Current land use, competing interests, car dependency, and associated inequalities and more are narrowing the opportunities of living healthy lives throughout the life course. At the same time, the 21st Century is proving to be a time of acknowledging disparities and the need for innovation and resilient communities. Voices are rising for fair and just communities and the right for everyone to have a healthy environment. These voices can be heard in those that subscribe to the social determinants of health and the UN Sustainable Development Goals (SDGs). Both camps are working to secure lasting gains for health and well-being of people and thriving communities that offer opportunities to all.
The idea that place contributes to health is not new. The field of urban planning emerged from the recognition that many factors contribute to the health and well-being of individuals and communities. From the 19th century onwards it was understood that investments in water and sewage infrastructure would reduce death and illness from infectious disease. In the last generation, innovative public health programs have engaged with non-health specific policies and agencies to design new processes for evaluating social determinants of health. A close cousin to sustainability is resilience which also has shared definitions in planning, health and increasingly in community development.
In all of this there has been a driving assumption across people and organizations that are investing in, and organizing for, fair and just development that building capacity among residents and local leaders across sectors (government, community development, private investment, health) can help result in equitable policies and systems-focused approaches and investments that yield multiple co-benefits, lower risks and improve well-being. In short, increased and informed civic participation will lead to more equitable infrastructure designed, and built, in and for the public interest. There is also an assumption that this development can enhance public life, decrease social isolation and marginalization, and create opportunities for health and well-being for all.
With large construction cranes filling the air space of nearly every major city across the globe, there has probably never been a better time to explore how to build healthy, equitable cities and share stories and practices. What are the key drivers for health-promoting equitable development; data, culture, policies, enlightened leaders, organized civic actors? How can this understanding best be applied and scaled up in differing contexts?
AUTHORS
Ascala Sisk, Deputy Director, Center for Community Investment, Lincoln Institute of Land Policy; Odetta MacLeish-White, Managing Director, TransFormation Alliance; Vedette Gavin, Principle, Verge Impact Partners; Tamika Butler, Director, Equity and Inclusion and Director of CA Planning, Toole Design; Liz Ogbu, Founder + Principal, Studio O; Veronica O. Davis, P.E., Managing Partner, Nspiregreen LLC; Nupur Chaudhury, Program Officer, New York State Health Foundation, Urbanist in Residence, University of Orange; Sharon Roerty, Senior Program Officer, Robert Wood Johnson Foundation; Hanaa Hamdi, Director of Health Impact Investment Strategies and Partnerships, New Jersey Community Capital; Kelly Worden, Director, Health Research, U.S. Green Building Council; Noxolo Kabane, Deputy Director, Western Cape Department of Human Settlements; Shelly Poticha, Managing Director, Natural Resources Defense Council; and Hedzer Pathuis, Strategic Project Manager, City of Utrecht.
“Active City: Designing for Health” (PDF) (Toronto Public Health report, 2014), https://www.toronto.ca/legdocs/mmis/2015/hl/bgrd/backgroundfile-81601.pdf
Building Humane Cities. TED Radio Hour, 28 September, 2018.
Building the foundations: Tackling obesity through planning and development. Town and Country Planning Association, February 2006.
Camargo Araceli, and others. Neuroscience for Cities. Future Cities Catapult.
City planning and population health: a global challenge.
Creating Liveable Cities in Australia.
De Leeuw, Evelyne. Animnations on Theme Cities and Equity.
Digital Place-Making-OurManukau from South Aukland.
Ellard, Colin. Becoming the City. What does it mean to ask whether a city is conscious? Conscious Cities. 2017.
Ellard, Colin. A New Agenda for Urban Psychology: Out of the Laboratory and Onto the Street. UD/MH Journal of Urban Design and Mental Health, 2017.
Ellard, Colin. Streets with no game. Boring cityscapes increase sadness, addition and disease-related stress. Is urban design a matter of public health? AEON
Fenyk, Heather. The Lower Raritan Watershed Issues Oveview.
Fenyk, Heather. Reading List.
Florida, Richard. How ‘Social Infrastructure’ Can Knit America Together. CITYLAB, 11 September, 2018.
From Precarious Settlements to Dignified Communities. Western Cape Informal Settlement Strategic Framework. Western Cape Government, September 2016.Prioritisation Model Guidance Notes.
Grant, Marcus, and others. Cities and health: an evolving global conversation. Cities and Health, Volume 1, Issue 1.
GreenWay Program. Briefing for Salzburg Global Seminar by Nick Chapman. Cooks River to Iron Cove GreenWay, Sydney, Australia. Located in Sydney's Inner West region, the GreenWay is a 5.8km environmental, active transport and cultural corridor linking the Parramatta River at Iron Cove with the Cooks River at Earlwood. Following the route of the Inner West Light Rail and Hawthorne Canal, the GreenWay features bike paths and foreshore walks, cultural and historical sites, cafes, bushcare sites and a range of parks, playgrounds and sporting facilities. For more information about the GreenWay Program and GreenWay Missing Links Capital Works Project , please visit www.greenway.org.au or contact Nick Chapman, GreenWay Place Manager, Inner West Council at nick.chapman@innerwest.nsw.gov.au.
Further Links:
https://www.greenway.org.au/news/council-adopts-greenway-master-plan
http://www.greater.sydney/district-plan
http://www.greater.sydney/greater-sydney-planning-awards#award2
http://www.healthyactivebydesign.com.au/case-studies/the-greenway
http://www.governmentarchitect.nsw.gov.au/resources/case-studies/2017/11/the-greenway
http://www.governmentarchitect.nsw.gov.au/articles/2017/06/sydney-green-grid
Gruebner, Oliver, Martin Sykora, and othes. Mental health surveillance after the terrorist attacks in Paris. The Lancet, 28 May, 2016.
Gruebner, Oliver, M A Rapp, and others. Cities and Mental Health. Aerzteblatt, 2017.
Gruebner, Oliver, Sarah R. Lowe, and others. A novel surveillance approach for disaster mental health. PLOS One, 19 July, 2017.
Gruebner, Oliver, Sarah R. Lowe, and others. The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy. International Journal of Health Geographics, 10 June, 2015.
Hunter-Adams, J, and others. Fault lines in food system governance exposed: reflections from the listeria outbreak in South Africa, Cities & Health, 1-5.
Hunter-Adams, J, and others. How to address non-communicable diseases in urban Africa. The Lancet, Diabetes and Endocrinology, 7 August, 2017.
Kabisch, Nadja, Dagmar Haase, and others. Urban green space availability in European cities. Ecological Indicators, March, 2016.
Kang, K., Ni, Y., Li, J., Imamovic, L., Sarkar, C., Kobler, M. D., Heshiki, Y., Zheng, T., Kumari, S., Wong, J. C. Y., Anand, A., Wong, C. W. M, Dingle, C., Denizen, S., Baker, D. M., Sommer, M. O. A., Webster, C. J., Panagiotou, G., 2018, The Environmental Exposures and Inner-and Intercity Traffic Flows of the Metro System May Contribute to the Skin Microbiome and Resistome, Cell Reports 24(5):1190-1202. e5. https://www.sciencedirect.com/science/article/pii/S2211124718310519
Kroll, Franziska and Dagmar Haase. Does demographic change affect land use patterns?: A case study from Germany. Land Use Policy, 3 July, 2010.
Living Cape: A Human Settlements Framework. Prepared jointly by the African Centre for Cities and the Western Cape Government. 13 October, 2017. Powerpoint.
Lyell's Brook Recreated: A Green Infrastructure Corridor to the Raritan River.
Metro First/Last Mile program and Strategic Plan: https://www.metro.net/projects/first-last/
Metro Blue Line First/Last Mile Plan: https://www.metro.net/projects/transit-oriented-communities/blue-line-
Measures Matter: Ensuring Equitable Implementation of Los Angeles County Measures M & A: https://dornsife.usc.edu/pere/measures-matter-la/
Metro Equity Platform: https://la.streetsblog.org/2018/03/02/metro-approves-equity-platform/
Moos, Markus. The velocity of density: Are we building more sustainable cities fast enough? Sustainability, 9(12), 2326-2336, 2017.
Moos, Markus, Vinodrai, T., and others. Planning for mixed-use: Affordable for whom? Journal of the American Planning Association, 84(1), 7-20, 2018.
Moos, Markus, Pfeiffer, D., and Vinodrai, T. (Eds.) The Millennial City: Trends, Implications, and Prospects for Urban Planning and Policy. New York: Routledge, 2017.
Neighbourhood Development Planning for Health. Evidence and guidance for promoting healthy, active communities through the neighbourhood planning process. Warwickshire County Council.
Nelson, Christopher and others. Can Measures Change the World? Standford Social Innovation Review. Winter 2018.
Oni, Tolullah, and others. Urban Health Research in Africa: Themes and Priority Research Questions. J Urban Health, August 2016.
“Pedestrian and Cycling Safety in Toronto” (PDF) (Toronto Public Health report, 2015), https://www.toronto.ca/legdocs/mmis/2015/hl/bgrd/backgroundfile-81601.pdf
"Preventing Injuries from Wintertime Slips and Falls in Toronto" (Toronto Public Health report, PDF), https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-97431.pdf
Pinao Helen. Healthy Planning and Regeneration: innovations in community engagement, policy and monitoring. ResearchGate, August 2017.
Pineo, Helen and Yvonne Rydin. Cities, health and well-being. RICS Insight, June 2018.
Public Health Monitor Utrecht.
“Road to Health: Improving Walking and Cycling in Toronto” (PDF) (Toronto Public Health report, 2012), https://www.toronto.ca/legdocs/mmis/2012/hl/bgrd/backgroundfile-46520.pdf
Reid, Dylan in Spacing Toronto:
Pollution and the fall and rise of urbanism
“Distracted walking” laws make no sense
“You cannot talk fatalities down” – international insights on walking and cycling
Do “Slow Down” lawn signs actually work?
The signal distance factor — safe crossing “deserts”
Busting some myths about pedestrian collisions
Slowly moving towards speed reductions in Toronto
It’s time for the City get rid of its sidewalk no-plough zone
Roerty, Sharon. Four Ways to Build Inclusive, Healthy Places for All. Culture of Health Blog. Robert Wood Johnson Foundation, 25 July, 2018.
Roerty, Sharon and Jennifer Gardner. Planning Public Spaces to Drive Health Equity. Meetings of the Minds.
Ross, Andrew and Michael Chang. Planning Healthy-Weight Environments – A TCPA Reuniting Health with Planning Project. Town and Country Planning Association, December, 2014.
Sarkar, C., Webster, C., Gallacher, J., 2018, Are exposures to ready-to-eat food environments associated with type 2 diabetes? Full data, cross-sectional evidence from N=347 551 UK Biobank adult participants, The Lancet Planetary Health 2(10):e438-450. https://www.thelancet.com/journals/lanpla/article/PIIS2542-5196(18)30208-0/fulltext
Sarkar C., Webster C.J. and Gallacher J., Residential greenness and prevalence of major depressive disorders: a cross-sectional, observational, associational study of 94 879 adult UK Biobank participants, The Lancet Planetary Health. 2018, 2(4): e162–e173. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30051-2/fulltext
Sarkar, C., Webster, C., Gallacher, J. (2017) Association between adiposity outcomes and residential density: a full-data, cross-sectional analysis of 419 562 UK Biobank adult participants. The Lancet Planetary Health, 1(7), e277–e288. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30119-5/fulltext
Sarkar, C., Webster, C., Gallacher, J., 2018, Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants, International Journal of Hygiene and Environmental Health 221(3):458-468. https://www.sciencedirect.com/science/article/pii/S1438463917305813?via%3Dihub
Sarkar C., Editorial: Towards quantifying the role of urban place factors in the production and socio-spatial distribution of mental health in city dwellers, Journal of Urban Design and Mental Health. 2018, 4: 2. https://www.urbandesignmentalhealth.com/journal-4---quantifying-place-factors-in-mental-health.html
Sawin, Elizabeth, Dr, Stephanie McCauley, and others. Multisolving at the Intersection of Health and Climate. Lessons from Sucessful Stories. Climate Interactive, January 2018.
Southern Corridor Enumeration, Cape Town. Executive Summary Report. South African SDI Alliance, 31 March, 2017.
State Housing. Northcote Development Project.
Superblocks to the Rescue: Barcelona's plan to give streets back to residents. The Guardian, Resilient Cities.
The Everyday Northcote Magazine.
The GRESB Health and Wellbeing Module.
The Just City Essays: Visions for Urban Equity, Inclusivity and Opportunity
The Treasury Living Standards Framework. New Zealand Treasury Department.
“The Walkable City: Neighbourhood Design and Preferences, Travel Choice and Health” (PDF) (Toronto Public Health report, 2012) https://www.toronto.ca/wp-content/uploads/2017/10/9617-TPH-walkable-city-report.pdf
Towards Incremental Informal Settlement Upgrading: supporting municipalities in identifying contextually appropriate options. Western Cape Governement, 2016.
Trowbridge, Matthew, Worden, Kelly and others. Using Green Building As a Model For Making Health Promotion Standard In the Built Environment. Health Affairs, No 11 (2016).
Wilkerson, Risa. What does a Culture of Compassion look like? Healthy Places by Design Blog, 18 July, 2018.
Infrastructure, community development and equity are broad terms that can have diverse applications and meanings. The uses of these terms for this program are defined here.
Community development: The United Nations defines community development as a “process where community members come together to take collective action and generate solutions to common problems.” We will be reviewing activities that build stronger and more resilient communities through an ongoing process of identifying and addressing needs, assets, and priority investments. Community development activities may support infrastructure, economic development projects, installation of public facilities, community centers, housing rehabilitation, public services, clearance/acquisition, microenterprise assistance, code enforcement, homeowner assistance and many other identified needs.
References to infrastructure include: transportation (access to public transportation, public transit pricing, alternatives to personal vehicle travel, public streets that are designed for all users); broadband (access to it, subsidies to support it); utilities including water and power (subsidies for low-income households, access to it, access to free and healthy drinking water in all community settings, lead abatement activities, and storm-water management); parks; housing; and mixed-use development.
The Robert Wood Johnson Foundation (RWJF) defines health equity as meaning that everyone has a fair and just opportunity to be healthier. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.
This program will bring together 60 innovators and stakeholders from around the world who have engaged citizens and communities in shaping their environments to support health and well-being. The group will span perspectives from citizen groups and civil society organizations; urban and rural design, planning and development; housing and transport; business and retail; public health and nutrition; sport, leisure and nature conservation; local government and participatory processes; central government; behavioral science and economics; education and culture; and the media.
This five-day highly-interactive program, held at Schloss Leopoldskron, home of Salzburg Global Seminar, will prioritize opportunities for cross-border sharing and learning. Participants will focus on building new insights and aggregating perspectives and experiences from relevant sectors, areas of expertise and regions. Working groups, each with a thematic and/or country focus, will prepare practical recommendations for action by different target audiences.
The session brochure can be downloaded here.
HEALTH AND HEALTH CARE INNOVATION IN THE 21ST CENTURY
Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series – Health and Health Care Innovation in the 21st Century – to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.
For more info, visit: health.salzburgglobal.org