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Could devolving powers make UK towns and cities more healthy?

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Giving town and cities more powers to decide over taxation and public spending could improve public health across the UK, an influential new report has found.

The role of cities in improving population health report, from The King's Fund, argues that devolution could play a crucial role in boosting public health and reducing health inequalities.

The report draws on case studies and interviews with local leaders in 14 world cities including New York, Madrid and Copenhagen to find new ways of tackling public health challenges.

It finds that the same characteristics that make cities engines of growth, innovation and creativity often lead to inequalities and concentrations of poverty and ill health.

One of the key findings was that international cities that have stronger powers have been able to use them to have a positive impact on the health of their populations.

These include using planning powers to create public spaces that encourage physical activity, bringing in controls on the advertising and sale of unhealthy foods, and investing in public transport and cycling/walking routes to reduce traffic and improve air quality.

The research also cites the examples of Tokyo and Madrid, where the empowering of local people has led to the creation of health-promoting neighbourhoods with strong social ties and vibrant community life.

Compared to other cities around the world, England’s cities have limited autonomy from national government and less control over revenue raising, with 90 per cent of tax revenues being raised centrally.

The report, therefore, calls on the government to consider extending further tax-raising and regulatory powers to cities.

'Around the world, cities are looking at what they can do to help residents live longer, healthier lives," said Chris Naylor, Senior Fellow at The King’s Fund and lead author of the report.

"Increasingly, leaders in cities such as Amsterdam, New York and Paris are using the powers and resources at their disposal to drive improvements in the health of their populations.

'The cities that have made the fastest progress are those where mayors and other local leaders have invested their own political capital in tackling public health issues, and where they are given the decision-making and tax-raising powers they need to take action.

"Granting England’s cities greater powers could help to reduce health inequalities and address growing problems caused by poor housing, air quality and other issues."

To read the full report, click here for the King's Fund home page.

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