A PROSPECTIVE RAPID INTEGRATED HEALTH IMPACT ASSESSMENT OF THE PROPOSED DEVELOPMENT OF A RETIREMENT VILLAGE AT BALTIC WHARF - TOTNES (Oct 2008)

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Background

Health Impact Assessment is an evidence-based process that aims to predict the positive and negative impacts of a strategy, proposal or development. Climate change and energy vulnerability present significant challenges for the development and sustainability of our communities. The adverse effects are likely to be particularly directed at the poor as energy poverty will increase and food security will be compromised, thus increasing inequalities in health. The Health Impact Assessment process provides an opportunity to promote sustainable communities, by ensuring that new strategies and developments are considered in the context of their contribution to the health and wellbeing of local populations.

Methods

A Rapid Integerated (health) Impact Assessment (IHIA) of the proposed retirement village within a planned development at Baltic Wharf, Totnes was carried out. An impact assessment tool specifically designed to consider sustainable development was used. This took the format of a desk-based assessment, using the development plans and additional evidence in order to coinsider the positive and negative impacts according to specific sustainability criteria. Participants included Public Health experts, representation from the local commuity and representives from the organisations planning the development. The purpose of this assessment was twofold: (i) to assess the sustainability of the development; (ii) to provide an example of how Health Impact Assessment can support and underpin the development of sustainable communities.

Results

Evidence gained from this IHIA indicates that the developer of the Baltic Wharf site (TQ9P) has taken environmental issues into consideration, and has also taken care to ensure that principles of sustainability (where considered practical) have been included in the development plans. However it is not clear if the plans for the Continuing Care Retirement Community development (CCRC) will meet the same building standards proposed for other areas of the site. The Baltic Wharf development appears to provide an opportunity to redevelop a brownfield site which will benefit the local community in terms of employment, housing, access to public space, and other amenities. The planned mixed open-market and social housing provides an opportunity to address the current lack of affordable homes in Totnes. The IHIA provides evidence to suggest that the CCRC may attract individuals from outside of the local community, thus potentially adding to the existing demand on local resources and services, in particular health services. Furthermore it is unlikely that those living in the social housing within Baltic Wharf would have the financial resources to move into the CCRC as this facility is likely to be expensive. Measures to mitigate these and other sustainability impacts need to be considered and implemented.

It is not clear if the Baltic Wharf development falls within the number of new homes proposed in the South Hams District Council (SHDC) Development Plan Document, or are additional to these numbers. If they are additional, the proposed development may result in local opposition and will further stretch local resources. However local support has been expressed for development on this site in contrast to other sites, and Baltic Wharf was identified as a preferred site within the SHDC Development Plan Document.   

Conclusions

The IHIA tool appeared to be a thorough template upon which to build an evaluation of the merits of the development proposals.

The emphasis on narrative rather than an artificial scoring device or Likert scale was useful as this required us to conclude that particular components of the development were either positive or negative, needed further investigation or were not applicable. Furthermore, the specific requirement to consider measures for maximisation and mitigation allowed for a facilitative rather than punitive approach. It was, perhaps too thorough to the point that some topics were not applicable to this development, and there was some replication in the questions.  This isn’t necessarily a weakness in the tool but it could, with greater experience in using it, be judiciously edited so that it applied only to the relevant topics.

The proposals for the Baltic Wharf development have clearly made sustainability central to the development plans. Therefore it would be a good test of the IHIA tool to use it again on another development where the developer had not already demonstrated an understanding and consideration of principles associated with sustainability. In this sort of situation the IHIA tool would be excellent for highlighting areas that needed attention.

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Recommendations

Policy and practice: Given the increasing concerns about sustainability (climate change and energy vulnerability) it makes sense for local governments to implement a policy that requires Integrated Health Impact Assessments (IHIA) to be undertaken on all new developments and strategic plans. Indeed this is already the case for many District Councils. Furthermore, in association with standard public consultation processes, IHIA draw together diverse and relevant agencies to input the necessary skills to provide the evidence of the potential impacts of strategies / developments on current and future infrastructure, as well as on health and wellbeing. Thus providing a rigorours and defensible evidence-base for local government decisions.

Education: The use of IHIA provides an opportunity to engage students of health and social care in a process that encompases the wider determinants of health in an evidence-based and systematic way. A wide range of impact assessment tools and development plans could be integrated into the health and social care curriculum, drawing together different skills and promoting interprofessional learning.

Limitations

A broad section of skills and local knowledge was available for this IHIA as evidenced by the participants. However, this IHIA was limited by the rapidity with which it was undertaken, the information available for the assessment and the lack of wider consultation with the local population. Therefore the outcomes of the assessment should be considered alongside other evidence and consultation.

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