How has planning evolved since World War II?

The greatest change to planning occurred as a result of World War II (1939 to 1945). It was clear that rebuilding cities and towns after the war would be a significant task. However, it was also seen as an opportunity to build better, healthier places.

The Town and Country Planning Act of 1947 was designed to support the large-scale rebuilding and planning of cities and towns. The Act nationalised land use and development rights, establishing that planning permission was required for land development. This meant that wide-ranging powers were given to local authorities (1). The Act was part of a wider legislative programme which included establishing the NHS through the National Health Service Act 1946. This Act formed the basis for the contemporary planning system in the United Kingdom today.

What happened next to public health in planning? A concern for health remained central to British planning until the 1960s. However, the garden city ideology was largely superseded by ‘modernist’ planning, a set of principles that sought a rational solution to overcrowded cities and housing shortages. One result was an increase in large-scale public housing schemes.

From a twenty-first century perspective, it is easy to be critical of the resultant tower and slab-block developments. However, initially many families welcomed having central heating and indoor bathrooms, and early communities embraced the change from Victorian houses.

Due to the economy and a shortage of skilled workers following the war, the mass housing developments often used innovative methods of building and materials to build quickly and cheaply, including prefabrication. This approach had implications for health. Construction was not always to the standard it should have been, and many flats were cold and damp in the winter due to poor insultation. Elements such as experimental heating systems could fail to work properly, and communal gardens could become litter-strewn and uncared for.

Despite our long history of understanding the detrimental effects on health of factors such as pollution and household overcrowding, practices still exist within our modern regulatory and governance systems that shape the development of the environment in ways that are likely to harm health. For example, throughout the 20th and 21st centuries as we have continued to urbanise car-centric design has taken precedence over people centred design (2). We continue to live with the health consequences of this trend today. Dispersed, car-oriented towns and cities promote sedentary lifestyles and local shopping areas have become, arguably, less healthy, often comprising a combination of fast-food outlets and other low-end retail.

But there is an appetite to ensure meeting health and wellbeing needs is a fundamental organising principle underpinning all planning policy and decision making. This has been partly driven by post-COVID lessons as well as strengthening evidence from research and advocacy groups (3). We will set out the legislative and policy drivers for public health in planning today in next week’s learning.