As the Government moves forward with plans for a new generation of towns, the opportunity to embed public health into the very fabric of these developments has never been greater. In this blog, Councillor Sarah Rouse explores how housing and placemaking can become powerful tools for improving health and reducing inequalities. Drawing on historical lessons and current public health thinking, she makes the case for putting health at the heart of planning, design, and delivery, ensuring that new towns are not just places to live, but places to thrive.
The Government's commitment to developing a new generation of towns-following recommendations from the New Towns Taskforce, marks a significant opportunity to rethink how we build communities. With at least three new towns to be progressed in this Parliament and more locations under consideration, this is not simply a housing programme. It is a chance to create places that actively support health, wellbeing, and equity.
To realise this vision, public health must be at the heart of planning, design, and delivery. This means drawing on the full breadth of public health expertise across local government, integrated care systems, and communities. It also means recognising the long-standing relationship between housing and health, and learning from the past to shape a healthier future.
Public health and housing have been intertwined for centuries. In the 19th century, the rapid urbanisation of Britain led to overcrowded slums, poor sanitation, and deadly outbreaks of cholera and typhoid. These crises prompted landmark legislation such as the Public Health Act of 1848, which introduced sanitation infrastructure, clean water supply, and drainage systems-laying the foundation for modern urban planning. Later, the garden cities movement, led by Ebenezer Howard, sought to create healthier environments by combining housing, green space, and employment. Towns like Letchworth and Welwyn were designed to reduce overcrowding and improve air quality, reflecting a deep concern for the health of residents.
After the Second World War, the UK embarked on a major programme of new town development to address housing shortages and urban sprawl. These towns, including Milton Keynes and Stevenage, were informed by public health principles such as access to green space, separation of industry from housing, and walkable neighbourhoods. More recently, the concept of healthy urbanism has gained traction, with public health influencing planning through initiatives that promote active travel, mental wellbeing, air quality, and social cohesion.
This legacy shows that when public health is involved, housing becomes more than shelter, it becomes a platform for wellbeing. Yet despite this history, the connection between health and housing is still too often overlooked in contemporary development.
Housing remains one of the most powerful determinants of health. The quality, location, affordability, and design of homes all influence physical and mental wellbeing. Poor housing contributes to respiratory illness, stress, injury, and social isolation. In contrast, well-designed homes and neighbourhoods can promote active lifestyles, social connection, and access to services. The New Towns Taskforce has rightly emphasised the need for 'healthy and safe places' with strong social infrastructure and environmental sustainability. But these goals will only be achieved if public health is embedded from the outset-not as a bolt-on, but as a core principle guiding every decision.
When public health is not involved in housing and placemaking, the consequences can be long-lasting. Developments may overlook the needs of older people, disabled residents, low-income families, or those with long-term conditions, entrenching health inequalities. Poor design and lack of green space can lead to isolation, anxiety, and stress. Without planning for health and care infrastructure, new developments can place unsustainable pressure on GPs, hospitals, and social care. Opportunities to promote walking, cycling, healthy eating, and social connection are lost when health is not considered in design. Environmental risks such as poor air quality, noise, and inadequate insulation can lead to long-term health harms. And without public health input, there may be no clear responsibility for monitoring or improving health outcomes in new communities.
To avoid these pitfalls and maximise the potential of the New Homes Programme, public health teams must be involved in shaping the vision for new towns. They can help ensure that health and wellbeing are central to local plans, environmental assessments, and infrastructure strategies. Health-informed design principles-such as walkability, access to nature, active travel, and inclusive public spaces-should be embedded in planning frameworks and developer agreements. Local health data and community health profiles can guide decisions about where and how to build, and what services are needed. Public health can also act as a bridge between housing, planning, transport, health care, and social care, ensuring joined-up thinking and shared goals. And through community engagement, public health professionals can help ensure that new towns reflect the needs and aspirations of the people who will live there.
This is not just a job for local authorities. Integrated care systems, NHS partners, housing associations, developers, and community organisations all have a role to play in building health into the foundations of new towns. Public health provides the evidence, tools, and leadership to make this happen-but it requires commitment across the system.
The New Towns Programme is an opportunity to create places that support healthier, longer lives. But this will only happen if health is treated as a core outcome of housing-not a secondary consideration. Public health should be seen not just as a stakeholder, but as a strategic partner in shaping the future of place. The decisions made now will shape the health of generations to come. Let's build with that in mind.
Councillor Sarah Rouse