Lucy Saunders – Director of Healthy Streets

Lucy Saunders is a unique combination of public health specialist, urbanist and transport planner. She created the Healthy Streets Approach, an evidence based-framework for decision making at every level to embed public health in city transport, public realm and planning. Building on her success in London she now shares her expertise with cities and regions globally.

As the founder of the Healthy Streets Approach, a unique evidenced based-framework for decision making that embeds and brings together public health in city transport, urban design and planning, can you explain how the approach works to create more sustainable and liveable cities?

I am a public health specialist which means my focus is on creating an environment that is designed around the needs of people, to enable them to live well. The Healthy Streets Approach is based on 10 Healthy Streets Indicators. If we focus all our decisions on improving these 10 Indicators then we create cities that meet human needs, streets that are safe and welcoming for all to live active, connected lives.

You worked with with Transport for London & The Greater London Authority  to implement the Healthy Streets Approach in London. What has been the impact and examples so far of how the Healthy Streets approach has improved the health of London’s streets?

I developed the Healthy Streets Approach back in 2011 and then took this to London to be the first place to apply this Approach. London is applying this Approach very thoroughly through changes to policy, governance, funding and practice. This is important because Healthy Streets is not about delivering a handful of high profile projects, it’s about changing everyday decisions and practice to deliver better outcomes for people across a whole town or city. The changes that have been taking place in London in the last couple of years are already making a difference but these may not be obvious to the citizens. The projects that are being funded, designed and implemented are more closely aligned with what people need. This is being measured with Healthy Streets tools e.g. the Healthy Streets Check for Designers and progress is tracked though annual reporting in the Travel in London publications.

Although the Health Streets Approach has 10 Healthy Streets Indicators, what do you think is / are the biggest indicator(s) of a liveable and healthy city?

The biggest indicator of a liveable and healthy city – when we are looking through the lens of streets and transport – relates to motorised vehicle use. The biggest health impacts of transport and streets in cities all relate to how we manage motorised vehicles, not just private cars but also freight, deliveries, servicing, taxis and public transport. We should only be using motorised vehicles for journeys that could not be done by more active modes of travel like walking and cycling and we should be making sure that the motorised vehicles in our cities are minimising their harm in terms of road danger, intimidation, community severance, air pollution and noise through how, where and when they are used and parked.

As well as working in the UK you are also now taking the Healthy Streets Approach to other countries around the world to improve the health of cities. How has the approach worked in different contexts and which cities are putting the health of their people first?

The Healthy Streets Approach is based on what humans need and this is the same worldwide, regardless of whether you live in a village, town or city. How you apply the Healthy Streets Approach is tailored to the local context in terms of resources, politics, opportunities, public opinion etc. London is a big, global city, with nearly 9million inhabitants and a unique set of challenges and opportunities. The other towns and cities now looking to apply the Approach are mostly smaller than London, with less public transport provision but otherwise facing many of the same challenges that London has.

I am not aware of any other city that has yet gone as far as London has to put health at the heart of decision making. Many cities are taking measures that will benefit health but to deliver change on a scale that will produce measurable impacts on improving population wide health and reducing health inequalities you really need health as the focus for decision making.

Smart technologies are increasingly being used by cities to improve the lives of their citizens, how do you see smart technologies working successfully to improve the health of streets?

Smart technologies can be really helpful in delivering Healthy Streets. For example better access to information about travel options and more integrated ticketing systems for public transport means more people can travel sustainably more easily. Technology that can restrict vehicle speed and movements in places with lots of people walking, cycling and spending time can also be seen as a really positive prospect on the horizon. What matters is to ensure that there is a strong policy framework in which new technologies are applied so that we use the opportunities to make the city better for people.

What policies would you recommend cities around the world implementing to ensure they are positively contributing towards healthy and sustainable streets and places?

I would recommend that cities focus on how they reduce the dominance of motorised traffic, this will deliver the biggest and broadest health benefits. It’s a fallacy to assume that you can maintain the same levels of vehicle use and deliver a better environment for people to live in. You have to tackle the root of the issue, this can seem a daunting prospect for leaders so they need the support of a positive framing, such as Healthy Streets,  which will engage the citizens and some key data to enable them to make the changes that are needed

One of the main aims of Cities Forum is promoting and inspiring best practice in city sustainability, how do you think that cities can learn from the Healthy Streets Approach to improve their sustainability and how can they utilise the tools that are part of the framework?

The Healthy Streets Approach is deceptively simple. Once you start digging in to what needs to change to deliver improvements in the 10 Healthy Streets Indicators you find that city planning needs to change in a range of ways to move away from the default setting of prioritising car movement and storage over human health. To achieve this you need to bring together a wide range of stakeholders to work towards delivering this one shared vision. London has shown that this can be done but it takes some time and commitment to achieve. While it is a big task it can be tackled in bite-sized pieces but carefully assessing what actions are most effective in what order. I have learned a lot from my experiences of working in London which equips me to do this assessment and planning. The Healthy Streets tools are available online for anyone to use but the real value that comes from the tools is in how they are used to change the decisions that are made and the systems in which those decisions are made.

What in your opinion is the most important challenge and solution facing cities in becoming more sustainable?

I see the biggest challenge as being the pace of change. Around the world we see cities striving to become more sustainable but the measures they are implementing are not keeping pace with peoples needs. I see a strong, positive and unifying policy framework as essential to delivering the pace of change needed while maintaining the support of the people. This is why I think the Healthy Streets Approach is so valuable, because it frames work by the wide range of stakeholders who make decisions relating to streets and transport it can deliver change on the scale that is needed. It is a positive and accessible framework which the public, business, policy makers and practitioners can all work together to deliver.


In the future how do you see the focus and priorities of the health of our streets evolving?

There is a strong and growing positive energy for focusing on the health impacts of our streets. In different places and at different times there are different priorities such as air quality, health inequalities, social connectedness, road traffic injuries, child development and physical activity to name a few. The Healthy Streets Approach does not focus on improving just one of these health impacts but all of them which means that one single approach can be applied over a prolonged period and can bring together people with differing priorities.

Pictures: Lucy Saunders –

Richard Lambert

About Richard Lambert

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Richard Lambert, Coordinator of Liveable Ciiies Prorgam. He has been working for 11 years creating sustainable urban communities in London, UK and Internationally. Specialising in the development of urban green infrastructure and pedestrian walking related improvement projects, policies and strategies.