From fast food to flood risk: how planning decisions affect our health and wellbeing

New explainer warns planning decisions are shaping Wales’ health, with urgent action needed.

Public Health Wales and the Welsh NHS Confederation have today published a new explainer showing how decisions about housing, transport, green space and food environments are directly influencing the nation’s health – and why Wales urgently needs a whole‑government approach to create healthier places and communities.

The report highlights that poorly planned environments are contributing to rising obesity, physical inactivity and widening health inequalities. In 2024/25, 27.3% of children aged 4 to 5 years were overweight or obese, while 62% of adults self-reported being overweight or obese. At the same time, new 24‑hour fast‑food outlets continue to be approved. Health boards are under growing pressure to expand weight management services, yet current capacity can only meet a fraction of demand.

Current planning laws give health boards limited powers to object to developments that may harm population health. While local health teams are feeding into Local Development Plans, progress is slow and opportunities to shape healthier environments are being missed.

The explainer shows that planning can be a powerful tool for improving health and wellbeing – enabling active travel, access to green space, quality housing, employment and healthy food. But it can also entrench poor health when unhealthy food environments grow, when developments are built around car use, or when housing and retail are placed far from services. Evidence shows that deprived areas can have up to five times as many hot food takeaways as more affluent communities.

The publication comes ahead of the new Health Impact Assessment Regulations, which from April 2027 will require public bodies to assess the health implications of major decisions. Combined with the Well‑being of Future Generations Act and the Welsh Government’s renewed focus on prevention – including a new Deputy Minister for Public and Preventative Health – the report proposes that Wales now has a major opportunity to redesign places in ways that support healthier lives.

Liz Green, consultant in public health, policy and international health and Cheryl Williams, principal public health practitioner, Wales Health Impact Assessment Support Unit (WHIASU), both Public Health Wales NHS Trust said: 

“Planning is one of the most powerful levers we have to improve population health. Good design can support physical activity, mental wellbeing, climate resilience and healthy food access – but poor design can do the opposite. This explainer sets out the evidence and the practical steps Wales can take now.

“It’s important, though, that we highlight examples of positive progress, including local authorities strengthening their Local Development Plans to address the density of hot food takeaways in deprived areas, and innovative design approaches such as green roofs and walls in Swansea.”

The Welsh NHS Confederation said the explainer should prompt “grown‑up conversations” about how planning decisions are contributing to ill-health and placing additional pressure on the NHS.

Darren Hughes, director of the Welsh NHS Confederation, said: “If we want to meet the new government’s ambition to get upstream and prevent illness, we must look beyond the health service and work with all partners, including local government. The wider determinants of health, including the environments people live in, are making them unwell and the planning system could play a crucial role in turning that around.”

Read the full explainer: How does Wales’ planning system impact on the health and wellbeing of the population?