Back from the brink | conference report – days 3 & 4 / 13 & 14 October 2021

This second and final part of our conference report highlights the key features of the very full programme of Days 3 & 4 of Healthy City Design International 2021, discussing the numerous solutions to bring us ‘Back from the Brink’ and develop the future of design and health.  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 came together representing the leading edge of thinking in the field from academics, practitioners, policymakers, and others.

The inclusive city.

Shaping health and equity in the city means designing for everyone in it, inclusivity should be embedded from the outset of any design process. In Day 3’s Keynote plenary chaired by Liz Paslawsky, Marcus Grant highlighted that whilst this is needed, there appears to be a discrepancy between what people say and what people do surrounding community planning.  He believes that it is necessary to link spatial planning to actual health and wellbeing to address this gap between words and deeds. By working with public, private and community sectors, planning can be creative and not just regulatory, maximising inclusivity.

The continued growth of cities globally means that planning needs to be creative, to consider the city size, self-sufficiency level, and open space provision. With the COVID-19 pandemic taking a hold of the world over the last year it is essential to consider placemaking as part of the global public health response and as places to create health. Rachel Cooper reflected similar concerns in posing the question of how do we need to rethink urban design post-pandemic? Covid has been found to be higher in cities with slums and yet the continuing growth of cities needs addressing and considered for any virus not just covid.  She also flagged the important issue of density as a contested and complex issue which her research investigates and one that is too frequently relied on within policy.

An improvement on urban design can be made by looking extensively at the current infrastructure in each city. This infrastructure can be positive and supportive of health, but we should recognise it can also facilitate to division within and between communities. Chris Murray, in Session 20: Improving Urban Design, Community Wellbeing and Cohesion, discussed that the lack of green space, combined with an overuse of concrete to obscure the natural beauty of an environment, can lead to an overall suppression of nature in the city, naming the English city of Coventry as an example. He emphasised that whether we redevelop existing infrastructure or build new, there needs to be an emphasis on the psychological impacts of the built environment on the community.

Sarah Niblock, also during Session 20, suggested the idea of having a psychological therapist in residence within building development organisations. She states that rates of psychosis are higher in the built environment, and by acknowledging these, we can incorporate critical human centred questions into planning and design from the start of any development, in the hope of reducing rates of psychosis.

Urban design and placemaking.

The World Health Organisation (WHO) have created an Urban Health Initiative which offers a model process for catalysing change. Nathalie Roebbel, in Session 25: Healthier Cities by Design, discussed how this innovative model aimed to place health at the core of urban developments. It has the potential to create demand for action in all sectors to include transport, housing, and environment. Evidence is produced with local data, to inform local policy-based scenarios, and engages local stakeholders.

Urban Habitats’ very own Mark Drane and Louis Rice of UWE Bristol, during Session 26: Healthy Buildings, acknowledged that the design of the built environment is important when considering the determinants of health. The idea that healthy buildings promote healthy users can be used to help designers understand why health is so important when considering building designs. There is a call for architectural tools to assess the holistic health of a community throughout the development process and not solely focus on the absence of disease as current tools tend to.

Ecological and planetary health.

In a similar call, Luke Englebeck, advocated in Session 29: Ecological Urbanism and Health on Day 4, for a holistic way of thinking, not just in the human health sense, but thinking from the gene to the biosphere. For human and planetary health, and to tackle the climate emergency, we need to go beyond the realms of combatting disease, thinking of the world as an ecosystem, and integrate this thinking into the urban design creating an eco-urbanism concept en mass. Paul Crook (Session 29) issued a stark warning that the loss of biodiversity is a critical risk to humanity.

A way to preserve the biodiversity that we have is to regenerate nature and be sustainable in our environments.  Mike Nightingale and Stephen Chance (Session 29) promoted the notion that ‘small is beautiful’, as a population it is essential that we reduce consumption, upgrade older buildings instead of rebuilding, and use renewable materials. Alongside this, our communities and wider population should promote a circular economy, circulating products and materials back into the market, reducing waste and supporting sustainable living.

Recent work undertaken by Lorna Gribbin of WSP (Session 30) aims to determine how we can create a liveable neighbourhood but collating a selection of sustainable development principles which can be used to deliver healthier liveable spaces. There are six principles that underpin this: resiliency and access (healthcare, education), social inclusivity, biodiversity, economic and cultural prosperity, active and connected communities and community responsibility. By adhering to these, social needs can be met for healthier place and planetary health.

Closing plenary.

The closing plenary, chaired by Sunand Prasad provided a thought-provoking reflections. Although these issues of urban design and human and planetary health can seem overwhelming we cannot simply ignore them anymore. Eime Tobari highlighted, these are of course not mutually exclusive concepts: progress in one of these areas can be positive for others. Harry Knibb emphasised from an investment perspective that we know that a change is needed and welcomed by many, nevertheless, in practical terms the idea of how we can make change is lacking or at least not translated across all the various actors who are needed to enact change. 

This is the value of Healthy City Design congress of course that these precise issues were discussed in other sessions providing great opportunities for shared learning. For example, Session 11 chaired by Mark Drane outlined innovative toolkits for design and health, and how developing these tools can give direction to designers and developers for the future of healthier cities.

Carolyn Daher noted that governments are not focussed on the ‘how’ and there is a danger of reliance of technological solutions.  The proposition that behaviour change will be the key is in our view contentious though depending on which population groups this is applied to.  It needs to reflect that the most vulnerable population groups they have been systematically stripped of choices that limit their ability to change behaviours and creating supportive settings is an equally important area of work.

Harry Knibb noted there needs to be a shift of capital investment toward sustainable development goals, whilst the cost to do this is high and too big for organisations or individuals, given the response to the COVID-19 pandemic, we know that spending on an immense scale is possible.

Key themes that emerged from Day 3 & 4 of the 2021 congress were the need to improve urban design whilst promoting community wellbeing and cohesion. Some ways to do this include creating healthy buildings, acting to create healthy cities and urban environments, and that this can be achieved by healthy urban design in planning. Ecological and planetary health are integral to human health and not mutually exclusive. If we create space for green and blue infrastructure within our lived environments, biodiversity can increase and nature has a chance to thrive. In closing the congress pointed to positive actions for future and how as global societies and populations we can move from targets to action across all sectors and all parts of society.  

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’.