Appendix 1 - Health and Well-being Screening Assessment · PDF fileWellbeing Screening Assessment for the Regeneration Plan. Appendix 1 ... China Clay & St Blazey Regeneration Plan

Appendix 1 - Health and Well-being

Screening Assessment of St Austell, St Blazey

and China Clay Area Regeneration Plan

Cornwall Council

May 2012

Health and Wellbeing Screening Assessment of St Austell, St Blazey and

China Clay Area Regeneration Plan

WHV285300JC

200.1

Prepared for Cornwall Council

County Hall Treyew Road

Truro TR1 3AY

Prepared by Parsons Brinckerhoff

The Forum Barnfield Road

Exeter EX1 1QR

www.pbworld.co.uk

CONTENTS Page

Executive Summary ...................................................................................... 1 1 Introduction ........................................................................................ 4 2 Health and well-being screening assessment of the St Austell, St Blazey

and China Clay Area regeneration plan .................................................. 8 3 Methodology ........................................................................................ 9 4 Determinants of Health and Community Context .................................. 13 5 Health issues arising from scoping ....................................................... 20 6 Recommendations and Mitigations ....................................................... 23 7 Summary ......................................................................................................................... 32

Figures

Figure 1.1: Socio-Environmental Model of Well-Being Figure 4.1 Cornwall Place Survey (2009)

Tables Table 4.1 Compatibility between Key Determinants of Health and Element within the Regeneration Plan Table 4.2 Regeneration Plan Criteria and Individual Guidance Note Components assessed for their impact on Human Health Table 4.3 Summary of Cornwall’s and Plan Area’s Community Baseline Evidence Table 6.1 Recommendations and mitigations arising from the Health and Wellbeing Screening Assessment for the Regeneration Plan

Appendix 1 - Health And Wellbeing Screening Assessment Of The St Austell, China Clay & St Blazey Regeneration Plan May 2012 Page 1

EXECUTIVE SUMMARY

On behalf of Cornwall Council (“Cornwall”) a Health and Well-being Screening Assessment has been undertaken of the proposed St Austell, St Blazey and China Clay Area Regeneration Plan (“the Plan”).

The overarching aims of the Plan are to stimulate regeneration and to direct development pressure to enable positive benefits for the wider area, including its infrastructure.

The Regeneration Plan requires that all development proposals submitted within the plan area fulfil the following set of Criteria:

a will achieve high environmental standards. Developers will be required to demonstrate how carbon reduction measures have been applied and how zero-carbon status can be achieved in the future;

b will achieve high quality and inclusive design and reinforce local distinctiveness;

c can support mixed use development in order to deliver new jobs, skills and economic growth to existing or new businesses, and strengthen local supply chains;

d can contribute infrastructure that meets the needs of existing and future communities, particularly addressing transport, education, flooding, health needs and community scale renewable energy schemes;

e can deliver affordable housing in accordance with adopted policy;

f can deliver sustainable travel patterns with an aspiration of achieving at least 50% of trips by sustainable travel means;

g can raise the aspirations, opportunities and well-being of communities in the area to ensure a good quality of life for those who live and work in the area and community cohesion;

h will productively and positively remediate and reuse previously developed land and despoiled, degraded, derelict, contaminated and unstable land including land in rural areas, particularly where the likelihood of early restoration of the land is remote, and where it is not of high environmental value;

i will avoid sterilisation of important mineral resources for extraction and safeguard sites for important related infrastructure;

j will maximise the provision and access to new and existing green spaces, and create new opportunities for flexible and productive land use including food and fuel production to assist in the creation of healthy, inclusive communities


An additional set of standards, set out as guidance, within the Regeneration Plan were provided to direct each specific set of criteria.

Key health issues were identified as having effects, both direct and indirect, on Cornwall’s wider community, including its population and economy.

Baseline data were used to establish the demographic, social and health profiles for the population within the geographical scope of the Health and Well-being Screening Assessment.

The sources of the baseline information included:

Eco-towns: Sustainability Appraisal and Habitats Regulations Assessment of the Eco-towns Programme, St Austell (China Clay Community);

Strategic Development Documents for the Cornwall Local Development Framework (LDF); and

Sustainable Community Strategies and Local Area Agreements.

In order to achieve a degree of resolution within the Health Impact Screening Assessment, an assessment of health, population, environment and deprivation was undertaken based on implementation of each of the specific guidance note components within the St Austell, St Blazey and China Clay Area Regeneration Plan. Each specific guidance component was assumed to be required to fulfil each specific set of criteria.

Health Impacts of the St Austell, St Blazey and China Clay Area Regeneration Plan

Community Cohesion:

The greatest potential impact on health identified was the risk that, should development proposals be permitted to go ahead in isolation, they alone would not be able to fulfil all of the essential requirements of the community, both old and new.

The social and economic demographic profile of an inward migrating population is expected to vary from that of the existing community. In order to minimise the risk that the proposed development did not integrate effectively with the existing community and affect community cohesion, a grassroots public engagement exercise will be considered. To provide continuity between the local community and the proposed developments, this exercise would focus on individual proposals and the aspirations of the existing community.


Continuity of Employment:

The Plan does not specify the scheduling of specific development types at this stage. Therefore, there is a need to ensure a balance between attracting employment opportunities and suitably skilled employees in order to avoid the failure of new business through lack of suitably skilled staff.

Infrastructure Delivery Plan:

Delivery of community and health facilities, e.g. health centres, schools, retail outlets, was identified as being essential to securing the health and well-being of the local population.

Environmental standards and quality of design:

Overarching positive health impacts are expected in respect of Environment and Housing, Crime & Safety and Community Cohesion should all of the guidance that underly the Plan Principles be achieved.

Transport:

There is an opportunity to draw links between sustainability and health benefits through cycling and other forms of active transport. Exploration of opportunities and facilities which supply sustainable year round tourism should also be considered.

Health and Well-Being Screening Assessment of the St Austell, St Blazey and China Clay Area Regeneration Plan


1 INTRODUCTION

1.1 Overview

1.1.1 Cornwall Council (Cornwall) has commissioned Parsons Brinckerhoff (PB) to provide specialist practitioner support for a Health and Well-being Screening assessment of the St Austell, St Blazey and China Clay Area Regeneration Plan (“the Plan”), which is currently under development.

1.1.2 According to ‘Health Impact Assessment: A Practical Guide’1, Health and Wellbeing assessments can provide

“both a health protection and health promotion tool.”

1.1.3 The five main drivers behind the rationale for undertaking a Health and Well-being Screening assessment of the Plan are:

The commitment by Cornwall to integrate health into the Plan process;

The legal requirement to consideration ‘Human Health’ in Strategic Environmental Assessment (SEA);

To contribute to the wider agenda relating to quality of life and reducing health inequalities;

To secure consistency between the Plan and work associated with Sustainable Community Strategies and Local Area Agreements; and

To coordinate the public health concerns in respect of air quality, noise and climate change, community cohesion, infrastructure delivery and provision of health facilities

1.1.4 The purpose of a Health and Well-being Screening assessment is to identify and assess both the beneficial and detrimental effects of a proposed plan, enhancing the benefits whilst minimising its potential detrimental effects.

1.1.5 Health impact assessments typically generate a mitigation plan as an output which is based on the assessment of a detailed proposal, plan or strategy.

1.1.6 The St Austell, St Blazey and China Clay Area Regeneration Plan, though containing elements which are highly relevant to health, has been based on inferred requirements rather than prescribed limits,

1Harris, P. Harris-Roxas, B., Harris, E., & Kemp, L. ‘Health Impact Assessment: A Practical Guide.’ Sydney: Centre Health Equity Training, Research and Evaluation (CHETRE) 2007

Health and Wellbeing Screening Assessment of the St Austell, China Clay & St Blazey Regeneration Plan


targets or thresholds. As such it is not possible to produce a comprehensive HIA and a Health and Wellbeing Screening Exercise has been undertaken instead.

1.1.7 This Health and Wellbeing Screening has been conducted alongside the Sustainability Appraisal (SA) and SEA and has informed both the SA and SEA process and the development of the Plan.

1.2 The St Austell, St Blazey and China Clay Area Regeneration Plan

1.2.1 Regeneration plans set out the economic and developmental aspirations for a particular area, and can, where successful, stimulate regeneration and direct development pressure.

1.2.2 Cornwall has developed a regeneration plan because St Austell, St Blazey and China Clay Area has:

“...experienced a decline in major employment sectors in the last 20 years. During the same period it (the area) has experienced a significant amount of housing development the quality of which varies greatly. A positive and innovative response is required that can bring wider socia.” 2

1.2.3 The Plan has established a high set of standards which development projects are expected to achieve. All forthcoming applications within the plan area will be assessed against these standards. It is intended that the aspirations within the Plan will attract development projects which are of an exceptional and transformative quality and which will improve both the fabric and economy of the area.

1.2.4 As a result of the Plan, the following topic headings have emerged which form the criteria framework:

Nature and Scale

Design and Environmental Quality

Job and Skills

Infrastructure

Transport

Community

Previously developed land and despoiled, degraded, derelict, contaminated and unstable land, including land in rural areas

2 Access via: http://www.cornwall.gov.uk/default.aspx?page=27043



1.2.5 Employment opportunities generated by regeneration of an area inevitably results in a beneficial health impact on the area’s population, reduces economic poverty, and positively impacts upon the community as well as the local and regional economy. Health improvements that occur due to economic growth can have further cumulative economic benefits. As better health increases labour supply and productivity, health has been a major contributor to economic growth.

1.3 Introduction to Health and Well-being

1.3.1 Assessment of Health and Well-being can be defined to1;

“include assessment of both health hazards and health benefits of a proposal and the potential ways in which health and well-being can be both protected and promoted.”

1.3.2 Health Determinants are the personal, social, cultural, economic and environmental factors that influence the health of individuals or populations. In addition to physical health, these include a range of factors such as income, employment, education, social support etc.

1.3.3 Health Impacts are the direct effect (e.g. release of pollutant) or indirect cumulative effect (e.g. loss of jobs or income) of a proposal on the health of a population. The impact may be either short or long term.

1.3.4 Health Inequalities can be defined as the differences in either health status or in the distribution of health determinants between different population groups. Some health inequalities are unavoidable, others are unnecessary and avoidable as well as unjust and unfair, and can lead to inequity in health.

1.3.5 With respect to the Plan, a Health and Well-being Screening Assessment looks at the impact of the Plan by examining the broader health implications utilising both quantitative and qualitative evidence.

1.3.6 Health and health inequalities are influenced by interactions between a variety of health determinants, including: income and poverty, housing, employment, the environment, transport, education, access to health services and the broader influence of well-being (Figure 1.1).



Figure 1.1: Socio-Environmental Model of Well-Being (Dahlgren and Whitehead, 1991)

1.3.7 A Health and Well-being Screening Assessment applies the model of

health and well-being shown in Figure 1.1 to determine the potential for any health inequality. The Socio-Environmental Model of Well-Being considers that health and well-being are a result of external influences, where an individual or family experiences a combination of adverse external factors which could result in health inequality.

1.4 Purpose of a Health and Well-being Assessment

1.4.1 The purpose of a Health and Well-being Screening Assessment is to identify and assess both the beneficial and detrimental effects of the Plan, enhance the benefits of the Plan whilst minimising its potential detrimental effects from its recommendations.

1.4.2 The Health and Well-being Screening Assessment:

Identifies how the Plan could affect health and inequalities, where there could be a disproportionate effect on certain populations or areas; and

Provides recommendations to inform the decision-making process by highlighting practical ways to enhance the positive impacts of the Plan, and to remove or minimise any health inequalities and negative impacts that might arise or exist.

1.4.3 Health and Well-being Screening Assessment provide organisations

a context in which they may deliver their statutory obligations and introduces health considerations into the planning process.



2 HEALTH AND WELL-BEING SCREENING ASSESSMENT OF THE ST AUSTELL, ST BLAZEY AND CHINA CLAY AREA REGENERATION PLAN

2.1 Overview

2.1.1 The overall aim of this Health and Well-being Screening Assessment was to identify the aspects of the Plan which have the potential to affect people’s health, both directly and indirectly. Some effects may be positive, others could be negative. The Health and Well-being Screening Assessment outputs will feed directly into the SA/SEA of the Plan, and will include recommendations which will remove or mitigate any possible negative impacts on people’s health. It will also identify opportunities to maximise the potential benefits to people’s health.

2.2 Aims and Objectives for the St Austell, St Blazey and China Clay Area Regeneration Plan Health and Well-being Screening Assessment

2.2.1 The specific aims of the Health and Well-being Screening Assessment of the Plan were to:

Assess the potential health impacts, both positive and negative, of the draft Plan;

Generate recommendations which encourage positive health impacts and minimise negative ones;

Assess the marginal, indirect, unverified and cumulative health

inequalities associated with the Plan; and

Maximise the health opportunities of the Plan.



3 METHODOLOGY

3.1 Introduction

3.1.1 The Health and Well-being Screening Assessment of the Plan was undertaken in four stages:-

1) Screening

2) Scoping

3) Assessment / Identification

4) Recommendations

3.2 Screening

3.2.1 The initial screening exercise simply evaluated the requirement for a Health and Wellbeing Assessment. The legal requirement to include the assessment of human health within the Plan dictated the need for a Health and Well-being Screening Assessment for the Plan.

3.3 Scoping

3.3.1 The purpose of the scoping step was to define the area of influence for the Health and Well-being Screening Assessment, identify the potentially affected communities, the key health issues and to develop the strategy to undertake the required assessment. Baseline data from the Plan’s SA/SEA was key to the successful implementation of this phase of the health and well-being screening assessment.

3.3.2 Scoping of the Health and Well-being Screening Assessment was undertaken as an initial identification of health determinants and key factors emerging from the baseline data as well as a high level desk top study of existing health information, gap analysis and literature review.

3.3.3 A compatibility test was undertaken upon the existing SA Objectives of the Cornwall LDF against relevant health determinants to be employed within the Health and Wellbeing Screening Assessment (Appendix A).

3.3.4 According to the Plan, proposals must have broad community support and should show how they fulfil the following specific criteria:

a. Will achieve high environmental standards. Developers will be required to demonstrate how carbon reduction measures have



been applied and how zero-carbon status can be achieved in the future;

b. Will achieve high quality and inclusive design and reinforce local distinctiveness;

c. Can support mixed use development in order to deliver new jobs, skills and economic growth to existing or new businesses, and strengthen local supply chains;

d. Can contribute infrastructure that meets the needs of existing and future communities, particularly addressing transport, education, flooding, health needs and community scale renewable energy schemes;

e. Can deliver affordable housing in accordance with adopted policy;

f. Can deliver sustainable travel patterns with an aspiration of achieving at least 50% of trips by sustainable travel means;

g. Can raise the aspirations, opportunities and well-being of communities in the area to ensure a good quality of life for those who live and work in the area and community cohesion;

h. Will productively and positively remediate and reuse previously developed land and despoiled, degraded, derelict, contaminated and unstable land including land in rural areas, particularly where the likelihood of early restoration of the land is remote, and where it is not of high environmental value;

i. Will avoid sterilisation of important mineral resources for extraction and safeguard sites for important related infrastructure;

j. Will maximise the provision and access to new and existing green spaces, and create new opportunities for flexible and productive land use including food and fuel production to assist in the creation of healthy, inclusive communities.

3.3.5 The Regeneration Plan outlined an additional set of standards (set out as guidance) for each of the criteria. The purpose of this guidance was to provide a greater degree of focus and direction to each of the Regeneration Plan criteria.

3.3.6 In order to achieve a degree of resolution within the Health Impact Screening Assessment, it has been necessary to assume that for a development proposal to achieve the specific Criteria, the guidance note components would need to be mandatory for each development proposal.

3.3.7 Therefore this assessment has focused upon the individual Regeneration Plan guidance note components were tested in terms



of their relevance to human health, rather than the overarching Regeneration Plan Criteria. Where an individual component was considered to be of no impact to human health, this was then scoped out of the assessment.

3.4 Assessment

3.4.1 The purpose of the assessment step was to collate the available baseline data and to collect and analyse the evidence from the literature review.

Baseline Information

3.4.2 The sources of the baseline information included:

Eco-towns: Sustainability Appraisal and Habitats Regulations Assessment of the Eco-towns Programme, St Austell (China Clay Community);

Strategic Development Documents for the Cornwall LDF;

Sustainable Community Strategies and Local Area Agreements;

Economic ambition: A Cornwall Council White Paper;

St. Austell, St. Blazey & Clay Area: Strategic Investment Framework & Economic Strategy, 2007-2013;

St Austell, St Blazey and China Clay Area: Draft Cycling and Walking Strategy Report; and

Which Way for the Clay: Creative Community Engagement, Project Report 2009.

3.4.3 Baseline data were used to establish the demographic, social and health profiles for the population within the geographical scope of the Health and Well-being Screening Assessment.

3.5 Assessment Matrix

3.5.1 The selected Plan Criteria and their individual guidance note components were then assessed for their impact against individual Health determinants. An Assessment Matrix was developed for the Health and Wellbeing Screening Assessment against which the Plan’s Criteria and the impacts of their individual guidance note components were scored against whether they would generate a;

Likely Positive Health Outcome;

Likely Negative Health Outcome;

Uncertain Effect; or

No Effect



3.5.2 The Health and Wellbeing Screening Assessment was further

supported in the assessment matrix with Commentaries and Assumptions as well as Recommendations to improve or mitigate adverse effects.

3.6 Recommendations and Mitigation

3.6.1 The objective of this phase of the work was to identify appropriate mitigation measures to minimize the negative impacts of the Plan and to maximize the opportunities for beneficial impacts.

3.6.2 This Health and Well-being Screening Assessment was undertaken in parallel with the SA/SEA permitting feedback of the findings into the assessment process at the earliest stage. Close collaboration between PB’s Health and Well-being and SA/SEA practitioners also avoided duplication of efforts in the development of baseline information and mitigation strategies.

3.7 Management Planning & Monitoring

3.7.1 Health mitigation measures identified in the recommendations stage of the assessment were, where appropriate, incorporated into the Plan’s SA/SEA report. Implementation of these measures will be overseen by Cornwall Council.



4 DETERMINANTS OF HEALTH AND COMMUNITY CONTEXT

4.1 Principal Determinants of Health

4.1.1 The following table indicates the principal determinants of health recommended by the WHO as healthy objectives for strategic planning purposes, their examples and compatibility with the regeneration plan outline guidance and acceptable components.

Table 4.1 Compatibility between Key Determinants of Health and Elements within the St Austell, St Blazey and China Clay Area Regeneration Plan

Principal Determinants of Health:3

Example Health Determinants

Relevant Criteria within the Plan

Age Age profile of population; health of population

Affordable Housing; High Quality Design

Lifestyle Physical exercise; use of alcohol/cigarettes/non-prescription drugs; diet; sexual activity; risk taking behaviour

High Environmental Standards ; High Quality Design ; Infrastructure; Transport; Community

Education and Economy Education and training ; careers advice government policies; gross domestic product; economic development; biological diversity; climate; Unemployment; income; economic inactivity; type of employment;

High Environmental Standards ; High Quality Design; Jobs & skills; Infrastructure; Transport; Community

Environment and Housing

Built environment; neighbourhood design; housing; noise, air and water quality; attractiveness of area; perception of environment; indoor air quality; visual impact

High Environmental Standards ; High Quality Design; Infrastructure; Affordable Housing; Transport; Community

3 Barton, H. et al. (eds) (2003) Healthy Urban Planning in practice: experience of European cities. Report of the WHO City Action Group on Healthy Urban Planning. World Health Organization, Regional Office for Europe, Copenhagen.



Accessibility Medical services; other caring services; shops and commercial services; public amenities; transport; information technology

High Environmental Standards ; High Quality Design ; Jobs & skills; Infrastructure; Transport; Community

Crime and Safety Road safety; community safety; safety of play areas; workplace conditions

High Environmental Standards ; High Quality Design ; Jobs & skills; Infrastructure

Community cohesion Neighbourliness; sense of belonging; local pride; social support networks; social isolation; peer pressure; family organisation; social exclusion; community identity

High Environmental Standards ; High Quality Design ; Jobs & skills; Infrastructure; Community

4.1.2 The Criteria and guidance around which the Heath and Well-being Screening Assessment has been undertaken are shown in Table 4.2. These were derived through consideration of where both the Plan Criteria and guidance were relevant to health. Any Criteria of no relevance to health were then scoped out of the assessment.

Table 4.2 Regeneration Plan Criteria and Individual Guidance Note Components assessed for their impact on Human Health

Criteria Guidance High Environmental Standards

New developments must look to create healthy places and flexible community spaces that can be adapted to the health needs of the community.

High Quality Design All new developments must: reach a Silver standard in the ‘Building For Life’ assessment scheme; provide a well connected network of streets, paths and trails as well as travel networks; create flexible accommodation; and design out crime.

Jobs & skills Proposals to assist in the generation of long term high quality jobs across a range of employment sectors. Flexible use of new building by minimising change of use of restrictive conditions.



Generation of a minimum of 50% of new jobs to be both permanent and high quality. All proposals to provide full mitigation of negative impacts, e.g. transport infrastructure. All new housing to demonstrate one new job per dwelling and contribute towards a sustainable supply chain using locally supplied resources.

Infrastructure Proposals must contribute towards the provision of infrastructure for both existing and new communities, including: a. The provision of a new A391 connection

from the A30 to West Carclaze. b. Improvements to the A390. c. Park and Ride facilities d. Public Improvement to existing transport e. Other transport infrastructure to connect

within and between residential areas and open countryside

f. New education facilities. g. New health care facilities, especially

dentists. h. Flooding alleviation schemes both surface

water and fluvial. i. Greenspace including allotments. j. Community facilities and services,

including youth facilities and facility co-location.

k. Leisure and recreation l. Employment space. m. Provision of next-generation broadband

network Affordable Housing Affordable housing provision to be based on

the existing adopted policy Supplementary Planning Document (SPD) for Affordable Housing. Any proposals for off–site affordable housing provision needs to clearly demonstrated that it would provide the greatest benefit to the regeneration initiative.

Sustainable Travel Proposals to aspire to achieve 50% of trips by non-car means.

Community Proposals need to quantify level of community support through consultation and surveys. Proposals to build on community support, instigating a positive change for the area. Active encouragement of community



involvement in shared resources. Joined up networks through joined up multi-functional greenspaces and green infrastructure networks which: encourage the movement of people and

biodiversity throughout the site promote active and healthy lifestyles for all

ages provide a choice of shade and shelter provide opportunities for food and energy

production through traditional means such as allotments or greenspace that can be adapted to future needs;

provide vehicle-free links with surrounding countryside and public rights of way.

Access to Green Space Proposals to provide a minimum of 40% of the total development area as a mix of public or private open spaces. A greenspace plan should be produced to guide the master planning and should set out to create a network of joined up sites that fill the gaps between existing green space features and sites of importance for biodiversity.

4.1.3 The above Regeneration Plan Criteria and individual Guidance components were then screened against their potential impact upon human health.

4.2 Geographical Scope

Area of Greatest Impact

4.2.1 The Regeneration Plan is both expansive and ambitious in nature, expecting to attract both new residents and new employees into the St Austell, St Blazey and China Clay area. It is anticipated that a large proportion of this new working and residential population will originate from other areas within Cornwall. Therefore the area of influence and potentially affected communities of the Plan were by default the entire County of Cornwall and its population.

4.3 Key Community Groups

4.3.1 Using baseline data, specific groups were highlighted as potentially vulnerable within the Plan area. These comprise:



members of the population who reside within areas with poor accessibility to jobs and services;

the long-term sick;

The most deprived quartile of the population;

The population over 65 years old; and

The population of working age who are unemployed.

4.4 Community Baseline

4.4.1 Clear links exist between individual well-being and the effects of poverty, deprivation and social exclusion4,5,6,7 From the summary of Cornwall’s community baseline (Table 4.3) there is evidence of both deprivation and health inequality and it is apparent that a significant proportion of the Plan area population are considered to be experiencing the effects of poverty, deprivation and social exclusion (Office for National Statistics, 2004).

4.4.2 Explicitly, primary drivers of deprivation in Cornwall are:

Economic inactivity; and

Low wages.

4.4.3 However there are also a number of additional contributing factors to deprivation, which include:

Lack of job security;

Poor service accessibility in rural areas;

Lack of transport options in rural areas; and

Lack of skills and low attainment of qualifications

4 Carlisle R, Groom LM, Boot D, Earwicker S. Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey. BMJ 1998; 316: 520-3 5 Harrison J, Barrow S, Creed F. Mental health in the north west region of England: association with deprivation. Soc Psychiatry Psychiat Epidemiol 1998; 33: 124-8. 6 Kendrick D. Prevention of pedestrian accidents. Arch Dis Child 1993; 68: 669-72. 7 Abdalla IM, Raeside R, Barker D, McGiugan DR. An investigation into the relationships between area social characteristics and road accident casualties. Accident Analysis and Prevention 1997; 29: 583-93.



Table 4.3 Summary of Cornwall’s and Plan Area Community Baseline Evidence

Health Determinant

Baseline Evidence

Lifestyle In the Plan area between: 18.9 to 22.7% of the population are suffering from long-term illness. 16.6% to 18.9%, people registered as smokers 32.1%, to 40.0% of the population in the RP area were registered as of an unhealthy weight. 3.8% to 5.8% of girls aged between 15 – 17 became pregnant during 2008. 4.1 to 4.3% of the GP registered population have been diagnosed as suffering from type I and II diabetes. Life expectancy varies between an average of 77 years in St Blazey & Parr to 81 years in Charlestown. 1 in 7 of all hospital admissions in Cornwall are due to alcohol, where up to 70% of the 44,000 presentations at A&E in Cornwall are alcohol related (According to national trends), costing more than £6 million each year. In England the estimated cost to the NHS per year of Alcohol Misuse £2.7 Billion; Smoking £2.7 Billion; Obesity £4.2 billion; Inactivity £1–1.8 billion Up to 140,000 working days are lost in Cornwall and the Isles of Scilly each year due to alcohol related sickness. Incidents of obesity in Cornwall’s school children almost doubles between Reception class children (9.9%) to year 6 children (17.9%). Only 1 in 8 of Cornwall’s adults do the recommended amount of physical activity

Unemployment/ Economy

37,000 jobless people in Cornwall in 2009 In Cornwall the Department of Work and Pensions pay £800,000 in working age benefits each working day On average 18.3% of working age people in Cornwall claim “out of work” benefit – in deprived neighbourhoods this rises to 50%. In the Plan Area 4.9% of working age are unemployed with up to 5.8% in some wards.

Health 27,300 claim benefits due to ill-health. 9.4% of residents within the Plan area claim sickness benefit, this rises up to 11.3% in some wards, in comparison to the national average of 8% (England). Up to 12.2% of residents in some Plan area Wards



claim to be in not good health, as opposed to 10.2% across the Plan area and 9% across England as a whole.

Income Average Gross earnings Cornwall in 2000 £16,533 Average Gross earnings England 2000 £22,183

Education Out of the 34 secondary schools in Cornwall, 12 fall below the national average for children attaining five GCSE’s above grade C, including English and maths, One in five people in Cornwall paying cash for their shopping would not know if they have been given the correct change 33.3% of people in the Plan areas claim not to have any recognised qualifications, this rises to 37% in some wards, whereas the national average is 28.9%.

Deprivation In 2001 18,000 children in Cornwall were living in Poverty

Transport/ Accessibility

In Cornwall 2 out of 5 jobseekers say lack of transport is a barrier to getting a job 48% of Plan area employees live within 5km of their workplace, though in some wards up to of employees have to travel over 10Km to their workplace.

Collisions In 2008 there were 209 Reported Killed and Seriously Injured casualties in Cornwall Cornwall is reducing its road casualty rate faster than any other similar rural road network transport authority.

4.4.4 Information gathered during a survey of the public undertaken across Cornwall in 2009 (Cornwall Place Survey 2009) highlighted that the issues which were considered to be of greatest importance and in most need of improvement were:

affordable housing,

wages / cost of living,

job prospects,

activities for teenagers and

public transport.

4.4.5 Results from the survey put race relations, cultural activities, pollution, community facilities and education of least importance and not in need of improvement (Fig. 4.1).



Figure 4.1 Cornwall Place Survey (2009)

5 HEALTH ISSUES ARISING FROM SCOPING

5.1 Discussion of Scope of Health and Well-Being Screening Assessment

Health Impacts

5.1.1 A screening of the full range of health impacts was undertaken for the assessment. It was not possible to quantify all the health impacts of regeneration with a consistent level of confidence, as potential health impacts from the different aspects of the regeneration plan vary considerably8.

5.2 Key Health Impacts

5.2.1 Key health impacts which could potentially arise as a result of the Plan’s implementation include but are not restricted to:

Impacts on access to employment and health services;

Impacts on the opportunity for training and education;

Impacts on road safety;

Sustainability and broader economic impacts;

8 Regeneration and Health: what’s the impact? scotregen: issue 36 : winter 2006/7 http://www.scotregen.co.uk/pdf.pl?file=surf/news/Scotregen%2036.pdf



Impacts on the local economy;

Access to green space and countryside; and

Impacts on safety and crime. 5.2.2 The assessment of health impacts was based on the type of impact

and its rating as potentially positive or negative.

5.2.3 The primary focus of the Health and Well-being Assessment of the Plan was contained within the document entitled ‘St Austell, St Blazey and China Clay Area Regeneration Plan Guidelines for Transformational Development Projects, Consultation Draft June 2011’as received by PB on the 2nd June 2011.

5.2.4 The proposals in this document reflect the aspirations and strategy of the proposed regeneration of the area and form the logical basis and justification for the individual development plans which will emerge at a later stage.

5.3 Key Issues Resulting from Assessment

Community Cohesion

5.3.1 Socially disadvantaged households with lower levels of literacy and connectivity are reluctant to engage in consultation exercises. There is therefore a risk of disparity between the existing and new residents in the community.

5.3.2 Positive health impacts upon all health determinants could occur should public engagement be both inclusive and transparent. Where development proposals are able to engage positively with community groups there is a greater probability of community ownership and community cohesion. Community Cohesion brings with it greater community awareness, participation and increased community spirit.

5.3.3 Negative health impact upon community cohesion could occur should any development fail to remain consistent with, and retain continuity with, the current identity of the existing community. Developments should be encouraged that meet the needs of the existing community as well as the needs of the migrating community. Negative impacts could occur where the public engagement exercise fails to secure community ‘buy-in’.



Continuity of Employment

5.3.4 Unemployment is known to generate high levels of stress and depression9. Should new businesses fail to appoint suitably qualified staff due to skills gaps, they will fail, resulting in unemployment. This would then present a risk of a negative health impact through the health determinant ‘education and economy’.

5.3.5 The Regeneration Plan’s approach of seeking economic growth across a range of sectors should provide some security to the goal of sustainable growth in employment, by avoiding dependency upon the success of a single sector.

Infrastructure Delivery

5.3.6 The Regeneration Plan requires infrastructure delivery to be shared between a variety of separate proposals. Should any of the individual development proposals not succeed and fail to supply the required infrastructure, the sustainability of existing development would be at risk. As access to employment, education and other services could be restricted, this could result in negative health impacts upon both the ‘Environment and Housing’ as well as ‘Education and Economy’ determinants of health.

5.3.7 Proposals should be designed to initially supply public facilities and infrastructure, design out interdependency upon other proposals, whilst avoiding patchwork development.

Design and Environmental Quality

5.3.8 Successful implementation of any or all of the individual components within the ‘Design and Environmental Quality’ guidance would result in a positive health impact on the following ‘Determinants of Health’;

Lifestyle;

Education and Economy;

Environment and Housing;

Accessibility;

Crime and Safety; and

Community Cohesion.

9 The impact of unemployment on health: a review of the evidence, R. L. Jin, C. P. Shah and T. J. Svoboda Canadian Medical Association Journal, Vol 153, Issue 5 529-540.



6 RECOMMENDATIONS AND MITIGATIONS

6.1.1 As a result of the Health and Well Being Screening Assessment of the St Austell, St Blazey and China Clay Area Regeneration Plan a series of recommendations and mitigations were derived. Full details of these are shown in Table 6.1, with a summary given below

6.1.2 Each recommendation or mitigation relates to a specific component within the St Austell, St Blazey and China Clay Area Regeneration Plan and its health outcome.

6.1.3 Where relevant, evidence was provided against either a recommendation or mitigation, to either verify or substantiate the health impact or outcome against a specific proposal component.

Community Cohesion

6.1.4 A collective community vision for either the regeneration as a whole or individual development plans would allow the existing and migrating community aspirations to be drawn together.

6.1.5 A specific programme of engagement could be devised in order to develop a collective community vision. One method of ensuring a greater probability of community engagement is through encouraging groups to develop their own small scale plans that they themselves can affect.

Continuity of employment with development

6.1.6 The Plan employment model could explore the possibility of adopting an ‘innovation centre’ approach, which has had some success in the South West. It could also begin to identify the available skills and skills gaps and explore funding opportunities for additional required skills training.

6.1.7 The development of a local ‘Green Supply Chain’ skills register could improve visibility of local skills and services. Liaising with Cornwall Development Company on educating the existing local Small and Medium-Sized Enterprises (SME’s) of the emerging sustainability market and its opportunities, would enable local businesses to adapt their business strategies and workforce skills accordingly.

Infrastructure Delivery

6.1.8 A centrally coordinated programme of infrastructural provision would ensure that the needs of the existing community are fulfilled.



In addition a robust method of infrastructure planning would make certain that the needs of future migrating community are also met.

Environmental Standards and Quality of Design

6.1.9 An opportunity exists to lower any potential barriers that may arise between existing and migrating communities by retaining an inclusive continued community involvement in the development design. This would provide an opportunity to secure post-development community stability in the area. This could take the form of incorporating existing community views at an early design stage of each development design, through a formal options process, avoiding the post-design community consultation.

Transport

6.1.10 The Regeneration Plan presents an opportunity to draw links between sustainable transport and health. Cycle lane design can be incorporated into populated areas to reduce the fear of crime.



Table 6.1 Recommendations and mitigations arising from the Health and Wellbeing Screening Assessment for the St Austell, St Blazey and China Clay Area Regeneration Plan

Key:

Likely Positive Health Outcome

Likely Negative Health Outcome

? Uncertain Effect

0 No Effect

Regeneration Plan Guidance

Health Determinant

Commentary & Assumptions Recommendations to improve or mitigate adverse

effects.

Age

Lifestyle,

Education and Economy

Environment and H

ousing

Accessibility

Crim

e & S

afety

Com

munity C

ohesion.

High Environmental Standards All new developments must create healthy places and flexible community spaces that can be adapted to the needs of the community.

Negative health impact upon Crime & Safety should design of public space generate a fear of both crime and antisocial behaviour.

An opportunity exists to lower any potential barriers that may arise between existing and migrating communities by retaining an inclusive continued community involvement in the development design. This would provide an opportunity to secure post-development community stability in the area.

High Quality Design

All new developments must reach a Silver standard in the ‘Building For Life’ assessment scheme.

Positive health impact upon all determinants of health

All new developments must provide a well connected network of streets, paths and trails as well as travel networks.

Positive health impact upon all health determinants.

Development proposals could promotion soft sustainable transport measures Efforts of modal shift towards targeted promotion of behaviour change through schools & healthy workplace, settings basis. Promotion of soft sustainable transport measures along with engineering solution, including; change the social climate to favour giving greater priority to both pedestrians and cyclists

reduce speeds and promote traffic integration budget for program of soft measures to encourage active travel

need to reduce actual and perceived barriers to active travel through a combination of infrastructure and behavioural interventions



10 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 11 ‘Cycle routes: their impact on neighbours’ Sustrans Information Sheet F23, 1999 12 Sustrans (1998) Designing for security on the National Cycle Network. 13 Cycle routes: their impact on neighbours. Sustrans FF23, 1999 14 The impact of unemployment on health: a review of the evidence, R. L. Jin, C. P. Shah and T. J. Svoboda Canadian Medical Association Journal, Vol 153, Issue 5 529-540.

Risk that there could be a negative health impact upon Lifestyle, should an increase in active travel not be taken up. The single biggest risk to health identified within the Cornwall LTP3 was the failure to encourage a ‘modal shift’ from car journeys to ‘active travel’”10 Cycle paths are often routed through isolated areas magnifying fear of crime. Unjustified perception Risk that fear of crime occurring on cycle path, possibly greater fear amongst females, may result in cycle paths experiencing a lack of use.11

Design out crime through populating the streets -where a ‘critical mass’ of people are using cycle and walking routes, the opportunities for anti-social behaviour and crime are reduced. Cycle routes running in the front of residential properties rather than at the rear is considered more secure.12 Sustrans evidence suggests that in residential areas, cycle routes improve security by increasing the level of movement in the street, providing informal surveillance.13

All new developments must create flexible accommodation.


All new developments must design out crime.


All new developments should provide a mix of open spaces amounting to 40% of total developmental area.

Negative health impact upon lifestyle, environment and housing and accessibility should the individual development proposals fail to supply a phased approach to delivery of useable open space. There is a need to avoid patchwork development and supply of public facilities. Negative health impact upon Crime & Safety should design of public space generate a fear of both crime and antisocial behaviour.

An opportunity exists to lower any potential barriers that may arise between existing and migrating communities by retaining an inclusive continued community involvement in the development design. This would provide an opportunity to secure post-development community stability in the area. Feedback of information to and exploration with the community upon provision of public spaces i.e. parks/ nature reserves/ community allotments.

Proposals will need to demonstrate that they can deliver both economic growth and jobs.

There are positive health impacts upon all health determinants should infrastructural improvement be successful. There is a risk of a negative health impact upon education and employment should planned new businesses fail to identify suitably qualified local staff due to skills gaps14.

Requirement for a centrally coordinated programme to clearly account for infrastructure provision through engagement with existing community. There should be a robust mechanism to match the future migrating community with business employment needs.

Proposals will need to demonstrate that they can deliver significant strategic infrastructural development including an improved A391 link route to the A30.

Risk that commercial developers may choose to exploit profitable development proposals and fail to deliver infrastructural needs.

Requirement for clear accountability of infrastructural delivery with a centrally coordinated programme.

Proposals will need to demonstrate that they can deliver significant strategic infrastructural development including a significant improvement to the A390.

Risk that commercial developers may choose to exploit profitable development proposals and fail to deliver infrastructural needs.

Requirement for clear accountability of infrastructural delivery with a centrally coordinated programme.

Proposals will need to demonstrate that they can deliver extension to new schools.

There are positive health impacts upon all health determinants should existing schools be either extended or new schools constructed.



15 Department for Environment, Food, and Rural Affairs (Defra), Flood and Coastal Defence Appraisal Guidance, FCDPAG3, Economic Appraisal Supplementary Note to Operating Authorities - Climate Change Impacts, October 2006. 16 Environment Agency, South West Region – Report on Regional Extreme Tide Levels, February 2003. 17 ‘The Flood and Coastal Defence Project Appraisal Guidance, FCDPAG3 Economic Appraisal, Supplementary Note to Operating Authorities - Climate Change Impacts 18 The impact of unemployment on health: a review of the evidence, R. L. Jin, C. P. Shah and T. J. Svoboda Canadian Medical Association Journal, Vol 153, Issue 5 529-540. 19 (http://www.poolinnovationcentre.co.uk/) 20 (http://www.lowcarboneconomy.com/profile/kensa_engineering_ltd/_case_studies_and_projects/tolvaddon_energy_park_cornwall/4707/486)

Proposals will need to demonstrate that they can deliver Flood alleviation schemes.

0 0 0 0 0 0 Development proposals could have a negative health impact upon the environment and housing due to development reducing the area of available floodplain storage.

Incorporation of SUDS to reduce flood risk and other environmental damage, as well as minimising the volume of an on-site attenuation facility, control surface water runoff, and provide natural water treatment. Flood mitigation works may include the incorporation of compensatory floodplain storage, which could be developed as part of on-site earthworks. Impacts of climate change pose a challenge to new developments and their flood plans, as the risk of sea level rise, and increase in frequency, severity, and intensity of coastal storms, and rainfall event changes.15,16 General guidance on climate change17 provides an appropriate precautionary response to the uncertainty of climate change on the environment.

Proposals must show they can enhance the existing pattern of development.

Negative health impact upon community cohesion should the development fail to remain consistent and retain continuity with the current identity of the existing community, meeting their need as well as the needs of the migrating community.

A collective community vision for the plan would draw together existing and migrating community aspirations.

Jobs & skills Proposals to assist in the generation of long term high quality jobs across a range of employment sectors. Minimum of 50% of new jobs to be both permanent and high quality

There are positive health impacts upon all health determinants should regeneration employment plans be successful. There is a risk of a negative health impact upon education and employment should new businesses fail to appoint suitably qualified staff due to skills gaps18.

The regeneration plan employment model could explore the possibility of adopting an ‘innovation centre’, which has had some success in the South West.1920 Identify available skills and skills gaps and explore funding opportunities for additional required skills training. Development of a local ‘Green Supply Chain’ skills register would improve visibility of local skills and services. Liaise with Cornwall Development Company on educating existing local SME’s of the emerging sustainability market and its opportunities in order that they are able to adapt their business strategy and workforce skills accordingly (c.f. EnviroSkill SW)21.

Proposals to design in the flexible use of new building by minimising change of use of restrictive conditions.


All proposals to provide full mitigation of negative impacts e.g. transport infrastructure.


All new housing to demonstrate one new job per dwelling.

X X X Positive health impact upon the majority of health determinants, though negative health impact upon age as well as environment and housing. This proposal assumes the exclusive provisions of housing to economically active householders, which though of benefit to the economy, could be discriminatory to older and disabled individuals.

Requirement to allocate a minimum housing provision to both older and or individuals with disabilities.

Proposals to contribute towards a sustainable supply chain using locally supplied resources.


Infrastructure

Proposals must contribute towards the provision of infrastructure for both existing and new communities, including;

Risk of a negative health impact upon community cohesion could occur should the infrastructure of the existing community not match the quality of the migrating community.

Requirement for a centrally coordinated programme to clearly account for infrastructure provision through engagement with existing community. There should be a robust mechanism to plan the future migrating community needs.



22 Coates, Nigel, 1999, 'The Safety Benefits of Cycle Lanes', Proceedings of the Velo-City '99 Conference held in Graz, Austria. 23 http://www.cyclecraft.co.uk/digest/research.html 24 http://db.cornwall.gov.uk/ltp/marchannex4/section_613155925896.html 25 5.5.1 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 26 5.5.1 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 27 5.5.2 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 28 5.5.2 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 29 ‘Cycle routes: their impact on neighbours’ Sustrans Information Sheet F23, 1999 30 Sustrans (1998) Designing for security on the National Cycle Network. 31 Cycle routes: their impact on neighbours. Sustrans FF23, 1999

a) The provision of a new A391 connection from the A30 to West Carclaze.

? ? X ? ? Negative health impact upon environment and housing should the individual development proposals fail to supply a phased approach to facility delivery. There is a need to avoid patchwork development in the supply of infrastructure improvements.

Scheme should include provision of cycle storage facilities at key interchanges and destinations along the network. Scheme should consider potential to integrate with and reinforce connections with existing habitat corridors where possible.

b) Improvements to the A390. Positive health impact for all health determinants through reducing congestion and improved air quality. Widening of roadways and junctions could lead to increased average vehicle speeds. At junctions, cycle lanes can increase accidents, especially if the lanes are not carried through the junction2223. Traffic levels on the A390 are set to rise by as much as 19% by 2016. Major road building schemes such as the A391 will improve reliability of longer distance trips; they will have a limited impact on traffic levels along the St Austell A390 corridor.

24

Junction widening needs to include widening of footpath and increased separation of pedestrian from speeding traffic. Priority should be given to cyclists at junctions. Need for consistency in layout, signing and markings. Unlikely to be a second chance to get cycleway design right. Schemes should include provision of cycle storage facilities at key interchanges and destinations along the network. Schemes should consider potential to integrate with and reinforce connections with existing habitat corridors where possible.

c) Park and Ride facilities ? X Negative health impact on community cohesion due to local people being against location of park and ride scheme. Positive health impacts upon economy and employment. “Current bus service in Cornwall is considered by the majority of consultees as expensive and below standard”25

All park and Ride schemes should provide adequate provisions for bike storage to encourage active travel. Active travel options should be encouraged in the first instance before motorised travel. Services need to be made to be regular and affordable.

d) Improvement to existing public transport

Impacts on employment/ unemployment, deprivation and community cohesion may depend on cost of transport. Services need to be made to be regular. Improving active transport aspect may include provision for bicycles on buses similar to provision made on trains. Current bus service in Cornwall is considered by the majority of consultees as expensive and below standard26 “Failure of the LTP3 to succeed in ‘modal shift from car journeys to ‘active transport to ‘active travel’ was identified as the single most highest risk to health within the LTP3.”27

All park and Ride schemes should provide adequate provisions for bike storage to encourage active travel. Active travel options should be encouraged in the first instance before motorised travel.

e) Other transport infrastructure to connect within and between residential areas and open countryside

Positive health impact upon all health determinants. Risk that there could be a negative health impact upon Lifestyle, should an increase in active travel not be taken up. The single biggest risk to health identified within the Cornwall LTP3 was the failure to encourage a ‘modal shift’ from car journeys to ‘active travel’”28. Cycle paths are often routed through isolated areas magnifying fear of crime. Unjustified perception Risk that fear of crime occurring on cycle path, possibly greater fear amongst females, may result in cycle paths experiencing a lack of use.29.


reduce speeds and promote traffic integration budget for program of soft measures to encourage active travel

need to reduce actual and perceived barriers to active travel through a combination of infrastructure and behavioural interventions Design out crime through populating the streets -where a ‘critical mass’ of people are using cycle and walking routes, the opportunities for anti-social behaviour and crime are reduced. Cycle routes running in the front of residential properties rather than at the rear is considered more secure.30 Sustrans evidence suggests that in residential areas, cycle routes improve security by increasing the level of movement in the street, providing informal surveillance.31



32 Department for Environment, Food, and Rural Affairs (Defra), Flood and Coastal Defence Appraisal Guidance, FCDPAG3, Economic Appraisal Supplementary Note to Operating Authorities - Climate Change Impacts, October 2006. 33 Environment Agency, South West Region – Report on Regional Extreme Tide Levels, February 2003. 34 ‘The Flood and Coastal Defence Project Appraisal Guidance, FCDPAG3 Economic Appraisal, Supplementary Note to Operating Authorities - Climate Change Impacts 35 5.5.2 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 36 ‘Cycle routes: their impact on neighbours’ Sustrans Information Sheet F23, 1999 37 Sustrans (1998) Designing for security on the National Cycle Network. 38 Cycle routes: their impact on neighbours. Sustrans FF23, 1999

f) New education facilities. 0 0 0 0 0 0 Risk of a negative health impact upon employment and education could occur should the new education facilities not meet the needs of the existing and new community.

Requirement for a centrally coordinated programme to clearly account for facilities provision through engagement with existing community There should be a robust mechanism to plan the future migrating community needs.

g) New health care facilities Positive health impact upon all health determinants. h) Flooding alleviation schemes both

surface water and fluvial. 0 0 0 0 0 0 Development proposals could have a negative health impact upon

the environment and housing due to development reducing the area of available floodplain storage.

Incorporation of SUDS to reduce flood risk and other environmental damage, as well as minimising the volume of an on-site attenuation facility, control surface water runoff, and provide natural water treatment. Flood mitigation works may include the incorporation of compensatory floodplain storage, which could be developed as part of on-site earthworks. Impacts of climate change pose a challenge to new developments and their flood plans, as the risk of sea level rise, and increase in frequency, severity, and intensity of coastal storms, and rainfall event changes.32,33 General guidance on climate change34 provides an appropriate precautionary response to the uncertainty of climate change on the environment.

i) Greenspace including allotments. Positive health impact upon all health determinants. Risk that there could be a negative health impact upon Lifestyle, should an increase in active travel not be taken up. The single biggest risk to health identified within the Cornwall LTP3 was the failure to encourage a ‘modal shift’ from car journeys to ‘active travel’”35. Cycle paths are often routed through isolated areas magnifying fear of crime. Unjustified perception Risk that fear of crime occurring on cycle path, possibly greater fear amongst females, may result in cycle paths experiencing a lack of use.36.


reduce speeds and promote traffic integration budget for program of soft measures to encourage active travel need to reduce actual and perceived barriers to active travel through a combination of infrastructure and behavioural interventions design out crime through populating the streets -where a ‘critical mass’ of people are using cycle and walking routes, the opportunities for anti-social behaviour and crime are reduced.

Cycle routes running in the front of residential properties rather than at the rear is considered more secure.37 Sustrans evidence suggests that in residential areas, cycle routes improve security by increasing the level of movement in the street, providing informal surveillance.38

j) Community facilities and services including youth facilities and facility co-location

0 0 0 0 0 Risk of a negative health impact upon both age and lifestyle should the new healthcare facilities of the new community not be sufficient.

Requirement for a centrally coordinated programme to clearly account for facilities provision through engagement with existing community There should be a robust mechanism to plan the future migrating community needs.



39 http://www.polkythleisure.co.uk/index.cfm?action=about 40 http://www.wheal-martyn.com/highlights.html 41 Marmot Review: First Phase Report, June 2009, page 17 (2.6 Action to reduce inequalities in social determinants) 42 Marmot Review: First Phase Report, June 2009, page 17 (2.6 Action to reduce inequalities in social determinants) 43 5.5.2 Health Impact assessment of Cornwall Local Transport Plan 3 November 2010 44 http://www.centerparcs.co.uk/index.jsp 45 ‘Cycle routes: their impact on neighbours’ Sustrans Information Sheet F23, 1999

k) Leisure and recreation Positive health impact upon all health determinants. Requirement to locate new developments close to exiting leisure facilities and recreation to provide good accessibility to leisure and recreation. Opportunity to invest in existing recreation and leisure facilities.39 40

l) Employment space. 0 0 0 0 0 0 Positive health impact upon employment and economy. http://www.cornwalloffices.co.uk/cornwall.office.rentals m) Provision of next-generation broadband

network 0 0 0 0 0 0 Positive health impact upon employment and economy.

Affordable Housing

Can deliver affordable housing in accordance with adopted policy.

Positive health impact upon all health determinants. Opportunity to permit allocation of housing to broader sections of the community, creating a varied community, thereby and avoiding housing inequality which can impact upon health.41

Any proposals for off-site affordable housing needs to be clearly demonstrated that it would provide the greatest benefit to the regeneration initiative.

Positive health impact upon Age, Lifestyle, Education and Economy, Crime and Safety. However risk that off-site affordable housing location could have negative impacts upon Environment and Housing, Accessibility and Community Cohesion through segregation of communities. Neighbourhoods with concentrated disadvantage, where services are overburdened, basic amenities in short supply and issues such as high crime, challenging schools and poor transport mar life, chances for many42.

Location of any off-site affordable housing should take the ‘Pepper-pot’ approach to distribution of affordable housing, placing affordable housing amongst other varied housing stock, avoiding ghetto-isation.

Transport

Proposals to aspire to achieve 50% of trips being undertaken by non-car means.

Positive health impact upon all health determinants. Risk that there could be a negative health impact upon Lifestyle, should an increase in non-car active travel not be taken up. The single biggest risk to health identified within the Cornwall LTP3 was the failure to encourage a ‘modal shift’ from car journeys to ‘active travel’”43.

Opportunity to draw links between sustainability to health benefits through cycling and other forms of active transport. Exploration of opportunities and facilities which supply sustainable year round tourism44.

Unjustified perception that risk that fear of crime occurring on cycle path, possibly greater fear amongst females, may result in lack cycle paths experiencing a of use.45 Cycle paths are often routed through isolated areas magnifying fear of crime.

Community Proposals to quantify level of community support through consultation and surveys.

Positive health impact upon all health determinants Where development proposals are able to engage positively with community groups there is a greater probability of community ownership and community cohesions.

Once the existing community begins to experience the developments beginning after the long period of waiting, the building process itself requires good construction management arrangement.

Potential negative health impact upon social cohesion. Socially disadvantaged households with lower levels of literacy and connectivity are reluctant to engage in consultation exercises. There is therefore a greater risk of disparity between the existing and migrating communities contributing to a lack of community cohesion.

A collective community vision for the plan would draw together existing and migrating community aspirations.



General Assumptions: 1. Community facilities and infrastructure to be delivered using a phased method and as required by the Infrastructure Delivery Plan 2. Transport Infrastructure planning shall conform to the priorities identified within the Cornwall LTP3 3. Development of employment space will be proportionate and retain continuity with both the locally available and probable workforce skills. Detailed Assumptions are provided in the matrix above.

46 http://www.sustrans.org.uk/what-we-do/liveable-neighbourhoods/diy-streets/diy-streets-resources-and-links

Proposals to build on community support instigating a positive change for the area.

Positive health impact upon all health determinants Community Cohesion brings with it greater community awareness, participation and increased community spirit. All of this would to attract people to move into the community.

There is scope for retro-designing-in improvements to current community facilities and access in order to maintain continuity between the existing and as well as the new community provision and facilities.46

Proposal to actively encourage community involvement in sharing resources.

Positive health impact upon all health determinants



7 SUMMARY

7.1 Significant Health Impacts of the St Austell, St Blazey and China Clay Area Regeneration Plan

7.1.1 A Health and Well-being Screening Assessment of the proposed St Austell, St Blazey and China Clay Area Regeneration Plan has been undertaken. Significant health impacts identified were:

Community: The single greatest impact upon health identified by the Health and Wellbeing Screening Assessment was the risk that should development proposals be permitted to go ahead in isolation that they alone would not be able to fulfil all of the essential infrastructural and community requirements.

The social and economic demographic profile of an inward migrating population would be expected to vary from that of the existing community. In order to attempt to minimise the possibility that the proposed development could fail to connect with the existing community and damage community cohesion, a grassroots public engagement exercise could be undertaken upon individual proposals in order to meet the aspirations of the existing community, providing continuity between the local community and the proposed developments.

Jobs and Skills: As the Plan does not specify the scheduling of specific development types at this stage, there is a need to ensure a balance of attracting employment opportunities in parallel with suitably skilled employees. Proposing the creation of high quality employment, with at least one employment opportunity per new dwelling is entirely dependant upon the calibre of available workforce, either existing or migratory.

Infrastructure: Delivery of community and health facilities, e.g. health centres, schools, retail outlets is essential in order to secure the health and well-being of the local population.

Design and Environmental Quality: Overarching positive health impacts upon Environment & Housing, Crime & Safety as well as Community Cohesion would be expected should all of the guidance note components within the Plan be achieved.

Transport: Opportunity to draw links between sustainability to health benefits through cycling and other forms of active transport. Exploration of opportunities and facilities which supply sustainable year round tourism.

7.1.2 Recommendations and mitigations were developed in response to these significant health impacts and include:



7.1.3 Draw together differing community aspirations through a collective community vision for the regeneration;

7.1.4 Encourage community groups to develop their own small scale plans in order to include them within the planning process;

7.1.5 Employment model could explore an ‘innovation centre’ approach;

7.1.6 To maintain an inclusive housing allocation, a quota system should be developed allowing older people and those with disabilities to become part of the community;

7.1.7 A local ‘Green Supply Chain’ skills register could improve visibility of local skills and services;

7.1.8 Coordinating a central programme to account for the infrastructure provision which meets with existing community and migrating community needs; and

7.1.9 Retaining inclusive continued community involvement in the development design which would provide an opportunity to secure post-development community stability in the area.



Appendix A Policy Context of the Health Impacts from the Regeneration Plan & SA Objectives

Health Impact

LDF SA Objective Spatial Scope

Plan / Programme / Strategy

Air Quality To reduce pollution and ensure air quality continues to improve

International EU Air Quality Framework Directive (96/63/EC) (EU, 2008) (also Daughter Directives 1999/30/EC, 2000/69/EC, 2002/3/EC, 2004/107/EC) EU The Ambient Air Quality Directive (96/62/EC) (EU Council, 1996)

National Air Quality Strategy for England, Scotland, Wales and N. Ireland (DEFRA, 2007)

Local Cornwall LDF Core Strategy, Draft Topic paper, Soil, Air and Water Quality (June 2010) Cornwall Air Quality Strategy, (Cornwall Air Quality Forum 2004)

Cornwall LDF Core Strategy, Draft Topic paper, Climate Change, (June 2010)

Accessibility and Transport

To improve access to key services and facilities by reducing the need to travel and by providing safe sustainable travel choices To reduce traffic congestion and minimise transport related greenhouse gas emissions

International Environment and Health, EEA Report No 10/2005 (EU, 2006)

National Every Child Matters – 5Green Paper (HMSO 2003) White Paper: Choosing Health, Making Healthy Choices Easier (DoH, 2004) Smarter Choices: Changing The Way We Travel (DfT, 2005) PPG 13 – Transport (ODPM, 2001)



Health Impact



Regional A Sustainable Future for the South West: The Regional Sustainable Development Framework for the South West of England (South West Regional Assembly, 2001) Cornwall Access Strategy, annex to LTP2 (Cornwall County Council, 2006)

Local Cornwall LDF Core Strategy, Draft Topic paper, Health, (June 2010) The 2020 Health and Well Being Strategy for Cornwall and the Isles of Scilly (Cornwall PCT, 2008) Joint Strategic Needs Assessment (NHS, PCT, 2009) Emerging Cornwall Sustainable Community Strategy (Cornwall Strategic Partnership, 2003) The Rural Economic Strategy (Rural Cornwall and Isles of Scilly Partnership, 2003) Cornwall LDF Core Strategy, Draft Topic paper, Transport and Accessibility, (June 2010)

Lifestyle To improve health through the promotion of healthier lifestyles and improving access to open space and health, recreation and sports facilities To encourage and safeguard local food production

National Tackling Obesities: the Foresight Report (IDeA's Healthy Communities Programme, 2008) Social-Marketing Based Strategy for Obesity Interventions (UWE Bristol, SWPHO, 2008)

Local The Health of the Population: A strategy to reduce obesity in Cornwall and the Isles of Scilly (NHS, PCT, 2006)

Crime & safety

To reduce crime, anti-social behaviour and fear of crime

Local Cornwall LDF Core Strategy, Draft Topic paper, Crime and anti social behaviour, (June 2010)

Education and

Economic Development, Regeneration and Tourism

International The Lisbon Strategy (EU Council, 2000)



Health Impact



Economy To support a balanced and low carbon economy that meets the needs of the area and promotes a diverse range of quality employment opportunities. Education and skills To maximise accessibility for all to the necessary education, skills and knowledge to play a full role in society Energy To encourage the use of renewable energy, increase energy efficiency and security and reduce fuel poverty

National Draft PPS4: Planning for Sustainable Economic Development (ODPM, 2007)

PPS6: Planning for Town Centres (ODPM, 2005)

PPS7: Sustainable Development in Rural Areas (ODPM, 2004)

Good Practice Guide on Planning for Tourism (CLG, 2006)

The UK Fuel Poverty Strategy (DEFRA, 2011)

Regional Regional Tourism Strategy: Towards 2015 -

shaping tomorrow’s tourism (SWRDA, 2005) Draft Regional Spatial Strategy for the South West incorporating the Secretary of State’s proposed changes (SWRA, 2008)

Regional Economic Strategy for South West England 2006 – 2015 (SWRA, 2006)

Local Employment Space Strategic Assessment for Cornwall & Scilly: 2007 – 2017 (Cornwall & IoS Economic Forum, 2007)



Health Impact



Cornwall Countryside Access Strategy (Cornwall County Council, 2007)

Cornwall LDF Core Strategy, Draft Topic paper, Economy, (June 2010)

Community Cohesion

To reduce poverty and social exclusion and provide opportunities for all to participate fully in society

National PPS7: Sustainable Development in Rural Areas (ODPM, 2004)

Local Cornwall Sustainable Community Strategy (Cornwall Strategic Partnership, 2003)

The Rural Economic Strategy (Rural Cornwall and Isles of Scilly Partnership, 2003)

Environment and Housing

Biodiversity To conserve, enhance and restore the condition and extent of biodiversity in the county and allow it’s adaptation to climate change. Landscape To protect and enhance the quality of

National PPS7: Sustainable Development in Rural Areas (ODPM, 2004)



Health Impact



the natural, historic and cultural landscape and seascape Water Quality To maintain and enhance water quality and reduce consumption and increase efficiency of water use. Housing To meet the needs of the local community as a whole in terms of general market, affordable, adaptable and decent housing Design To promote and achieve high quality design in development, sustainable land use and sustainable built development

Local Cornwall Sustainable Community Strategy (Cornwall Strategic Partnership, 2003)

The Rural Economic Strategy (Rural Cornwall and Isles of Scilly Partnership, 2003)

Age Accessibility To improve access to key services and facilities by reducing the need to travel and by providing safe sustainable travel choices Energy To encourage the use of renewable energy, increase energy efficiency and security and reduce fuel poverty

International White paper – ‘European transport policy for 2010: time to decide’ (EU Council, 2001)

National PPG 13 – Transport (ODPM, 2001)

PPS6: Planning for Town Centres (ODPM, 2005)

The UK Fuel Poverty Strategy (DEFRA, 2011)
