There is no getting away from the fact that we as a nation are getting fatter. The issue of obesity is never out of the media and Government initiatives are constantly being launched to help us get fi tter. But how does the housing sector squeeze into all of this? Michelle McKenna investigates

With waist-lines generally expanding, must we change the type of homes that we build to accommodate our ever-larger population? And can our urban environment have an effect on our weight? These are the questions that the housing sector must inevitably address.

The Government-commissioned Foresight report, Tackling Obesities: Future Choices project, published in October 2007, predicted that if no action was taken, 60 per cent of men, 50 per cent of women and 25 per cent of children would be obese by 2050.

The health implications of obesity include an increase in the risk of type-2 diabetes, some cancers, and heart and liver disease and according to the Department of Health the direct costs to the NHS are estimated to be £4.2 billion. Foresight has forecasted that this will more than double by 2050 if things continue as they are.

The report also talks of wider costs to society and the economy such as a reduction in productivity due to increased sickness absence and it has estimated that weight problems have already cost the wider economy in the region of £16 billion set to rise to £50 billion per year by 2050 if left unchecked. So what about housing? If we as a nation continue to get bigger are features such as wider hallways and hoists for lifting people to become the norm? The recent case of 39-stone Michael Williment of Norwich has attracted wide-scale media interest and a hail of criticism.

Williment, 67, who is registered disabled, and his wife Heather are currently tenants of Norwich City Council but their home in a sheltered accommodation block is to be demolished as part of a redevelopment scheme.

Having been unable to find the couple a suitable new home the council turned to Flagship Housing Association for support, who was also unable to come up with the goods and the decision was taken to build a two-bedroom bungalow.

Designed by architects Chaplin Farrant, it is being built by contractor Lovell, funded through a combination of private finance and a grant from the Homes and Communities Agency.

The property will include a carport, wet room with shower, height adjustable kitchen units and two hoists.

A spokesperson for Norwich City Council explained that the council didn’t hold statistics on obesity, adding: “We have an obligation as a social landlord to meet the needs of people with assessed medical disability needs and this man has been assessed as having a disability.”

Flagship said that the property “will provide a suitable environment for a household with a physical disability”. Its spokesperson added: “Our obligation is to work with local authorities in their role as the Strategic Housing Authority, to provide homes for those who need them. As well as general needs housing, we build purpose built bungalows for people with physical disabilities. These are generally, fully wheelchair accessible. In the two instances of homes for obese customers, the properties have been designed around their specific needs, in the same way.”

The HCA also spoke of a commitment to accommodating individual’s needs. A spokesperson said: “The HCA works with local authorities to deliver homes that meet the needs of local people. This will include homes of different sizes, types and design that are appropriate for families, older and vulnerable people, disabled people and support the HCA’s commitment to environmental sustainability.”

It would seem that cases such as Michael Williment’s are rare – Flagship builds approximately 1,000 homes each year and only twice in 15 years has it been asked to provide purpose built homes for obese people.

But if the statistics for future obesity levels were to become fact then surely we would see more specially adapted homes, raising the question is this really a matter for the housing sector or should it be left to the health care professionals?

The relationship between housing and obesity was highlighted during the World Health Organization’s fourth ministerial conference on Environment and Health in Budapest in June 2004.

It was stated that “the increasing prevalence of obesity in many countries means that it should now be considered a pandemic” and that understanding, measuring and altering the “obesogenic” environment was critical to success in dealing with the pandemic, adding that housing policies have a “crucial role to play.”

In 2006, CABE, the government’s advisor on architecture, urban design and public space released a report highlighting how urban design can be key to tackling the problem of obesity.

“Physical activity and the built environment” called on architects and designers to create places that encourage people to walk and cycle during everyday activities, rather than just for fitness.

And this is still very much the school of thought within CABE today. David Ward public affairs adviser for the body said that there should be more funding and priority for active travel and better public spaces and green infrastructure to encourage people to exercise.

He said that while it is possible to adapt homes to accommodate larger people “you are trying to shut the stable door after the horse has bolted” and that it was through town planning and creating neighbourhoods where people are more likely to go out and exercise, where high impact gains could be made.

Ward explained that often new housing developments are “residential ghettoes” with no nearby services, making people reliant on their cars and that some urban environments were “hostile” and discouraged people from walking about. “You have got to have walkable and friendly streets,” he said. While making streets more pedestrian friendly and creating more open spaces is a step in the right direction, Ward realises that it is not a case of waving a magic wand and immediately changing people’s attitudes.

“Not everyone is suddenly going to become some sort of fitness fanatic over night,” he says. “The point here is it is about enabling people to make healthy decisions and if you create an environment that is nicer to be in and you create public spaces that people want to go to, for a coffee or whatever then they are more likely to go and walk down to that public space and meet their friends than they are to drive somewhere and drive back and be pretty sedentary.”

There is no doubt that there has been a shift towards creating better environments, as highlighted by the launch of the Government’s £30 million healthy town’s programme.

Nine English towns have been chosen to try out a series of health initiatives including a loyalty card allowing individuals to earn points by buying healthy food and taking part in exercise which can be redeemed for free sportswear or games equipment.

Other ideas include redesigning town centres to encourage walking and cycling, a grow-your-own fruit and vegetable scheme for social housing tenants and a ‘cycle-recycle’ project to help people learn to ride and look after their bikes. Action is also being taken to make parks more attractive places to visit,
and to create safe active travel corridors.

The initiative is part of a wider £372 million project to encourage healthier living, and runs alongside the Change4Life “lifestyle revolution” scheme to help parents ensure their families “eat well, move more and live longer”. While Ward says that the initiative is a positive step he also points out that it is not going to change everything on its own and “the key thing is recognising how planning as a whole needs to operate.”

He believes that a more joined up approach between local authorities, the Primary Care Trusts and Government departments is needed. “It is one thing the planning department in a local authority talking to the PCT but the Highways engineers need to be brought in as well to create these walkable, friendly streets,” he explains.

More Government funding for things such as active travel is necessary if we are ever going to catch up with countries such as Holland where their budget for active travel and cycle parking at train stations is the same as the active travel budget for the whole of the UK. “They do have advantages in Holland such as wider roads, which can be better designed with separate bits for people to cycle in which is not as easy here, so it is not a case of us being bad and them being good but certainly we have got a bit of catching up to do,” says Ward.

He said that a good example of a joined up approach is a customer service centre in Sunderland which houses a GP practice, minor injuries unit, a community cafe, library, gym, housing office, and Surestart services. Ward explained that by bringing all of these services together in a focal point people are more likely to walk to the centre than they would be if the services were situated in different parts of the town.

Of course, the obesity figures that are quoted are merely predictions for the future and if the right action is taken now to help people become more healthy and active then they may never become a reality.

But one thing that seems to be certain is that the obesity crisis is not just an issue for the NHS and if other bodies don’t get involved the implications could be far reaching and the way in which we build homes could change.

It would seem that the answer is not in specialist housing provision but looking at the wider picture and at how the communities that we build and the environments that we create can not only make people happier but healthier too.

Fact file

• Among adults, the prevalence of obesity has trebled since the 1980s
• Obesity is responsible for 9,000 premature deaths a year
• The Health Survey for England data for 2007 shows that 23.6 per cent of men and 24.4 per cent of women were obese, and 41.4 per cent of men and 32 per cent of women were overweight. It also revealed that 16.4 per cent of girls and 17.1 per cent of boys aged 2-15 were obese, and 14.3 per cent of both girls and boys were overweight
• Healthy Weight, Healthy Lives: A Cross-Government strategy for England was published in January 2008. It was the first step in a sustained programme to combat obesity and support people to
maintain a healthy weight.
• The ‘Tackling Obesities: Future Choices’ Foresight project, sponsored by the Public Health Minister, Dawn Primarolo, was an in-depth two-year study by almost 250 experts and scientists to examine the
causes of obesity and map future trends to help Government plan effective policies both now and in the future.
• The Change4Life advertising campaign began on 3 January 2009 and aims to make the subject of weight and physical activity a hot topic