Sustainable local economies for health project (SLEHP)

Introduction
There is a direct relationship between health and sustainability - a community must be healthy to be sustainable whilst an economy cannot be sustainable without the good health of its participants. The fundamentals needed to build healthy communities and sustainable economies are very similar and include: good housing structures, employment opportunities, high educational/skill levels, community cohesion, good transport infrastructure; high environmental quality - all with due regard paid to the social inequalities existing in different locations.

As “employment health” is a major determinant of health in general, it seems pertinent to examine the health of local employees and factors which may contribute to healthier employment in conjunction with local sustainability.

As part of the "London Works for Better Health" project, Brook Lyndhurst was asked by the London Health Commission to address the question ‘What makes a local economy which is both sustainable and health promoting?’ Brook Lyndhurst developed a London-specific framework that allows stakeholders to make decisions that are both sustainable and healthy in their local communities.

Methodology
The research involved an in-depth literature review drawing on the evidence base in all aspects of local economies, sustainability and health, e.g.diversity, recruitment, affordable housing, childcare provision, transport and skills. It also drew on the distinctive characteristics of London – as an economy and a place to live and work.

Brook Lyndhurst developed a matrix of factors which shape healthy and sustainable local economies, with the following frame of reference:

• Health factors relating to employment were assimilated through desk-based research and independently verified by key people working in public health. 
• Sustainable factors of a local economy were identified from the UK and London's Sustainable Development Commission Indicators and verified by desk-based research.
• Health factors were identified as those affecting individuals in relation to employment, whilst sustainable factors were identified as those affecting the place in which decision-makers operate.
• Brook Lyndhurst & London Works identified the intersection points in the matrix, where there were "in principle" connections between health and sustainable development factors. The links had to be causal in either direction.
• The "in principle" connections were then researched to validate arguments.

The factors identified as determinants of healthy sustainable local economies were then analysed in the context of specific London issues (lenses). 

Conclusion
The results are a matrix of "in principle" connections between health and sustainability in relation to employment and the local economy. For example, an important determinant of “employment health” is an individual’s ability to build and sustain strong social networks at work (psychosocial), whilst a sustainable local economy should positively address issues of diversity, equal opportunities, learning skills, education and income (social). SLEHP’s proposition is that a healthy sustainable local economy is one that incorporates factors on both these dimensions. At a practical level, it will require policies and good practice in relation to, for example, bullying, disabilities, mentoring and ESOL provision (English for speakers of other languages).

The resultant framework is a robust and practical means to help policy-makers and practitioners (particularly in regeneration and economic development) recognise the elements which make up a local economy which is both sustainable and healthy thereby achieving a positive impact on the health and sustainability of the locality in which they operate.

The SLEHP framework has since been used by the Barts and The London NHS Trust within their redevelopment programme and with Southwark Local Strategic Partnership.