Physical environment: introduction and policy context

The environment has been recognised as a key determinant of health throughout history, and has been described as such in many of the current models of health. Many important advances in public health in the 19th century, in particular improvements in water supplies and sewerage systems, were based on controlling the built and natural environment. The clean air acts in the latter part of the century significantly reduced the levels of respiratory disease in the population. As illustrated by Good Places Better Health (248 KB) and the Scottish Government’s vision and outcomes for the Environment Strategy for Scotland, the potential for the environment to create and nurture health is recognised as a vital counterpart to the ongoing challenge of reducing and eliminating environmental hazards.

Key physical environment factors that can nurture health and wellbeing include:

  • Having good quality green and blue (water) space within walking distance
  • The ability to move around places easily and safely on foot or by bike
  • Contact with nature in everyday life
  • Good maintenance of streets and public spaces
  • The availability of services and amenities
  • Effective public transport
  • Having places to meet people
  • Feelings of safety
  • Thriving communities with access to job opportunities

Aspects of the physical environment that are important to health and wellbeing in 21st century Scotland cover both traditional environmental health issues (such as air, water, pollution) and those related to the social sphere (housing, neighbourhoods, safe areas etc.). The benefits and the adverse influences that the environment can have are not fairly distributed across society, and the environment is part of the causal chain of health inequalities.

Policy context

The Place Standard for Scotland, a tool for assessing the quality of a particular place in order to drive or shape change, has been developed in partnership by Scottish Government, NHS Health Scotland (now Public Health Scotland) and Architecture and Design Scotland. The Place Standard Tool strategic plan 2020-2023 provides details of the national and international policy context, and sets out the vision and aims of the tool. A report on the Evidence behind the Place Standard Tool and Place and Wellbeing Outcomes summarises the evidence behind the themes and outcomes of the Place Standard Tool and their links with health and wellbeing.

The Shaping Places for Wellbeing programme was a joint delivery partnership by Public Health Scotland and the Improvement Service, which ran between 2022 and June 2024. It aimed to deliver preventative interventions to reduce health inequalities, while delivering on national actions around climate change and Covid-19 recovery. The programme worked with seven ‘project towns’ in Scotland, and produced ‘how to guides’ around adopting a place-based approach.

Several indicators in Scotland’s National Performance Framework are related to the physical environment, including under environment and communities.

Both community planning and spatial planning have vital roles in shaping the physical environment. Community planning is the process through which public agencies work with communities to plan and deliver services. Spatial planning in Scotland is currently shaped by Scottish Planning Policy which sets out national planning policies which reflect Scottish Ministers' priorities, and the National Planning Framework which provides a framework for the spatial development of Scotland.

The Scottish Government’s Climate Change Plan, and its update in 2020, set out the path towards a low carbon economy, in response to the long-term environmental threat posed by climate change. The Scottish Government’s Environment strategy for Scotland provides an overarching framework for Scotland's existing environmental strategies and plans, including the Climate Change Plan. The Scottish Government also sets regulations and strategies to limit pollution in Scotland, which are implemented by the Scottish Environment Protection Agency (SEPA) and local authorities.  Cleaner Air for Scotland 2 is the key strategy for improving air quality.

Globally, the Commission on Social Determinants of Health (2008) emphasises the positive impact on health equity, physical and mental health and wellbeing that a well-designed environment can bring, especially in an urban setting. The WHO European Healthy Cities Network aims to ensure that cities are positive environments that contribute to a healthy population.

Section Updates:

  • The last major update of this section was completed in September 2024.
  • The next major update is due to be completed by end March 2025.