Local Air Quality Management policy and practice in the UK: The case for greater Public Health integration and engagement

Abstract The UK’s Local Air Quality Management (LAQM) regime is designed to protect people’s health from the ill-effects of air pollution, but it is failing to achieve its full potential. The Public Health aspects of, perspectives on, and integration and engagement in, LAQM have been poorly considered to date. This critical literature review assessed LAQM-related strengths and limitations in order to explore how Public Health, through greater integration and engagement, can add value to the regime. ‘Structure’ and ‘process’ weaknesses were identified, including: a poorly defined Public Health role, a narrowly-scoped prescribed process, risk assessment uncertainties, ineffective communications, shallow evaluations and disconnected policies. Separately and cumulatively, these have hindered Public Health integration in LAQM policy and practice and stunted the regime's evolution. Engaging Public Health in LAQM future design and delivery can help solve these problems, by improving risk assessments and raising awareness of air pollution and other health-influencing relationships, targeting action in high-need areas, coordinating air pollution mitigation and health improvement interventions, and connecting different policy areas. Increasing Public Health integration and engagement in LAQM can enhance the existing regime. Acting now is timely from both LAQM and Public Health perspectives. This review's findings should be used to inform debates and decisions around the future development of Local Air Quality Management arrangements both in the UK and beyond.