The links between urban planning regulations and health

The practical notebooks of the Institut Paris Région (n°13)

June 2021

Institut Paris Région (IAU)

Today, the social and economic effects of the immediate environment on people’s health no longer need to be demonstrated. The inhabitants, aware of the risks to which they are subjected, are increasingly concerned about their well-being and health. Events linked to global warming or to epidemic or pandemic episodes call into question planning policies and their capacity to prevent risks. It is not just a question of organising « repairs » but of developing the resilience of our society. How can health be made a major entry point in spatial planning? The field of intervention of planning documents already integrates numerous themes implicitly linked to health. However, few of them address the issue of health. This practical notebook aims to reveal the actions that can be implemented via urban planning documents and their benefits for the health of populations. The available levers are presented and illustrated by examples of territorial coherence schemes and local urban plans, with extracts from their regulatory section.

To download : institut_paris_region_cp13_bat_web.pdf (18 MiB)

A historical link as evidenced by legislative developments

The links between urban planning and health have existed for a long time. The assimilation of health issues through town planning and construction regulations has been nourished by different approaches which complement each other: - firstly from the point of view of public health and safety (hygiene movement, police of buildings threatening ruin, fight against risks and nuisances generated by industrial activities); - then from the point of view of environmental health (aspiration of city dwellers to a better living environment in the 1970s, rise in power of environmental concerns and integration of health into them in the 1990s); - and in a more recent period, from a ‘social’ point of view (accessibility, taking into account of vulnerable people…).

Fight against insalubrity and protection against industrial pollution and risks

The first major law focusing on the problems of existing housing dates back to 1850 and was quickly followed in 1902 by other texts to fight against unhealthy housing and blocks. In addition, a law of 15 March 1928 organised the reorganisation of defective housing estates which had multiplied in an anarchic manner. However, actions to combat substandard housing became widespread in the 1950s through the urban renewal policy defined as a national obligation by the framework law of 7 August 1957. More than sixty years later, these issues are still relevant and are included in the policy to combat substandard housing, whose provisions have been enriched by successive laws, the most recent of which is the Elan law of 2018.

Concerning risks and nuisances, it was an imperial decree of 15 October 1810 that laid the foundations for the regulation of dangerous, inconvenient and unhealthy establishments. These rules made it possible to control and limit the installation of the first factories in the middle of the industrial revolution in residential areas. In the 1950s, the nuisances and pollution generated by industrial activities in the heart of Paris were pointed out for their harmful effects on the health of local residents. They then left the urban heart of the region.

Since then, legislation has been enriched, and establishments that are sources of nuisance and risk are subject to a specific regime (technological risk prevention plans, installation and operation authorisations).

From quality of life to environmental health

Green spaces and wooded areas have long played an important role in urban policies, but the aspirations of city dwellers for a quality environment - over and above the question of access to the aforementioned spaces - became more significant with the slowdown in urban growth in the 1970s. At the same time, the European Conference on Nature Conservation proposed that the European Convention on Human Rights should be amended to guarantee everyone the right to enjoy a healthy and unimpaired environment, but only resulted in a recommendation in 1973. Health then officially became an element of sustainable development, closely linked to environmental protection in the Environment Code (see Article L. 110-1-II) and in the Constitution (Environment Charter). At the same time, since the law of 30 December 1996 on air, the impact assessment of development projects has included the effects on human health, an obligation that will be extended to environmental assessments of plans and programmes. The first national environmental health plan was drawn up in 2004 and implemented at the regional level. The Île-de-France region is currently working on its third regional environmental health plan (PRSE3), produced by the DRIEE (now the DRIEAT) and the Regional Health Agency (ARS) for the period 2017-2021. Its purpose is to articulate existing regional approaches or those being developed around four axes:

The PRSE3 is not enforceable and therefore has no legal link with the various development plans and other sectoral plans. However, its content makes it more of an instrument for dialogue with public actors, which provides a certain flexibility. It is made up of action sheets, the very first of which deals with taking health into account in planning policies.

Towards more inclusive urban planning

Accessibility and adaptability to users with disabilities or reduced mobility are also public health issues, but legislation in this area is more recent and more sectoral than for the themes discussed above. The law of 30 June 1975 on disability set out the first rules on accessibility, reinforced thirty years later by the law on equal rights and opportunities, participation and citizenship for people with disabilities. Subsequently, the Elan law of 2018 will establish a percentage of accessible housing, supplemented by a percentage of adaptable or upgradeable housing. This law also introduced among the general objectives of urban policies the principle of ‘universal design for an inclusive society with regard to people with disabilities or loss of autonomy’. The law of 28 December 2015 on the adaptation of society to ageing makes a timid link between urban planning and the issue of ageing, which must be taken into account during the diagnosis of the urban planning document. It includes an annexed report on the need to adapt urban policies to the needs of the elderly, but this report has no legal force.


To go further


  • Le guide ISadOrA, une démarche d’accompagnement à l’Intégration de la Santé dans les Opérations d’Aménagement urbain, sous la direction de l’École des hautes études en santé publique (EHESP) et de l’agence d’urbanisme Bordeaux Aquitaine (a-urba), mars 2020, 355 p.

  • Adam (M), Cocquière (A), « La planification face aux enjeux de santé environnementale », Note rapide Planification, n° 877, L’Institut Paris région, décembre 2020

  • Santé et territoires, collection « Points FNAU - Alternatives (n° 11) », FNAU et Gallimard, 2019, 176 p.

  • Mieux connaître la santé des Franciliens et ses déterminants dans les nouveaux territoires de coordination. Profil des 22 territoires du projet régional de santé d’Île-de-France : mises à jour 2019 et nouveautés, Observatoire régional de santé, L’Institut Paris région, décembre 2019

  • Pour une meilleure intégration de la santé dans les documents de planification territoriale, collection « Avis et Rapports », Haut Conseil de santé publique, avril 2018, 200 p.

  • Du calme en ville : aménager en faveur du bien-être, collection « L’essentiel », Cerema, février 2017, 62 p.

  • Agir pour un urbanisme favorable à la santé : concepts et outils, École des hautes études en santé publique et ministère des Affaires sociales et de la santé, mai 2016, 192 p.

  • Guide Plan local d’urbanisme et santé environnementale, Agence régionale de santé Aquitaine et agence d’urbanisme Bordeaux Aquitaine (a-urba), novembre 2015, 164 p.

  • ORS Île-de-France, Profils socio-sanitaires des communes d’Île-de-France (format PDF)

  • Impact sanitaire du bruit des transports dans l’agglomération parisienne : quantification des années de vie en bonne santé perdues. Application à l’agglomération parisienne de la méthode de l’OMS pour la détermination de la morbidité liée au bruit, Bruitparif, ORS Île – de – France, septembre 2015, 30 p.

  • « Territoires, incubateurs de santé ? », Les Cahiers, n° 170-171, L’Institut Paris Région, septembre 2014, 196 p.



• Sdrif : le référentiel territorial du projet Île-de-France 2030 (Refter) est un outil d’accompagnement de l’ensemble des acteurs franciliens (élus, associations, habitants, professionnels) à la mise en oeuvre du schéma directeur de la région Île-de-France. Il propose une déclinaison territoriale du projet régional, en termes d’éléments de diagnostics, d’objectifs, d’orientations, de cadrages quantitatifs (

• SRCE : le schéma régional de cohérence écologique de la région Île- de- France ; le référentiel du SRCE élaboré par l’ARB, département Biodiversité de L’Institut Paris Region, en partenariat avec la Région Île-de-France et la DRIEE ( ). Il permet de connaître les enjeux, actions et cartes à la commune.

• PDUIF : fiches pratiques pour la mise en oeuvre du plan de déplacements urbains Île-de- France ( ).