1. Spatial policy development and PH engagement Issues and experience Dominic Harrison Director of Public Health Blackburn with Darwen Twitter @BWDDPH

2. Ill health is a function of place & space as much as people & behaviours Source: Ben Barr University of Liverpool 2014 Change the people…. but the health risks remain ?

3. Do we really Know enough about what makes places healthy or unhealthy? Source: Due North (2014)

4. Kings Fund (2014) Public support for spatial & infrastructure public health action and investment Vs bio-medial & behavioural interventions

5. Amsterdam wasn’t always Amsterdam How the Dutch got their cycle paths. A mass die-in outside the Amsterdam’s Rijksmuseum in the 70's. Source: @edcrooks 9.50 am 23/11/13

6. Time for a cultural change in place and space ? Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62341-7/fulltext

7. Spatial Planning & Health - Cultural interventions? Road safety & Speed : AustraliaPublic Utility of Streets: UK

8. Creating Healthy Places- Strategy 1.Social Determinants of Health Fund - £1m out of £13m to 9 other Directorates – delivery of evidenced based marmot interventions Plus accountability for 5 Public Health outcomes. Accountability through a Public Health Delivery Agreement. 2.Embedding capacity/ relational intervention : Senior Public Health staff linked to each Directorate. 3.Multiple ‘entry points’ for healthy place development : e.g using Health Overview and Scrutiny to develop Appreciative Enquiry approaches to Obesity & Food Poverty 4.Restructuring mainstream service delivery : Promoting community resilience including restructuring health and local government services into a locality delivery system with ISNA/HWB Strategy/service planning coming from ‘below’. 5.HIAP: Wide range of ‘health in all policies’ approaches – Social value, integration HIA/EIA, etc

9. Risk Factors or Risk Conditions Choice or ‘choice architecture’ LA Public Health Service Investment ‘Perspectives/Narrative ’ Not everything that is a public health investment comes with a public health label In fact 1.Public Health Directorate Headcount = less than 1% of all Council employees 2. Public Health budget = about 3.5% of total LA annual spend So Developing new models of Health Governance of total public services investment in ‘place’ is key….

10. What's the worst that could happen ? Source: @Darth_Harper 7.58pm 21May 2014