Healthy cities make for healthy inhabitants

A healthy city should integrate health considerations into the planning and design of the urban environment. Clare Wildfire explains how this approach can lead to better social outcomes for people of all groups and ages.

Inhabitants of cities are becoming more engaged and speaking out on issues that affect the quality of their lives. Increased health and longevity are now as important to people as wealth and ownership of assets.

Improving health is interlinked with many of the Sustainable Development Goals, which highlight how healthy populations are essential for social, economic and environmental sustainability. And while access to good healthcare services – hospitals, doctors’ clinics and pharmacies – is important, it is not the main factor that influences health outcomes for those living in cities. A recent US study revealed that this shapes only 20% of a typical community’s health¹.

The precautionary principle – do no harm – is key to the responsible development of cities, but our efforts must look beyond this to seek positive health outcomes for all. At Mott MacDonald we’ve identified seven areas where these efforts can best be targeted:

1. Pandemic resilience

A key lesson from the COVID-19 pandemic is that infrastructure within a city, such as schools, transport systems or sports and entertainment venues, can help spread communicable diseases. We can do more to prevent and prepare against pandemic threats, so that our cities and economies continue to thrive, which in turn will protect social outcomes.

The three dimensions of pandemic resilience can be understood as:

• Absorb – introduce measures to reduce pathogen transmission, protecting health and improving user confidence
• Adapt – be more responsive to societal needs by ensuring appropriate planning, flexibility and continuity of services
• Transform – be more versatile and enable certain types of infrastructure to perform a different role to their usual function whenever needed

2. Green and blue infrastructure

Green infrastructure – street trees, green roofs/walls, parks, woodland, gardens, allotments – and blue infrastructure – ponds, canals, rivers, wetlands – are essential to health and wellbeing.

Planting in cities can contribute to better air quality and more pleasant microclimates. Gardens, allotments and trees can be a source of healthy food. There has been a resurgence of gardening and a huge growth of demand for allotments during the COVID-19 pandemic, largely due to the mental wellbeing they can bring. Parks, allotments, open green spaces and water features are places where all inhabitants can coexist happily and engage in a more active lifestyle.

By integrating these assets into green and blue arteries threaded through a neighbourhood, they can be valued as opportunities to promote and protect the health and wellbeing of city dwellers, and bolster the wider ecosystem.

3. Promoting healthier lifestyles

Placemaking – the considered design of public spaces – influences people’s decisions about how they commute, shop and use their leisure time. Making a clear, joined-up street and landscape strategy part of public realm design can encourage people to walk or cycle to local shops, schools, workplaces or transport hubs, and thereby instil more active and healthy behaviours in adults and children.

This strategy could include:

• Street layouts that prioritise and create continuous safe passage for pedestrians and cyclists
• Aesthetically pleasing routes for active mobility that feature green and blue infrastructure, and provide easy access to local amenities
• Provision of facilities to encourage active leisure, such as green spaces, urban gardens, playgrounds, sports grounds, skate parks and swimming pools
• Mixing retail, residential and commercial areas with active street frontage to encourage busy, well-lit thoroughfares
• Plentiful seating to encourage older and disabled people and parents with children to enjoy the outdoors and enable them to rest during journeys
• Clear legibility of routes and destinations

Challenging precedents in how we plan neighbourhoods can make active travel the easiest choice for the people who live in cities. But we must also recognise the need to maintain viable methods of vehicular travel for those for whom the car is a lifeline.

Healthier lifestyles are also crucial to helping tackle obesity and its associated health risks, such as heart disease and osteoarthritis. Access to healthy food options can be an issue in cities, while the provision of transport services and the zoning of food retail activities are too often uncoordinated. But thoughtful, holistic urban planning can help influence the nutritional choices and improve the diets of a city’s inhabitants.

Cities are starting to develop strategies that will see local policies encourage developers to invest in options – such as urban gardening and local food markets – to make healthy eating aspirations a reality.