Economic development is often seen as the engine of prosperity, designed to create more jobs, investment and growth. But without attention to people's health, its benefits are likely to be partial and fleeting. Poor health holds back individuals, limits productivity and weakens local economies. Good health is a pre-requisite of growth as well as aby-product. It makes growth possible and should be considered a central measure of success.
Health and growth – inextricably linked
When communities struggle with poor health, participation in the workforce drops, productivity declines and public services absorb the strain. Despite growing recognition of these links, health remains largely absent from most local growth strategies.
Our new research with the Growth and Reform Network presents evidence of what is effective in integrating health into housing, employment and regeneration from existing practice. Although some places in the UK are pioneering new approaches, practice is uneven and lacks a consistent understanding of impact. As the Government devolves more powers, this could even risk widening inequalities rather than reducing them.
Double dividends for health and growth: evidence from the UK and beyond
Our review of 144 international approaches shows many high-income countries are already showing what is possible in improving health through economic development. Our global peers already treat health as core infrastructure, with real and tangible benefits to health from action on housing, the built environment and regeneration, community infrastructure and labour market engagement. The UK must catch up – for the sake of both our health and our economy.
For example, in New Zealand, retrofitting homes has improved respiratory health, reduced school and work absences and decreased health care demand. In Andalusia, largescale, coordinated housing and community infrastructure investment has been associated with lower preventable mortality. Targeted support in Germany increased employment among those with severe mental health problems by nearly 19%.
Closer to home, The Health Foundation's Economies for Healthier Lives programme shows how local decision-makers are connecting economic development with residents' health. In Havant, engaging with both employers and young people not in education, employment or training has created opportunities for good-quality work, particularly for young people with health conditions. In Salford, community wealth-building has introduced new contracts for social enterprises. Across Glasgow City Region, major capital investment decisions are now assessed on their impact on health inequalities.
These successes demonstrate that economic policy designed with health in mind can yield double dividends: stronger economies and healthier communities.
Driving an upswing through policy change
The Devolution Bill sets out a requirement for 10-year local growth plans to develop local economies. Pride in Place will invest billions in regeneration, high streets and community assets, giving local areas a chance to design environments that promote connection, activity and belonging. The New Towns programme will deliver thousands of homes, with 40% affordable housing, alongside schools, GP surgeries, green space and transport links.
Together, these initiatives could redefine what ‘good growth' looks like, if health is built in from the start. However, new towns and local plans risk repeating old mistakes: poorly connected neighbourhoods, straining public services and areas that lack the skills that businesses need. The result would be widened inequalities and weaker long-term growth.
To seize this moment, health must become a standard expectation in every local growth plan - not an optional add-on. The Health Foundation and the Growth and Reform Network are calling for amendments to the Devolution and Community Empowerment Bill to make this happen, alongside practical support so this can be implemented across the UK.
Action for policymakers to strengthen growth and health
Drawing on our evidence we have developed policy solutions so that growth and health are delivered hand in hand.
- Require health assessments alongside economic and environmental appraisals for all local growth and new town plans
- Establish a set of shared key indicators and outcomes that have an evidenced link to health and make this a condition of funding while allowing local flexibility to tailor approaches to what the community needs
- Involve public health teams early in the design, delivery and evaluation of local economic strategies. Publish clear guidance for strategic authorities on co-design and iterative evaluation and provide resources for capacity building.
Igniting economic growth in all places
The Devolution Bill should ensure successful local growth is accessible for all parts of the UK. If health becomes a shared outcome across all levels of government, new towns and local plans can deliver prosperity that is both fair and long-lasting.
At The Health Foundation, we will continue to explore how devolution can strengthen health including through our work through the West Midlands Combined Authority on the Mayoral Regions Programme. Devolution offers the chance to bring decision-making closer to communities, but it will only fulfil its promise if good health is treated as a foundation of growth.
Sharlene McGee is a policy manager in the Healthy Lives team at The Health Foundation.
