Planning 'key to improving health'

TASMANIA'S hospitals are under pressure.

Increasing numbers of people are presenting to emergency departments, while others have waited more than a year for elective surgery, in a public hospital system costing about $830 million a year to run.

Launceston General Hospital had a record 44,723 emergency department presentations last year, up 21.6 per cent from 2008, and Tasmania Health Organisation North chief executive John Kirwan said there was only so much they could increase capacity to cope.

Could town planning make a difference?

As Tasmania's health system is increasingly challenged by high rates of obesity, physical inactivity, unhealthy eating and chronic disease, health advocates are looking to the unseen forces that often influence our wellbeing.

The Heart Foundation Tasmania chief executive Graeme Lynch said this included urban design and infrastructure.

For 10 years the foundation has been developing and pushing for a state policy for healthy places and spaces, which would mandate that state and local governments and developers design towns and facilities with healthy lifestyles in mind.

Labor and the Greens backed the policy during the state election campaign, and Mr Lynch said it had support from the Director of Public Health, the Health and Wellbeing Advisory Council and the Premier's Physical Activity Council.

Deputy opposition leader Jeremy Rockliff said the Liberals would consider a state policy encouraging physical activity as part of their new planning structure.

Mr Lynch said there was strong evidence that urban planning and design could make the healthy choice the easy choice for whole populations.

He said infrastructure for walking, cycling, and good public transport within towns was proven to significantly increase physical activity, and access to shops and community centres helped promote healthy eating.

"This is really important because physical inactivity is one of the - if not now the single biggest - risk factors for heart disease, stroke, diabetes, a lot of cancers and kidney disease," Mr Lynch said.

He said there were strong, proven links between green environments, open spaces and mental health, with parks and community spaces also important for social cohesion.

According to last year's State of Public Health report, 65.5 per cent of Tasmanian adults were obese, 69.4 per cent were insufficiently physically active, and less than 20 per cent of secondary students got enough physical activity in 2011-2012.

Mr Lynch said this was partly fuelled by the state's built environments, with Ravenswood and Rocherlea examples of poor town design which further fuelled disadvantage.

"Planning has put people who are socially and economically disadvantaged out away from the concentration of the better facilities and open spaces that are well designed, without good walkways and pathways, and just access," Mr Lynch said.

Tasmanian Chamber of Commerce and Industry chief executive Michael Bailey said health-minded design was important to workplace health and safety, the economy and productivity, but he was hesitant to see it legislated as a state policy.

"I think what's a more important discussion is just making sure that businesses and developers understand the benefits of this sort of thinking, that really to me that's where this discussion lies," Mr Bailey said.

Property Council of Australia state chief executive Mary Massina said anything that ensured better planning and consistency across Tasmanian cities was a good thing.

Ms Massina said the Property Council had called for a set of interlocking state policies, which would set guidelines for governments on what was achievable and what the targets were.

"What we actually need to ensure, is state policies when they are developed, actually are mutually supportive of each other," she said.

Mr Lynch said he had heard concerns that the policy would create red tape, but insisted it would only guide future planning decisions.

"It doesn't actually cost money because it's a way of designing, not actually imposing cost burdens on people," Mr Lynch said.

He said if the state government was serious about making Tasmania the healthiest state in Australia by 2025, they would have to consider the Heart Foundation's state policy."The most powerful way of changing the health and wellbeing for the whole of population ... is doing health by stealth or making healthy choices the easy choices, where individual decision making doesn't come into it, you just create a healthier environment," Mr Lynch said.

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