19. Linking Landscape Planning and Health

Landscape Planning in Germany is an independent official planning instrument regulated by §§ 8–12 of the German Federal Nature Conservation Act (Bundesnaturschutzgesetz – BNatSchG) and the respective sections of the nature conservation acts of the 16 German federal states.² Landscape Planning generally exists on four different spatial-administrative levels or tiers: federal state, region (or similar administrative units, e.g. counties), municipalities, and partial areas of municipalities. On each of these levels, landscape plans cover the entire planning area, which means they comprise settlements as well as non-settlement areas (the only exception being North Rhine-Westphalia). Landscape planning aims to achieve the objectives of nature conservation as laid down in § 1 of the Federal Nature Conservation Act (BNatSchG) through protection, management, development and restoration of nature and landscapes. These objectives are the long-term safeguarding of: (1) biological diversity; (2) the performance and functioning of ecosystems, including their ability to regenerate, and the sustainable provisioning of natural resource functions; and (3) the diversity, uniqueness and beauty as well as the recreation value of nature and landscapes. Thus, landscape planning serves as a spatially oriented sectoral planning instrument for nature conservation, and delivers an ‘ecological contribution’ to comprehensive land use and spatial planning and other sectoral plans, such as traffic, agricultural and forestry planning. Requirements formulated by the landscape plans have to be integrated into the respective spatial or land-use plans at the same spatial level in order to become legally binding. Nonetheless, spatial or land use plans and sectoral plans have to consider the requirements of landscape plans, but can deviate from them if appropriate reasons are given in the planning process. Thus, there is a strong link between landscape and spatial planning (at the regional and federal state level) and land use planning (at the local level), even if landscape planning remains independent. Furthermore, all spatial and land use plans (and in some federal states, also landscape plans), are usually subject to a Strategic Environmental Assessment (SEA) according to the EU SEA Directive, by which potential impacts of plans on the environment and on human health are assessed. In the following text we concentrate on landscape plans at municipal level (aka ‘The local landscape plan’), as this is a sufficiently concrete level (scale usually 1:10.000), appropriate for considering health issues related to distinct areas; although health topics could also be an issue at other levels in the planning system.

In the UK, planning is devolved to the four countries of England, Wales, Scotland and Northern Ireland, whose enabling legislation and guidance tools are largely country-specific (Winter et al. 2016). The English planning system, on which we put a certain focus here, differs strongly from the German one; with the ‘Localism Act’ of 2011 the regional planning tier was abolished and almost all planning responsibility was conferred to the local level. The only guidance for local planning is given by the ‘National Planning Policy Framework’ (NPPF, Department for Communities and Local Government 2012), which has to be “taken into account in the preparation of local and neighbourhood plans, and is a material consideration in planning decisions” (ibid., p. 1), the legislative basis of which are the ‘Planning & Compulsory Purchase Act’ (2004) and the ‘Town and Country Planning Regulations’ (2012). Local Plans have taken over the function of the former ‘Local Development Frameworks,’ which were a portfolio of different planning documents, with a ‘Core Strategy’ as their central element. Both kinds of local planning documents still co-exist and have to consider environmental and landscape issues, according to sections 9 (‘Protecting Green Belt land’) and 11 (‘Conserving and Enhancing the Natural Environment’) of the NPPF. Under the Town and Country Planning (Environmental Impact Assessment) Regulations 2017, local planning authorities have a general responsibility to consider the environmental implications of developments that are subject to planning control. The 2017 Regulations integrate Environmental Impact Assessment (EIA) procedures into this framework but apply only to those projects that are likely to have significant effects on the environment, e.g. airports, major road developments; power generation installations; mining, etc.

Despite environmental issues only playing a subordinate role in the formal UK planning systems, no separate or independent landscape planning system exists. One could argue that this obvious neglect of environmental and landscape issues in UK land-use planning has led to attempts to fill that gap, for example, by a considerable amount of local and (sub-)regional level, informal planning instruments such as ‘Green Infrastructure Frameworks’ and ‘Green Infrastructure Strategies’ (for a comprehensive overview on the political and neo-liberal background of this development see Hehn 2016). Green Infrastructure (GI) is “a network of multi-functional green space, urban and rural, which is capable of delivering a wide range of environmental and quality of life benefits for local communities” (Department for Communities and Local Government 2012, p. 52). The respective definitions of GI can differ and include different types of ‘green’ (e.g. even light railway lines) or aquatic features such as rivers, canals and ponds (ibid.). GI strategies are prepared at a local level to establish, maintain and enhance a municipality’s GI, often not only to achieve ecological aims but also economic and social benefits (e.g. economic growth, property values, labor productivity, social cohesion, or quality of place) (Manchester City Council 2015). Many GI-strategies are explicitly aimed – amongst other things – at improving the health and well-being of residents. To some extent, aims or measures stated in GI strategies are incorporated into the Local Plans and/or Core Strategies and thereby influence official, legally binding plans. In the following sections we concentrate on Local Plans/Core Strategies and GI strategies, particularly regarding possible differences in how they tackle health issues.

As there is a certain ‘traditional’ (even if criticised and contested) emphasis on biodiversity in landscape plans in Germany, human health has never been an important topic there. Although human health is mentioned in §1 BNatSchG as one reason for protecting nature, it doesn’t have the status of a ‘natural asset,’ which landscape planning is obliged to deal with. Consequently, considering health issues is a voluntary task, unless landscape plans are subject to a SEA, as is the case in some federal states. In such a case, potential health impacts of the landscape plan have to be assessed and valued, but still no kind of ‘pro-active planning for health,’ especially regarding health promotion, is required. Furthermore, differentiated knowledge about health effects of biodiversity, landscape and green spaces is often lacking amongst conservationists and landscape planners, at least if it reaches beyond the general notion that ‘a good environmental condition is the basis of human life.’ At the same time, health authorities are seldom involved in planning decisions. Consequently, very few landscape plans explicitly and pro-actively refer to human health (Rittel et al. 2016). Where this is done, it happens in the context of experiencing nature, urban green spaces and recreation, as in the local landscape plan of the city of Hohen Neuendorf (Stadt Hohen Neuendorf 2014) as an example.

Nonetheless there are many links to health issues in landscape planning in general, but also in the respective single planning documents. Human health is often addressed implicitly, e.g. when dealing with ‘recreation,’ but also when dealing with other issues, such as air purification, groundwater protection, soil conservation, climate change, etc. (see examples in Sect. 19.2 and more comprehensively in Sect. 19.4). But these connections – and therefore the relevance of conserving and enhancing landscape and green spaces for human health – are not explicitly set out. As such, it has to be assumed that landscape-health relationships are largely irrelevant as a basis for political and administrative decisions, even if health impacts of intended land use changes have to be assessed by the SEA for local land-use plans, which, again, are mainly restricted to the avoidance or minimization of potential negative impacts of the plan, e.g. by noise and air pollution or the release of hazardous waste. More attention is paid to health in some informal planning concepts on urban development (Claßen and Mekel 2017; Rittel et al. 2016), but there is no strong link to landscape plans.

During the last few years, health has received increasing consideration in different documents (and sometimes additional funding) related to issues of landscape and urban green space planning, published by the German Ministry for Environment and Building (German Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety, BMUB)³ and the Federal Agency for Nature Conservation (BfN). In some cases, this is linked to the concepts of Green Infrastructure and Ecosystem Services, which, despite many possible points of critique (e.g. Heiland et al. 2016; Silvertown 2015), suggest an intention to raise awareness for a stronger consideration of health (and other human needs and interests) in nature conservation, landscape planning and landscape architecture. Examples include the ‘Federal Green Infrastructure Concept’ (BfN 2017a) and its underlying research report (Heiland et al. 2017), the reports of TEEB Germany for urban and rural areas (Naturkapital Deutschland – TEEB DE 2016a, b), the ‘Urban Green Infrastructure’ brochure with recommendations for municipalities (BfN 2017b) and the ‘White Paper on Urban Green’ (BMUB 2017). Rittel et al. (2016), being a result of a research project funded by the BfN, directly addresses municipalities in order to use synergies between landscape planning and health. It remains to be seen how these efforts and documents affect planning practice in the mid- to long-term perspective.

As in Germany, public health has only become a formal consideration within the UK planning system relatively recently, although it should be noted that the promotion of public parks in urban areas in 19th century UK was premised on the need to protect the health of industrial workers. The current planning system is based conceptually on post-WW2 Town and Country Planning legislation, which made implicit (but not explicit) assumptions about the desirability of separating industrial zones from residential and recreational areas, in order to protect health.

Currently, Health Impact Assessment (HIA) across the UK is promoted by the government’s Department of Health (DH) as a means to assess the health impact of new government policy and its implementation (DH 2010a, b). Government guidance on the planning system states that local planning authorities should ensure that health and well-being and health infrastructure are considered in local and neighbourhood plans and in planning decision making. However, the use of HIA in the UK is only recommended as one way of considering the issues: “A health impact assessment may be a useful tool to use where there are expected to be significant impacts” (Ministry for Housing, Communities and Local Government 2014). Nonetheless, this guidance regards GI as a tool to link health and planning. It names safe and green open spaces as places for active play and food growing, and identifies green space accessibility by walking, cycling and public transport as attributes of a healthy community.

To gain insight into the current trend of incorporating health issues into the UK’s spatial plans, an analysis of ten English planning documents has been carried out: six Core Strategies/Local Plans and four GI Strategies, all published or adopted in 2010 or later.⁴ The planning documents were chosen to cover municipalities differing from one another in terms of inhabitants, size and geographical location as well as legal liability (Local Plans and Core Strategies being statutory, GI Strategies being informal and voluntary).⁵

The findings show that all planning documents deal with human health, but in different ways. All six Core Strategies/Local Plans mention health issues only implicitly, mainly in the context of climate change adaptation and mitigation as well as flood defense, thereby strongly targeting health protection. In contrast, all four GI Strategies explicitly name the improvement of health, due to the establishment or improvement of GI, as an objective, aim, or vision, and clearly refer to health promotion (e.g. encouraging active exercise in green spaces), while health protection plays a subordinated role in most cases. Nonetheless, both kinds of planning documents address physical activity by identifying the need for high-quality walking and cycling routes. However, differing reasons are given: Core Strategies/Local Plans mainly justify this on the basis of reduced vehicle emissions, improved safety of pedestrians and cyclists, as well as less congestion; whereas GI Strategies strongly promote access to the outdoors to encourage physical activity, leading to reduced obesity and respiratory diseases. Again, GI Strategies connect green structures and health more directly and explicitly.

Two important requirements of health are recreation and food supply. Recreation is frequently mentioned in the two kinds of planning documents: Green spaces are recognised as recreational opportunities and thus their maintenance or improvement is generally seen as an important goal of planning in all of the ten analyzed documents, even though they are more often and more intensively mentioned in GI strategies. Most of the investigated GI documents draw an explicit connection between healthier lifestyles and the improvement of areas for recreation. The investigated Local Plans/Core Strategies (with a few exceptions) do not draw this connection but rather look at recreational areas from a planning point of view (e.g. maintenance and development of a network of recreational routes that provide easy access to countryside areas ensuring that the need for recreational areas of all residents is met).

Regarding food supply, half of the investigated documents – three Core Strategies/Local Plans and two GI Strategies – promote ‘grow your own’ schemes. These include community food groups as well as individual growing plots and allotments. It should be noted that the health benefits of growing one’s own food are not only from healthy nutrition but also arise from the physical outdoor activity (and potential social cohesion benefits) related to it. Van den Berg et al.’s (2010) study of 120 allotment holders and 60 non-gardeners in the Netherlands found that allotment gardeners are more physically active; 84% of allotment gardeners met the national recommendations for physical activity, compared to 62% of non-gardeners.

To sum up, as far as our selection of ten case studies allows, it can be said that the contribution of green spaces and elements to human health is already integrated into England’s planning approaches, but it is more explicit in the informal and voluntary GI documents. Core Strategies/Local Plans refer to health issues in an implicit way by dealing with topics such as climate change adaptation and mitigation, walking and cycling routes, recreation, or ‘grow your own’ schemes, without clearly mentioning the health effects of the respective aims and actions. Therefore, it can be assumed that the status quo in official planning documents is similar to Germany. Recently, Public Health England has issued guidance (2017) to try to link HIA to EIA, and to encourage public health teams to engage with the planning system in this regard. It recognises that, for major developments at least, the consideration of impacts needs to be multi-dimensional and consider health as well as the landscape and other environmental issues.

Before considering specific health benefits that green spaces can offer, general quality criteria must almost always be fulfilled in order to ensure, at least in principle, that people may be willing and able to use a green space and therefore take advantage of its health potential. The criteria that support inclusive use include: safety issues (e.g. ensuring good visibility), cleanliness (e.g. provision and emptying of waste bins, lack of vandalism), appropriate equipment for different types of uses (e.g. benches, playgrounds, providing shade), sufficient pathways, accessibility and approachability (e.g. enough entrances, including step-free ones, consideration of potential obstacles such as busy roads).

Aesthetic-symbolic health potentials can be promoted by designing green spaces in a way which enables people to perceive a green space as attractive, ‘unique’ and to identify with it. This is closely related to its perceived beauty (evoked, e.g. by the play of light and shadow, water in various forms, sightlines, trees and different types of vegetation, attractive leaves and flowers) and to the emphasis or creation of features that reflect typical local characteristics. Of course, ‘beauty’ and ‘place identity’ are based on different individual and community values and experience, a fact reinforcing the importance of user analysis and/or stakeholder participation.

Social health can be promoted by allowing for interaction and integration, e.g. by areas usable for picnics, playing, growing food or organising community gatherings and events, etc., by separating areas for different, conflicting uses, and by use of barrier-free design, e.g. allowing access for wheelchairs and pushchairs and for people with mobility and sensory impairments. Enabling and fostering nature experience (e.g. by a variety of plant species also providing food for insects and birds, areas managed to promote wildlife and maintained less intensively; see Davies et al. Chap. 12, this volume), opportunities for gardening and self-harvesting, but also retreats which offer the possibility for quiet relaxation and restoration are important for mental health and stress-reduction (see Marselle et al. Chap. 9, this volume).

With regard to physical health, a range of options for play and sports should be provided, as well as for walking (by far the most common form of physical activity), although possible conflicts between nature conservation and health must be taken into account. This applies to allergenic plants (see Damialis et al. Chap 3, this volume), plants with thorns and toxic parts (especially near playgrounds for children), or meadows managed for wildlife, rather than closely mown lawns, which could increase the risk of tick infestation (WHO 2016; Müller et al. Chap. 4, this volume).

In conclusion, two points must be emphasised: Firstly, one single green space will not usually include all recommended features and elements, as this is unlikely to be possible in a limited space and as individual elements and uses can be in conflict with each other. Secondly, all points described in this section exclusively refer to health aspects, not to other requirements green spaces should fulfill, e.g. in terms of biodiversity and nature conservation or climate adaptation. Of course, in landscape planning these other demands have to be considered as well, and sound decisions have to be made in favour of one of them if conflicts cannot be avoided or minimised.

Especially in urban areas, it is not individual green spaces which determine the ‘green quality’ of a city, but the entire system of green spaces, which is unique to every city. Relevant questions for human health regarding this are as follows: How are different green spaces distributed within a city (and its surrounding regions)? Is there a spatial concentration of green spaces or are they evenly distributed across the city? How many inhabitants have easy access to these spaces and are they close to their homes? Do different green spaces offer possibilities for different uses and requirements, so that the whole green space system enables a good variety of uses and offers possibilities for many different user preferences? Are the green spaces interlinked (for example by smaller ‘greenways’) that allow for walking, hiking or cycling in a green environment for a longer distance? Only after these questions are answered, can the potential health effects of ‘local green’ be assessed for an entire municipality or city.

To ensure a minimum supply of public green spaces to their inhabitants, different cities have come up with standard values on recommended accessibility standards for green space per inhabitant. Some consider a minimum size of green space that should be available within a maximum distance from every inhabitant’s home, e.g. Natural England’s 2010 recommendation (by no means always met) of a minimum of 2 ha of green space within 300 m (5 minutes’ walk) of home. Others consider a minimum of green space per inhabitant. In Berlin, for example, 6 m² per inhabitant are considered necessary, even if this standard is not fulfilled in all parts of the city (Umweltatlas Berlin 2017). Beyond this, distinctions are made between different types of green spaces regarding their proximity to housing areas (Rittel et al. 2016, 56f; WHO 2016). Furthermore, the spatial network of all green spaces and greenways of a city is crucial. Beyond supporting walking or hiking during leisure time (e.g. ‘20 green main routes’ in Berlin, the Highline Park in New York), this should encourage daily physical activity as an integral part of people’s life, which is, according to health scientists, one of the most important aspects of health promotion in settlement areas (Rittel et al. 2016, p. 59; Ward Thompson 2013). The journey to work, to school, going shopping, etc. should be covered as much as possible - not by car - but on foot or by bike. Special attention to this issue is paid in the next section.