware

But as people move into the new flats built on these sites (which they often pay a lot of money for) some inevitably complain about the noise coming from the venues. Venue owners in Shoreditch (one of London’s hip neighbourhoods) actually put up signs warning would-be buyers that there are live music venues in the area.

Up until now, these complaints caused big problems for music venue owners, because planning principles were not on their side. The onus was on them to ensure their neighbours weren’t disturbed by music and loud noises. But putting in proper soundproofing or keeping customers quiet can be difficult and expensive.

This doesn’t just affect the kind of places run on a shoe string on the outskirts of town. Even London’s mighty Ministry of Sound – which has been a mecca for House music lovers since 1991 – was caught up in a lengthy planning application for a tower block of flats nearby – a case which eventually ended in the flats having to be soundproofed.

A matter of principle

The way the planning system works, is that local authorities in England and Wales produce their own development plans, which must align with national policy as set out in a 2012 document called the National Planning Policy Framework (NPPF). This document made a small move to protect venues, by saying that if they wanted to expand, then there should be no unreasonable restrictions. But it didn’t address the situation described above.

Some local authorities have already started to draw up their own policies, which put the burden of noise reduction measures firmly on the developer who is making the change – whether it’s for flats or other uses. This is the legal principle, known as the “Agent of Change”. The bill, now supported by government, will ensure that the principle is embedded in the NPPF – so all local authorities will have to follow it. It will also carry more weight in appeals against planning decisions.

Although the “Agent of Change” principle will help prevent live music venues from closing, it won’t be enough on its own. Sadly, it would not address other issues such as rising rents, hikes in rateable values and property owners preferring to redevelop their buildings into flats. For example, consultancy firm Nordicity estimated that a revaluation of business rates would cause a fifth of London’s grass roots venues to close. And London’s oldest LGBTQ venue, the Royal Vauxhall Tavern, is still engaged in a battle to save it from redevelopment, by way of a community buy out.

Yet past examples show that people can save their local pubs from closure, whether through local campaigning or by taking ownership of the buildings. And to see creativity and culture, especially for young people, supported through the dusty corridors of parliament, is truly heart warming.

Marion Roberts is Professor of Urban Design, University of Westminster.

This article was originally published on The Conversation website and has been republished with permission under a Creative Commons licence. Read the original article.

If you enjoyed this blog, why not read some of our other blogs:

Exploring Barnahus: a Nordic approach to supporting child abuse victims

Barnahus (which literally means Children´s house) is a child-friendly, interdisciplinary and multiagency centre where different professionals work under one roof in investigating suspected child sexual abuse cases and provide appropriate support for child victims.

Learning from the Nordic countries

Barnahus has assumed a key role in the child protection and child justice systems of many Nordic countries, including Sweden and Iceland. While there are some small differences in definition of the model across these nations, the general principle remains the same: to create a one-stop-shop for services that children can access under one roof. Services range from country to country, but usually include a combination of police, criminal justice services, child and adolescent mental health practitioners, paediatric doctors and social services.

The Barnahus model involves a high level of interdisciplinary working between different teams and allows for a complete package of care and support for a child to be created to reflect their needs. Within the Barnahus centres there are normally facilities including medical rooms, interview rooms, courtrooms, and residential facilities for those young people deemed at risk and who need to be taken immediately into temporary residential care.

Evaluations of areas that use this model of intervention have found significantly better outcomes for child victims and their families because of the multidisciplinary and multi-agency approach. Some discussions have also suggested that creating an adapted model for adult victims could also be a possibility in the future.

Reducing the trauma for victims of child sexual abuse

In England, it is estimated that only 1 in 8 victims of child sexual abuse are identified by the authorities. Children who disclose that they have been sexually abused face multiple interviews in multiple settings to a number of different people, often asking them the same questions. This can be confusing and frightening, as well as traumatic for many children who have to repeatedly recount the story of their abuse. Once the interview process is over, they can also then face long waiting times to access specialist therapeutic support.

The Barnahus model seeks to reduce some of the trauma experienced by victims of child sexual abuse by making the approach child-focused, emphasising the importance of a positive, safe and supportive environment in which to be seen by specialists, give evidence and receive support. For example, within the models used in Iceland children and young people are interviewed and examined within a week of the abuse allegation being made. These interviews are all conducted and recorded in a single location with specially trained officers and medical professionals, and they are then used in court as evidence, avoiding the victim having to revisit court in order to give evidence or testify.

Inside the centre, a specially trained interviewer asks questions, while other parties watch via a video link. Any questions they have are fed through an earpiece to the interviewer. Lawyers for the accused have to put all their questions at this point.

Another benefit to the model is that children who are interviewed are then able to access immediate assistance and counselling; in the current system in England, children may face cross-examination in court months after the alleged abuse, and would have to wait for victim support therapy.

Allocation of funding from government

In 2017, in response to the success reported in the Nordic models, the UK government earmarked Police Innovation Funding of £7.15m to help establish and roll out a similar scheme in London, which would see criminal justice specialists working alongside social services, child psychologists and other services and, it is hoped, pave the way to create a UK-wide Barnahus model in the future.

Building on the existing model in London, CYP Haven, which provides largely clinical, short term care, will provide a multi-agency, long-term support and advocacy service that is expected to support over 200 children and young people each year. Criminal justice aspects of aftercare will be embedded in the service, with evidence-gathering interviews led by child psychologists on behalf of the police and social workers, and court evidence provided through video links to aid swifter justice.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

If you enjoyed this blog, you may also be interested in our other articles:

Child abuse by children: why don’t we talk about it?

Secure care in Scotland: measuring outcomes and sharing practice

Walk this way- the benefits of walking for people and cities

In a quality city, a person should be able to live their entire life without a car, and not feel deprived” – Paul Bedford, City of Toronto Planning Director (2014)

Improvements to the design and layouts of streets and cities can have a significant impact on encouraging more of us to walk. However, many people living in cities face a significant number of barriers to being physically active where they live, particularly in relation to walking. Pathways and public spaces such as parks and throughways are often unappealing, unsafe, congested, traffic filled, noisy or for some completely inaccessible, which leads to a reliance on vehicular travel and a reluctance to be physically active within the city environment.

Walkable environments consider not only the physical design of routes, but also features and facilities that are inclusive of the widest possible range of needs; for example, places for people to rest along their journeys (including well designed seats and benches), accessible toilet facilities, signage and street design that is sensitive to a range of needs and that can help with orientation and wayfinding. However, the benefits are clear across the board when it comes to trying to make our cities more walkable (and as a result healthier). This blog post outlines a few of these potential benefits, and considers how planners can get involved in realising some of them through effective planning and design in their own cities.

Social benefits
Safe, walkable, environments can provide opportunities for people of all ages and abilities to stay socially connected and engaged. This can be particularly helpful in communities with a lot of children, older people or vulnerable adults. Having areas that are known to be safe can help to encourage people to leave their homes, reducing the impact of loneliness and social isolation, and improving their sense and feeling of community in their local area, which in turn can help with health and wellbeing and community cohesion.

Health benefits
Walking is good for us! In August this year a survey by Public Health England revealed that four in 10 middle-aged adults fail to manage even one brisk 10-minute walk a month. This despite research showing that walking each day can rapidly reduce risk of health conditions such as stroke and heart attack. Promoting active lifestyles through encouraging walking has also been shown to help tackle the growing issue of obesity, particularly among younger people. Walking can also be good for mental health, particularly when it is done as a group. Increasingly, walking interventions are being prescribed as part of social prescription initiatives to help people regain health, fitness and confidence. But in order for these to be effective, spaces and suitable environments for walking need to be made available.

Environmental benefits
For many cities, London, Manchester and Glasgow included, congestion and air pollution are major issues. Creating walkable cities, and encouraging walking, cycling and other more environmentally friendly modes of transport can have a significant impact on the levels of pollution within an area. Reducing vehicle use can also have an impact on noise, water, thermal and light pollution in our cities too. Some attempts are being made to reduce the level of pollution in our cities – vehicles in central London have been subject to a congestion charge for a number of years. However, recent developments and attempts to reduce the high levels of air pollution in the city have led to the introduction of the “T-Charge”. It has been suggested that the money raised from this charge could be used to fund green transport initiatives, and this includes improving cycle and walkways and making streets more easy to navigate on foot.

Economic benefits
Walkable spaces can act as a catalyst for local economic vitality, regeneration and tourism. Research has shown that improving public spaces, and creating an environment which encourages more people to walk safely, (and free from the noise, smell and feelings of claustrophobia that can come with high levels of car traffic) has a significant and positive impact on businesses, resulting in people spending more time, but also more money in shops and town centres.

Creating walkable cities: what can be done to help
Planners and city officials are increasingly aware of the need to promote more open, safe and accessible public spaces in new development areas. However, some cities have already implemented practices that could be taken forward in the future. Organisations like Living Streets have produced road maps and blueprints of how cities can use planning to improve public spaces, make them walker friendly and reduce reliance on vehicles. Consultancies like Arup have also produced research on the benefits of creating “walkable cities” and in 2014 RTPI launched their own report on the benefits of planning for “healthier cities” (which includes provision for making cities more walkable). In 2017 the World Health Organisation (WHO) published a briefing on transforming public spaces to promote physical activity in cities. There are a number of ways in which planners and city planning teams can have a positive impact on promoting change to encourage more walking in our cities including:

  • Create walkable neighbourhoods – In Melbourne a “local connectivity plan” was introduced in 2014. The plan was used to build a network of neighbourhoods which had social, leisure and retail facilities within a 20 minute walk of people’s homes.
  • Prioritise walking, and “walkable spaces” in development and regeneration plans – The mayor of London appointed a walking and cycling commissioner in 2017, whose role is to make walking and cycling easier and safer across the capital. The mayor’s new ‘healthy streets’ approach is a commitment to a system of healthy streets and strategies that will help Londoners use cars less and walk, cycle and use public transport more.
  • Make walking safe – Designing walkways and footpaths that incorporate wide, well lit pathways, well signposted and nicely designed and maintained routes has been shown to be one of the main factors in encouraging people to walk more within their local area.
  • Make walking easy (and fun) – Go Jauntly is a new walking app that uses photographs rather than maps to guide users on routes around woods and byways. Walkers can add their own routes, and it is hoped that it the app will “increase the social appeal of people walking together” coming up with new routes within their own neighbourhoods, or areas they like to walk in.

If you found this article interesting, you might also like to read our previous blogs:

It’s a kind of magic: how green infrastructure is changing landscapes and lives

Hidden in plain sight – the value of green spaces

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Zero suicide cities: learning from Detroit in the UK

Suicide is the biggest killer of men under the age of 45. Yet people still experience stigma when seeking help for mental illness, despite high-profile discussions of mental health issues such as those by members of the royal family and sportspeople. And a report into the Government’s suicide prevention strategy in March 2017, suggested that although 95% of local authorities now have a suicide prevention plan, there is little or no information about the quality of those plans, or whether adequate funding is available to implement them.

The lack of progress made on improving suicide and general mental health provision has led to a growing frustration among professionals and resulted in attempts to create new approaches to tackle mental health issues, and in particular to improve access to support for people in crisis or at risk of suicide.

The idea of a “zero suicide city” was first adopted in Detroit in the late 2000’s, with others following its lead in subsequent years. With reports finding that around 14 Londoners a week took their own life in 2015 (735 in total), an increase of a third from the 2014 statistics, a report in February 2017 by the London Assembly Health Committee suggested that London too should take this approach.

So what can London, and other areas of the UK, learn from Detroit’s approach? And how can services act to reduce the number of people taking their own lives?

Zero-suicide cities

Poverty and high unemployment in Detroit are contributing factors to high levels of depression among city residents. As a result of these high rates of depression and very high suicide statistics, Detroit-based mental health professionals adopted a new approach to tackle the stigma around mental illness and use identifiers to highlight cases of crisis, or potential crisis. The focus is on preventative care, encouraging professionals to act upon signs of mental illness before a suicide or attempted suicide takes place.

Patients attending health clinics for other illnesses, including diabetes or heart failure, are also now screened for depression and other mental health issues before they are released. This allows people deemed to be ‘at risk’ to be identified as soon as they come into contact with medical professionals, who can then refer the patient to a mental health specialist if needed, rather than reacting to mental illness once it reaches crisis point.

In order to support this approach, a centralised IT system was created which means results are traceable, and surveys and information are standardised so they can be used and accessed across clinics throughout Detroit. Coordination with non-medical practitioners, including social workers, employers and family members, has also been key in identifying people at risk and signposting them to help at every possible opportunity. There has also been additional training for staff to improve recognition of identifying factors. Patients can email their clinicians or liaising staff directly and attend regular drop-in appointments. Up to 12,000 patients using mental health facilities are tracked each year in the city and some statistics suggest that the clinics reduced suicides by over 80%.

There have been some criticisms of the system however, despite the reduction in the number of suicides in the city. Critics highlight the fact that many of the poorest and most severely in need of help are not reached as they do not have health insurance and so do not attend those clinics involved in the scheme.

Ultimately, however, the scheme seeks to provide better preventative, coordinated and targeted care to those who are at risk or show some signs of mental health crisis. And some in the UK have suggested there are lessons that could be learned from this approach.

Whole system approach to suicide prevention in the East of England

Four local areas in the East of England (Bedfordshire, Cambridgeshire & Peterborough, Essex and Hertfordshire) were selected in 2013 as pathfinder sites to develop new approaches to suicide prevention based in part on the Detroit model.

Since then, Mersey Care, Cambridge and Peterborough Clinical Commissioning Group and Teesside councils have also become aligned with the programme and are continuing with their approach towards improved suicide prevention. The Centre for Mental Health evaluated the work of some of the sites during 2015.

The evaluation found there were a range of activities that had taken suicide prevention activities out into local communities. They included:

  • training key public service staff such as GPs, police officers, teachers and housing officers
  • training others who may encounter someone at risk of taking their own life, such as pub landlords, coroners, private security staff, faith groups and gym workers
  • creating ‘community champions’ to put local people in control of activities relating to promoting positive mental health and signposting to help services
  • putting in place practical suicide prevention measures in ‘hot spots’ such as bridges and railways
  • working with local newspapers, radio and social media to raise awareness in the wider community
  • supporting safety planning for people at risk of suicide, involving families and carers throughout the process
  • linking with local crisis services to ensure people get speedy access to evidence-based treatments.

However, subsequent research also highlighted some of the challenges. The marketing of the pilots was seen to be damaging and misleading with regards to creating “zero suicide areas”, rather than suicide prevention areas. It has also been suggested that although the campaigns serve to raise publicity and awareness, there is little evidence that the schemes actually reduce the number of suicides in an area any more than “traditional campaigns” to better signpost people to available support.

In addition, many of the projects struggled past the initial implementation stage to have long-term impact, as the buy-in from local GPs and other service professionals was not as high as was expected.

Final thoughts

Widening and improving access to support and services for people at risk of mental ill health or suicide is a big challenge for health and social care professionals. Identifying those people at risk is one of the key barriers and taking inspiration from schemes like those trialled in Detroit is one way for professionals in the UK to adapt their approaches in order to overcome these barriers.

Providing more opportunities for people to get help, and better training for professionals who may come into contact with people with mental illness are some of the ways that current schemes are trying to address mental health and suicide in particular.

However, as many of the evaluative studies from test sites in the UK have found, going beyond that to take mental health into the community, in order to create whole system pathways of care across multiple settings and professions, remains a challenge.

As the London Assembly report pointed out, another key aspect is creating an open environment for people to talk about how they are feeling. This week is Mental Health Awareness Week 2017 and the theme is ‘surviving to thriving’ – and emphasising that good mental health is more than the absence of a mental health problem. Whether in the workplace or in the home; with friends, family or colleagues; it’s important that everyone feels that they have a space where they can talk, and to cultivate resilience and good mental health.

If you enjoyed this blog, you may also be interested in our other articles on mental health in the workplace.

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Driving diesel out of town: how cities are tackling the deadly problem of air pollution

2017 was less than a week old when, on a single day, London used up its entire annual air pollution limit.  European Union air quality standards permit the maximum safe levels of toxic nitrogen oxide (NO2) to be exceeded no more than 18 times a year. But on 6 January just one site – Brixton Road in Lambeth – generated levels of NO2 high enough to burn through the capital’s annual limit.

Experience underlined that the first breach of the year was always unlikely to be the last. In 2016, another part of London (Putney High Street) exceeded the limit 1,200 times. Other UK cities are also badly affected by air pollution. Government figures show that 38 out of the country’s 43 air quality zones breached legal limits for air pollution in 2015.

The deadly effects of air pollution

Since 2012, evidence on the effects of air pollution on the environment and public health has been mounting. Health issues such as cardiac and respiratory conditions can be aggravated by poor quality air, which can also cause lung cancer. In the UK, pollution is estimated to cause the early deaths of 40-50,000 people each year, while in London 9,500 are believed to have died prematurely in 2010 due to air pollution. Beyond the human costs, poor air quality also has economic costs (around £15-20 billion a year), as well as damaging biodiversity, wildlife and crops.

Action on air pollution

“Nearly 40 per cent of all NOx emissions within London come from diesel vehicles, and unless this is explicitly tackled it will be impossible to cleanse London’s air.”
Lethal and illegal: solving London’s air pollution crisis – IPPR

The most significant cause of poor air quality in the UK is road traffic pollution, and in particular nitrogen oxides (NOx) from diesel engines. In recent years, scientists have been highlighting the dangers of diesel, but the Volkswagen emissions scandal underscored just how bad diesel vehicles are for urban environments.

In 2015, the UK government announced plans to discourage diesel vehicles from entering clean air zones in Birmingham, Leeds, Southampton, Nottingham and Derby. Further measures are expected to be unveiled in the coming weeks. Meanwhile, the Mayor of London,  Sadiq Khan, announced yesterday that from April 2019 the most polluting vehicles will have to pay a daily charge to drive within central London. He is also proposing to expand this charge, the Ultra Low Emission Zone (ULEZ), across Greater London for heavy diesel vehicles, including buses, coaches and lorries. In the meantime, from October this year, cars, vans, minibuses, buses, coaches and heavy goods vehicles (HGVs) in central London will need to meet minimum exhaust emission standards, or pay a daily £10 Emissions Surcharge (also known as the Toxicity Charge, or T-Charge). In addition, London has been considering more innovative approaches to cleaner transport.

Last month, four House of Commons committees announced an unprecedented joint enquiry into the health and environmental effects of toxic air. Louise Ellman of the Transport Committee acknowledged the need for an efficient and flexible transport system, but added:

Emissions from vehicles are a significant problem and the standards that governments have relied on have not delivered the expected reductions. We will be asking what more can be done to increase the use of cleaner vehicles as well as to encourage the use of sustainable modes of transport.”

Cracking down on diesel vehicles

But many believe tougher action is needed, and that the time has come to drive diesel vehicles out of towns and cities.

This month, Westminster City Council becomes the first in the UK to impose additional charges for parking diesel-powered vehicles. For a trial period, drivers of diesel cars and vans will have to pay an additional 50% to park in one of the borough’s most heavily polluted streets.  Westminster’s Councillor David Harvey believes the charge will cause drivers to make more environmentally-friendly choices:

“Additional charges for diesel vehicles will mean people think twice about using highly polluting cars and invest in cleaner transport that will make a real difference in the quality of air we breathe and our environment.”

Another London council – Hackney – has gone further, announcing plans to ban any non-electric cars from parking on several streets bordering the City of London’s financial district.

International action

Beyond the UK, national and local governments are also taking the problem of air pollution caused by diesel emissions more seriously.

In December 2016, the longest and most intense pollution spike for a decade jolted the authorities in Paris into restricting traffic coming into the city. On alternate days, drivers of vehicles with odd-number and even-number licence plates were told to leave their cars at home. At the same time, public transport in the city and the suburbs was free of charge. The following month, a mandatory scheme was introduced in Paris and Lyon obliging drivers to display anti-pollution stickers indicating the age and cleanliness of their vehicles. Paris had already announced that cars registered before 1997 would be banned from the city between 8am and 8pm on weekdays.

Paris has also forged a joint agreement with Athens, Madrid and Mexico City to completely remove diesel vehicles from their city centres by 2025. The Netherlands is also believed to be considering a diesel ban, although reports of a similar move in Norway proved premature.

Meanwhile, Barcelona’s ambitions for car-free “superblocks” to improve the city’s air quality have received international attention, but have also encountered some local resistance.

The death of diesel?

Some are concerned that a total ban on diesel vehicles is being put forward too easily as a solution to the problem:

Transport for London recently sought public consultation on what they should do to improve air quality, and their website notes that people are twice as likely to die from lung diseases if they live in “deprived vs. affluent areas of London”, both signs that this problem is too complex to be solved by a blanket ban on diesel cars.”

But as the case mounts against diesel, drivers are taking note. In February 2017, registration of diesel cars in the UK fell by 9.2%, while demand for alternative fuel vehicles saw a dramatic increase of 48.9%. London and other UK cities may not yet have completely banned diesel vehicles from their centres, but increasingly the question is not if, but when.

If you’ve enjoyed this blog post, check out our other articles on air quality:

Graduate ‘brain drain’ – is regional economic growth the solution?

college graduates groupBy Heather Cameron

With the economic performance of cities and regions increasingly reliant on the skills of their workforce, the longstanding issue of graduate ‘brain drain’ to London and the south is something that needs to be addressed.

Although students attend many of the universities spread across the country, a significant number of graduates flock towards the capital at the end of their studies. According to a recent report from Centre for Cities, this deprives other cities of skilled workers and essentially damages the overall economy.

The evidence

A quarter of all new graduates in 2014 and 2015 were found to have moved to work in London within the six months of finishing their degree. And the highest achievers make up a significant proportion. While London accounts for around 19% of all jobs, of the graduates that moved city six months after graduation London employed 22% of all working new graduates, and 38% of those with a first or upper second class degree from a Russell Group university.

Although most cities experience an overall graduate gain, cities outside London don’t retain the majority of students that move to their city to study – the ‘bouncers’ that drive the brain drain overall, overshadowing any gain:

  • Manchester lost 67% of these students upon graduation;
  • Birmingham lost 76%; and
  • Southampton lost 86%.

Other figures show that 310,000 graduates have left the north in the past decade, contributing to a net average deficit of 7,500 highly qualified workers leaving annually, or 75,500 over a decade.

Northern regions have to some extent offset the effect of local brain drain by attracting enough highly qualified foreign workers to fill the gap. But with reductions in immigration, these regions could be left lacking.

Given the UK’s current position regarding the EU, concerns have also been raised over whether Britain faces a further brain drain of academics to Europe, following Brexit. A recent survey highlighted that 42% of academics said they are more likely to consider leaving Britain after the vote to leave.


While it may seem plausible to assume that higher salaries are the reason for this brain drain, it appears that the main pull for graduates is the availability of jobs and career progression, which London’s vast labour market offers.

However, as recent research from Homes for the North has identified, these are not the only reasons. It highlights the importance of additional non-work drivers of graduate location decisions, including the cost and quality of housing, quality of local amenities and the prospect of home ownership.

Of the graduates polled, 80% said the quality of housing was important, while more than 60% said the cost of housing was important. The quality of green spaces and local amenities was also deemed important by over 60% of graduates.

What can be done to redress the balance?

There have been numerous graduate retention initiatives at the local and regional level aimed at tackling the uneven distribution of graduates, such as graduate wage subsidies and local graduate job matching.  But it seems little has improved. The Centre for Cities research argues that these alone will not tackle the root cause of the graduate brain drain.

It suggests that cities themselves have a vital role to play in ensuring the local job market offers an appropriate number of graduate job opportunities that will allow them to both retain graduates and attract graduates from elsewhere. Policy should therefore broaden its focus to improve local economies by investing in transport, housing and enterprise, rather than focusing solely on graduate retention and attraction policies.

The chief executive of the Centre for Cities commented that the government’s new economic and industrial strategy should be used to strengthen existing devolution deals for city-regions such as Greater Manchester, extending their scope to grow.

Indeed, the industrial strategy green paper, published in January, clearly places emphasis on addressing the economic imbalances across the UK through a number of measures, such as working with local areas to close the skills gap, including new schemes to support the retention and attraction of graduates. However, the strategy has been criticised for providing little clarity on how regional rebalancing and sectoral deals will work in practice.

Final thoughts

While it appears clear that cities outside London need to improve their graduate offer with better job prospects, the evidence on graduate migration suggests it is more complex than this.

As has been argued, the provision of good quality affordable housing could play a role alongside high-skilled job creation and opportunities. With the cost of living in London so expensive, this would make sense, particularly as the average graduate salary in London is not that much higher than the average across other UK cities.

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Night mayors: building bridges between businesses and communities

We’ve previously written about the importance of the night-time economy as a driver of tourism, leisure and business growth in towns and cities. And we’ve also blogged about the challenges facing night-time industries, notably the number of nightclubs forced to close due to economic factors and security concerns.

A growing number of city authorities are responding to these developments, and exploring new ways of meeting the distinctive economic development, public safety and quality of life demands presented by cities after dark.

The pros and cons of the after-hours economy

The UK night-time economy is substantial. One estimate has put its value at £66bn, employing 1.3m people. In London, an already thriving after-hours economy is set to grow by a further £77m a year following this year’s launch of the 24-hour Tube on the Victoria, Central and Piccadilly lines.

But a city’s nightlife is about more than commerce. Noise, violence and other forms of anti-social behaviour can upset nearby residents, and put people off living in or visiting a city.

Some authorities have taken a hard line towards areas with a reputation for trouble at night. The New South Wales government has introduced laws to crack down on drug and alcohol-fuelled violence in parts of Sydney. But, while the new rules – including 1.30am lockouts and 3am last drinks at nightclubs – have reduced street crime, their impact on Sydney’s night-time economy has been devastating. More than 100 venues have closed, and the once booming entertainment district of King’s Cross is now being described as a ghost town.

Night mayors: bridging the divide

There’s a balance to be struck between protecting communities from anti-social behaviour and enabling a dynamic night-time economy to flourish. One idea for bridging these competing interests is the appointment of an individual dedicated to the needs of the city after dark.

Shortly after the Night Tube started operations, the Mayor of London, Sadiq Khan, announced plans to appoint a “Night Czar”. The role of this new figure will be to engage with night-time businesses, residents and public authorities, and to create a “vision for London as a 24-hour city”. And on 4 November it was confirmed that the new Night Czar would be the writer, broadcaster, DJ, performer and campaigner Amy Lamé.

London is following a trend set by other cities that have recognised the need for a distinct approach to their after-hours economies. In 2014, Marik Milan was elected Amsterdam’s first night mayor. Previously a nightclub promoter, Milan leads a non-profit foundation funded jointly by the city council and the business community.

One of his early successes has been helping to establish 24-hour licences for selected nightclubs on the outskirts of Amsterdam. It’s hoped that the relaxation of licensing laws will help to relieve the pressure on the city centre, while regenerating pockets of the city lacking both daytime and night-time offerings. And, given that most problems happen when clubs are opening or closing, the 24-hour approach may also lower the chances of disturbances.

Marik Milan also wants to bring some of the positive lessons from music festivals into the centre of Amsterdam. He’s suggested that the presence of stewards, trained in how to de-escalate situations and report incidents, could make for a safer city, especially at weekends.

Milan believes his approach, in contrast to that adopted in Sydney, is more likely to bring positive results:

“Cities are always interested in solutions, but if they keep treating night life as a problem, they’ll keep having the same outcome.”

An idea whose time has come?

The successful deployment of night mayors in Amsterdam and other Dutch cities has prompted municipalities around the world to consider, and in some cases, to copy their example. In France, night mayors have been elected in Paris, Toulouse and Nantes, and they are also to be seen in Zurich and most recently in the Colombian city of Cali. Similar posts have been proposed for cities such as Berlin, Dublin, Toronto and New York.

Earlier this year, Amsterdam hosted the first Night Mayors Summit, at which city representatives could combine knowledge and share experiences on their night-time economies. This short film, from Monocle magazine, reports on the summit, and explains how the cities of Amsterdam, Berlin, Tokyo and Sao Paulo are exploring creative approaches to managing the night-time economy.

It remains to be seen whether London’s new night czar can win the support of local communities while championing the capital’s night time culture. But the experience of Amsterdam suggests that it’s an idea worth exploring.

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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.


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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Controlling the urban landscape: the pros and cons of putting public spaces in private hands


A 2007 report from the Royal Institution of Chartered Surveyors (RICS) described the growing private ownership and management of the public realm as a “quiet revolution in land ownership”.

The study included a handful of early examples, such as the Excel Centre and Canary Wharf in London, and Liverpool’s Paradise Street development (later rebranded Liverpool One). Since then, more of these privately owned public spaces (POPS) have been appearing across the UK, including Granary Square and the Queen Elizabeth Olympic Park in London, Gunwharf Quays in Portsmouth, and Brindleyplace in Birmingham.

The evolution of public space

Until relatively recently, local government owned, managed and maintained streets and squares in the UK’s towns and cities. But over the past two decades, budgetary constraints have diminished local authorities’ ability to maintain the public realm. Increasingly, the gap has been filled by the private sector, which has created new POPS.

On the face of it, the redevelopment of previously run-down areas with no cost to the public purse would appear to be a good thing. But there are concerns about the private landlords of these spaces who have the power to restrict and control activities of the public using these spaces.  Alongside these new private-public developments, the rise of Business Improvement Districts (BIDs) has increased private sector influence over town and city centres.

A bridge too far?

The issue of privatised public spaces was given renewed prominence with the proposals for a new “Garden Bridge” across the River Thames. Designed by Thomas Heatherwick  the project envisions a pedestrian bridge with its own elevated garden.

Supporters say the Garden Bridge will enrich London, providing economic, environmental and aesthetic benefits. But opponents have expressed concerns about a list of rules prohibiting activities on the bridge, such as busking and cycling. Restrictions of this kind have been applied to other POPS, sometimes resulting in awkward encounters between members of the public and security guards representing the property managers.

As things stand, the fate of the Garden Bridge remains uncertain, following the decision by the Mayor of London to set up an inquiry into the project’s use of public money, and a warning from the National Audit Office that the money may have been wasted.

The pros and cons of POPS

But does it really matter if urban spaces that appear to be public are actually privately-owned?

No, say POPS supporters. Without private funding, spaces such as Brindleyplace and LiverpoolOne might not have been developed at all. Furthermore, the cost of maintaining these privately owned public spaces can be borne by the private sector, instead of local authorities (and the taxpayer). They also point to Liverpool One as a successful example of town centre regeneration, and suggest that private ownership of public space can be a catalyst for renewal of neglected spaces.

But others are unhappy with the creeping privatisation of public spaces, arguing that they sacrifice community spirit and historical identity for the sake of a sterile, monotonous, corporatised spaces. Opponents of POPS are also concerned about the restrictions land owners place on such spaces.

The view from Aberdeen

One city which has recently bucked the trend towards private control over public spaces is Aberdeen. In 2010, the city council planned to hand over the historic Union Terrace Gardens in the city centre to a consortium of business interests – Aberdeen City Garden Trust – under a long lease. The trust released its plans to redesign the Victorian park, raising the sunken gardens to street level. Campaign groups mounted opposition to the scheme, but it was narrowly approved in a city-wide referendum in 2012. However, a new Labour administration came to power shortly after the referendum, and the scheme was finally scrapped. During the summer of 2016, the council announced new plans to redevelop the site, which will remain in public hands.

Final thoughts

The Aberdeen example shows that moves to put public spaces in private hands are not universally popular, or inevitable. Even so, many local authorities are struggling to maintain public spaces, leaving the way open for private developers. The Queen Elizabeth Olympic Park, in the borough of Newham, is one of the most recent POPS to appear in London. Sir Robin Wales, the elected mayor of Newham would have preferred the park to be maintained using public funds, but has accepted that his borough could not afford to manage it: “We know we don’t have an income stream.”

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