Back from the brink | conference report – days 1 & 2 / 11 & 12 October 2021

The role of the environment and particularly cities in supporting health for people and planet has been an increasing focus over recent years.  In spring 2020 however the COVID-19 pandemic presented a new challenge.  It emptied city centres, changed working patterns and disrupted supply chains, causing unprecedented economic and psychological pressures for communities.  18 months later the harsh reality of the health and social inequalities experienced by many citizens in their urban environment has been emphasised once again.

The aim of Healthy City Design International 2021 was to explore how cities can be brought ‘back from the brink’ to create green, equitable and inclusive environments.  Urban Habitats was delighted for a second year to support the congress as Knowledge Leader partners.

The pandemic forced this year’s congress online for a second year.  Nevertheless a global community of circa 400 participants across 30 countries [MD1] came together representing the leading edge of thinking in the field from academics, practitioners, policymakers, and others.  There was so much great content that we’ve split our conference report into two and this part covers themes emerging from the first two days of the congress.

Designing for climate, community and social value.

The need for a sense of shared vision when we design for climate, community, and social value, emerged as an early theme in the first day of the congress. It’s this ideology of shared vision that will allow generations to be inspired to achieve a healthier environment, and in the wider context Net Zero.  All future change to the built environment needs to be towards Net Zero and must be inclusive of the whole community. Minnie Moll from the Design Council emphasised in the Opening Plenary that when integrating change in the community, communication must be at the forefront, without this the future progress could be hindered.

There needs to be a shift in thinking.  Muir Gray[MD2]  suggested a move away from describing health and the causation of disease as purely the effect of individual lifestyle factors and also an environmental problem that can stem from the built fabric of a community.  Yet most of the built environment around us already exists so there needs to be an increased focus on refurbishing and retrofitting the existing: there needs to be incentive to work with existing infrastructure to create healthier spaces.

Jenny Roe whilst co-chairing Session 2: Restorative Cities, highlighted that there is a need to “build from the bottom up” meaning to build and co-create with the community when developing the built environment. Working with Layla McCay, together they have created the Restorative City Framework which sets out seven key principles that are paramount linking urban design to mental health and wellbeing. These principles can be intertwined by planners, urban designers, and anyone working with design that wants to incorporate health and wellbeing and equity into their process. COVID-19 for example has highlighted the unequal access to green space and this needs to be addressed for all ages in the community to promote a healthier environment.

Also in Session 2 Tim Gill focussed his talk on the role of children in the built environment, identifying that children are catalysts for change. He suggests that a lot can be learned from creating with them in mind.  Children love play and by adding play ideologies into the design process then joyful spaces for everyone can be created.

Pandemic resilience and renewal

The COVID-19 pandemic was unsurprisingly reflected in many sessions.  A year on from the immediacy of the impact at last year’s congress it was informative to hear what researchers and practitioners have experienced and learned during this time.  One clear theme is that the built environment immediately around us is very important to our health and wellbeing especially when residents have been told to ‘stay local’. In domestic surroundings, Sem Lee emphasised in Session 6: Pandemic Resilience: Urban, Housing and Health Strategies, the importance of being able to be active within your lived environment, and the access to outdoor space that enables this. Parks and greenery are fundamental to the wellbeing of people in their domestic setting, they provide a sense of autonomy and enable people to feel comfortable in their surroundings.

From Sem Lee’s study[MD3]  it was clear to ascertain that sufficient personal space, exposure to natural light and good ventilation in the home-made people feel more comfortable in their domestic environment, helping a person’s health and wellbeing. This has potential for how we create and inform development for pandemic resilience communities and urban housing.

Environment, health and healthcare

Community health relies on collaborative working and as in previous years the idea of building wellness into the environment was strongly emphasised at the congress.  An interesting concept presented in Session 7: Hospitals as Anchors for Community Health, by Prachi Rampuria is that of integrated care into the community to support health and wellbeing at the source. A change of how care is thought about could put the hospital at the centre of an ecosystem with interconnected services and buildings.  Current design cultures do not always produce a positive impact for the wider community and this needs to change.

An integrated approach to healthcare design would mean maximising green exposure for the service users, potential of fresh produce grown in and around hospital grounds and the feeling of a safe place for the community. Another way of thinking about the impact the hospital could have on the health and wellbeing of the community is by thinking of the hospital as a ‘city within a city’ as Mike Apple (Session 7) suggests, we transform traditional building design, collaborate with the community, and create a welcoming space. There needs to be a step further and create working partnerships between all those in the wider hospital organisation from community organisations to health and technology companies to developers.

Whilst change has commenced in small, case study style projects, to really transform and design for healthy streets, as Geoff Southern outlined in Session 8: Designing Healthy Streets there are calls for a shift in legislation to support change. Strategic thinking, legislative change and community input could be the change needed for healthier, greener environments for all. The Planning For the Future Paper as mentioned by Oliver Jones in Session 9: Planning Reform in the UK: Design for People and Planet does recognise the link between place and health which is positive, however there are concerns about the lack of follow through on this yet.

Homes and neighbourhoods

And as a final theme from these first days of the congress, looking forward as Sarah Lewandowski expressed, health needs to be at the centre of every decision made about the built environment. To do this, emphasis can be placed on community engagement to ensure the views of diverse communities are carried through the building development process.  One approach to this are Park Advisory Groups (PAGs).  Joost Declercq suggested a way to transform brownfield areas for community use, by utilising visual mapping to conceptualise community needs and assets. Armel Mourgue discussed the efficacy of using PAGs, and their ability to show developers exactly what is needed at a local level. This grass roots knowledge is what is needed to make any space a destination, providing a liveable and adaptable public realm.

These first two days of Healthy City Design International Congress of 2021 provided an invaluable insight into the behind the scenes work of individuals, organisations, and communities. Key themes that emerged from Day 1 & 2 of the congress are that designing for climate, community, and social value can create a better environment incorporating and influencing health and healthcare within a population. By promoting community engagement, homes and neighbourhoods can experience the positive effects of designing healthier places.

In line with this, legislation and policymaking on a universal scale should evolve to reflect the need for health to be incorporated into investment plans from the outset. The space in which we live is vital to our health and the health of the planet: we need to design with that in mind for future progress.

Urban Habitats:

Urban Habitats was delighted for a second year to support the congress as Knowledge Leader partners.  Urban Habitats works across the fields of population and planetary health.  This work is grounded in evidence informed approaches that support communities and organisations to reduce inequalities and create health.

Healthy City Design International: Research, Policy, Practice

Healthy City Design International Congress & Exhibition is a global forum for the exchange of knowledge on the research, policy and practice of designing healthy and sustainable cities and communities.  The theme of this year’s congress was: ‘Back from the brink: Designing for climate, community and social value’.