Health and the ethics of planning

Only the other day yet another study added to the quantum of "what we already know, which is that people who are physically active are half as likely to get cardiovascular disease as those who are inactive. Being active at any age helps control weight and reduce blood pressure and cholesterol. Itwill provide long-term benefits for your heart's health and general health." The mounting evidence is unassailable. People with high cholesterol levels, people who smoke, people who lead sedentary lifestyles, people who are overweight are all likely to hear from their medical practitioner about diet and exercise. And enticements to exercise are frequently available, the pool, the path, the track, the pitch. Half an hour's exercise every day protects you from cancer, depression... the list is impressive. Planners have responded with healthy places and spaces guidelines which focus on making the physical enticements available in every 'community' so that individuals can do the right thing for their own good. All this evidence, however, it just one part of the picture—the individual behaviour part. It's the part that you can deal with yourself if you decide to. But its not the whole picture. In the other part of the picture are the things that you as individual can do nothing or little about. The interesting thing is that it is this other part of the picture which epidemiological research shows has by far the greater influence on your risk of heart disease, cancer, mental illness and premature death, For example, this research has been demonstrating for more than a decade that individual behavioural factors account for only a tiny proportion of risk of death from coronary heart disease and that social factors account for the major part. This research which initially focused on mortality and coronary heart disease has been extended—to "morbidity and mortality, obesity, teenage birth rates, mental illness, homicide, low trust, low social capital, hostility, and racism' and more recently to "poor educational performance among school children, the proportion of the population imprisoned, drug overdose mortality and low social mobility/'^