Is Transition good for a community’s health? Janet Richardson is Professor of Health Services Research at Plymouth University in the School of Health and Human Sciences and is the first person to do a Health Impact Assessment of a Transition initiative. In 2011 she did a “rapid” Assessment for Transition Town Totnes. What did it discover, and what can we learn from that?
What is a Health Impact Assessment?
A Health Impact Assessment is a framework which includes a number of tools to assess the potential health impact of something like a planning decision, it could be around the building of a major supermarket or a housing estate. It’s a mechanism for looking at the potential health and wellbeing impacts on the community who are likely to be directly affected by the changes.
You did one for Totnes in 2011 that looked at the health impacts particularly around the Transition Streets programme that was running at the time. Could you tell us a bit about that and what its findings were?
We looked at one of the major Transition Town projects, the Transition Streets initiative and we applied a Health Impact Assessment framework, but particularly looking at sustainability. Obviously the focus on the Transition Streets is around building resilience and looking at sustainability around peak oil and the effects of climate change.
We used that framework and allied that framework to a Health Impact Assessment decision making tool. It was a rapid Health Impact Assessment, so we looked at desk-based material and we also interviewed key informants in the community who would potentially give a different view, so they were purposely selected in order to provide a range of views about the project.
What we found was that on a range of health and wellbeing measures the initiative itself had enormous capacity to increase the health and wellbeing of the people who were participating in that particular project, the Transition Streets initiative. Primarily that health and wellbeing benefit was through community engagement and engaging with immediate neighbours.
The health and wellbeing benefits of increasing socialisation and increased capacity to engage with the local neighbours who the people involved in the project might not ordinarily have engaged with, because there was a focus to that engagement. Other benefits were around exercise, so increasingly the people involved with the project were spending more time outdoors, working in their gardens, sharing food, cycling, those kinds of benefits.
The potential health and wellbeing benefits were associated with the people who were engaged in the project. One of the issues that we raised was the need then to look at people who are not engaged in the project like that in the town, and how those benefits through engagement can filter out across the town to other people who are perhaps harder to reach groups. That’s one thing that’s quite a challenge to do anyway, in any kind of project – a Transition Town project but also a health promotion project or community engagement project. It’s really how you have a mechanism for engaging those hard to reach groups who potentially could have much more benefit than the ones who are likely to engage.
How big a piece of work would it be to do a Health Impact Assessment of the impact that Transition Town Totnes has had since it started?
That would be a really interesting piece of work because what you’d be looking at is not just the impact on the local community but the impact on the infrastructure as well. Health Impact Assessments do also look at the impact on the development of infrastructure so it could be small scale, large scale, but I think so many years on that would be an interesting retrospective. The thing with the impact assessment framework and the process is that often the process is done retrospectively. It’s much better, particularly for planning development if the process can be done prospectively, so what you can do in terms of benefits is look at potential mitigating factors.
If you see that the likelihood of changing traffic flow to accommodate a housing estate or a supermarket is going to potentially increase the risk of road traffic accidents, you can mitigate for that. So it’s a really good framework to develop mitigation strategies for developments. Also, retrospectively you can look at what benefits you might have had from the impact of the project as a whole.
If you look across what a group like Transition Town Totnes does, you could argue that pretty much everything it does benefits public health, like being involved with a community energy company, having a greater sense of agency as to where the future of your community is going – it’s hard to think of anything involved with Transition that doesn’t have a benefit. How do you see that overlap, that merging of the two?
There are overlaps at different levels. If you start with an end point such as a disaster: major flooding for an example that we’ve seen recently and are likely to see more of. There are obviously disaster management plans in place. Those could potentially overlap with the social capital in the town.
If you know where the social capital is in the town and the skills, particularly in a town like Totnes with such a range of diverse skills, if there’s the potential for at that point in time within your disaster planning to know what the social capital in the town is.
More broadly with the health service which is a huge consumer of energy, there’s lots of overlap there in terms of how we manage it. The NHS Sustainable Development Unit is doing sterling work on that, focusing on the estates management and being more energy efficient. But public health has a huge remit for health promotion and primary prevention and a lot of the work around Transition is capitalising on staying well.
The challenge is behaviour change. With behaviour change it’s harder to change behaviour for the benefit of some things that are going to happen in X number of years. Climate change is a bit like smoking. Obviously the long-term benefits of giving up smoking are phenomenal. The short-term benefits are good as well.
But it’s about educating and supporting people to change their behaviour in a way that is going to be good ultimately for the planet and for our children but also will have immediate impacts on health and I think those are the kinds of messages around Transition and working alongside public health that can be quite positive.
There is huge potential and particularly with the ageing population and the need to look at loneliness and how we support people with long term conditions. Building social capital and community resilience can really be mobilised to support some key public health issues.
[This is an abridged version of the full interview, which you can hear below]