To run or not to run: Keeping fit and healthy in the UK’s capital

I recently witnessed a friend of mine pondering over what could be worse for his health – going for a run on a really polluted street, or simply not going for a run at all. I thought ‘Is this really what it’s come to?’

Sadly, I think it is. But as a Londoner, I hope that the Mayoral election on 5 May will prompt discussion on how we can build a healthier London.

If you’ve been following London media, you’ll have noticed common themes cropping up in the numerous mayoral debates taking place across the city, with candidates being questioned on big domestic policy issues such as policing, housing, public transport and business. But air pollution has also emerged as a key theme.

My friend’s dilemma about whether to go for a run highlights the role our environment can have in shaping our choices (both positively or negatively) and ultimately our overall health outcomes, which are influenced by factors such as access to health care, schools and education; conditions of work and leisure; homes and communities; and our chances of leading a flourishing life.

We know that health inequalities run deep in London: you are more likely to live for longer if you live in one of London’s wealthier boroughs. There are many other crucial issues relating directly and indirectly to the health of Londoners including youth and maternal unemployment, homelessness, hate crime, violence against women, education and the high costs of childcare, to name but a few.

In addition, whoever wins the next election will face the challenges of dealing with cuts to public services and a climate of austerity.

So what powers does the London Mayor have to improve health?

Part of the London Mayor’s role is to reduce health inequalities and to promote improvements in Londoners’ health and wellbeing. The Mayor has the power to develop a strategy on tackling health inequalities, as well as strategies on topics including transport, economic development, housing, spatial development, environment and culture.

While the London Mayor only has executive responsibility over transport, housing and economic development, these aspects of our environment together probably have the greatest impact on our health. For instance, at the recent Salzburg Global Seminar (co-hosted by the Health Foundation) engaging local businesses and employers in the health of their local populations emerged as one of the opportunities yet to be grasped.    

So, critics may have claimed that London mayors can’t leave a lasting legacy because they have ‘no or very little control over education, health or the criminal justice system’, compared to the mayors of New York, Tokyo or Paris, but this underestimates the impact our wider environment has on our health.

Given where their direct power will lie, what are the five main party candidates - Zac Goldsmith, Sadiq Khan, Caroline Pidgeon, Sian Berry and Peter Whittle - pledging to improve health?

Air quality

Given that air pollution is accountable for 10,000 premature deaths per year in London it may not be surprising that air pollution features in most of the manifestos. This ‘invisible killer’ is also an issue that the public cares about. In a recent YouGov survey, 43% of parents rank air pollution as the biggest health threat facing Londoners today, above the likes of poor diet, drug use and unprotected sex.  

Boris Johnson set out plans for an ‘Ultra Low Emission Zone’ to be rolled out in 2020. Four of the five candidates outline ways in which they would either improve it, expand its remit, or speed up its introduction. Other proposed policies include tougher rules on heavy goods vehicles, pedestrianising parts of central London, using cleaner energy sources, improving delivering the charging infrastructure for electric cars and increasing congestion charges.

Compared with other major capitals though, these measures may not be enough. Cities like Paris and Delhi have already imposed car bans when pollution levels become too high, something which has yet to happen in London, although a couple of the manifestos do mention introduction of ‘car free days’ in some parts of London.

Active lifestyle

Only 2% of journeys in London are made by bicycle, a stark contrast to cities like Amsterdam and The Hague, where this figure is closer to 70%. Cycling deaths are well publicised in the media, and so encouraging and creating a more hospitable environment for cyclists has featured in most manifestos, through continuing delivery of the Cycle Superhighway Programme and extending mini-Holland projects.

Candidates have pledged to create and improve green spaces in London, protect the Green Belt, and establish safe walking routes in order to encourage more walking in city.

Healthy food and streets

Some manifestos seek to tackle the clustering of fast food outlets in London’s most deprived boroughs. Policy commitments range from ‘pocket farms’ (green spaces where children can grow their own food and raise chickens) to preventing the spread of fast food outlets near schools, mapping food poverty, and extending meals on wheels and free school meals.

Housing

The poorest parts of London face issues of overcrowded homes, leading to respiratory problems, infections, mental health issues. Some candidates have committed to building thousands more council homes, with solutions including turning the Olympic precept (Londoners’ council tax cash that went towards the 2012 Olympic Games) into a housing precept, amongst others. There is however disparity over how many homes will be affordable, what land is available, and the accessibility of skilled workers to build these new homes.

How does this make me feel as a voter?

As a Londoner myself, I would have liked to have seen population health referred to more consistently across all the manifestos. However, whatever the outcome of the election, I’ll keep my fingers crossed for some innovative solutions to emerge from City Hall and hope that in the future, the Mayor can lead the way as a champion for improved health.

Oh, and my friend pondering whether to run or not? Being rather a fan of running myself, I’m happy to say that he decided to just keep running!  

A full list of all mayoral candidates and links to their manifestos is available at the London Elects website. 

Natalie is a Policy Analyst at the Health Foundation.