Arup Thoughts: Are developments really improving health?

To address the pressures of growing and aging urban populations, cities need to be made of high-quality places that contribute positively to physical and mental health.

By Hannah Wright, Arup, Netherlands January 17, 2017

The built environment has an important impact on health, and healthier cities are linked to more resilient people, places, and profits. However, there is less evidence to show how living and working environments are designed to improve well-being. Are design solutions actually delivering the intended health outcomes?

In a similar way to reviewing treatment for a health condition, planners, designers, developers, property managers, and governments need to review and evaluate developments to understand their health outcomes. A health impact assessment is one way to consider the effects of proposed interventions during the development of a project. Arup’s design protocol for mobilizing healthy living suggests that understanding the actual effects is less common.

This lack of follow-up makes it difficult to identify whether the right interventions are being made. This can relate to challenges, such as inconsistent data, the need to evaluate over time, and a potential lack of incentives for those planning and delivering projects as compared with those managing urban interventions.

The drive toward more preventive health care recognizes that the healthier people are, the less strain we put on our health care systems. Regular physical activity has been shown to reduce the risk of mortality by up to 30%, depression by up to 30%, cardiovascular disease by up to 35%, and the list goes on. The World Health Organization places insufficient physical activity as one of the 10 leading risk factors for death worldwide. Despite knowing the benefits, individuals are still not active enough.

There is growing interest from developers and investors in using land assets and built-environment interventions to contribute to preventive health care. In the U.K., the National Health Service (NHS) has announced 10 "Healthy New Town" demonstrator sites as testing grounds for developments that contribute to improved health. While in the U.S., Tampa aims to be the first WELL Certified city district implementing measures that promote better quality of life to residents and visitors alike.

To optimize the potential of investments such as these, lessons can be learned from past built-environment interventions that have attempted to provide healthier places to live and work.

Considering evaluation at inception and understanding the changes in people’s health before and after interventions will help to decipher effective approaches to planning for well-being. Whether that be buildings that promote interaction, public spaces that provide respite and connect us with communities, or streets that encourage people to walk and play.

In the U.K., organizations like the What Works Centre for Well-being (WWCW) are taking actions to understand what makes an effective intervention. In Australia, an evaluation is already happening that includes the RESIDE residential environments study in Perth, which assesses the effect of the West Australia Planning Commission’s livable neighborhood guidelines over 9 years. The evaluation has found that for every 10% increase in overall policy compliance, participants were 53% more likely to walk in their neighborhood. While in Amsterdam, initiatives to connect and engage the community through health values are using mobile apps to create spaces that the community values as well as supporting local evidence bases on health.

Evaluation will help designers refine their design solutions and pursue the most effective interventions for healthier cities. Since persuasive narratives are crucial for explaining the intangible outcomes and benefits of healthier cities to decision makers, there is also an opportunity to demonstrate the benefits of, and incentives for, investment in healthy developments in the future. 

Hannah Wright is an urban planner at Arup. She is involved in sharing best practices and research to join up the disciplines involved with green infrastructure. This article originally appeared on Arup Thoughts Blog. Arup is a CFE Media content partner.