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How do cities impact our health and wellbeing?

Built environment professionals are taking a greater interest in the impact of urban environments on health and wellbeing. But what do we really know about how cities impact health? The Guardian held a roundtable in December with a number of health and planning experts on this topic and recently published an article on the results. I highlighted the complexity of this question at the outset of the roundtable, which was also picked up in the article. I’ve supplemented the brief commentary in the Guardian’s article with a few links below for further information.

The Lancet/University College London Commission on Shaping Cities for Health produced a summary of the key issues regarding planning and designing healthy cities. The authors discuss the concept of an ‘urban advantage’ with regard to health. But this is not automatic and needs to be created through appropriate policies and infrastructure. In support of the urban advantage perspective, an editorial on Cities, Urbanization and Health discusses the situation in developing countries where cities are able to provide health services and interventions that are not readily available in rural areas.

I found Steve Cummin’s lecture on Improving Heath in Cities: the Challenge of our Urban Environment a really interesting overview of the impact urban environments on non-communicable diseases. Steve highlights that non-communicable diseases (such as heart disease and diabetes) are rising faster in cities than elsewhere. His research covers areas like the contribution of putting grocery stores in ‘healthy food deserts’ and how the urban environment impacts on physical activity.

A specific part of the urban built environment that was highlighted at the Guardian roundtable was housing. When asked what the most significant health issue in London was, Paul Plant from Public Health England responded that affordable housing was currently top of the list. Spending too much of a limited income on housing, not having secure housing or living in poor quality housing can all impact on health and wellbeing. I was surprised to hear that housing was at the top of Paul’s list, but also pleased to see that there was recognition amongst health professionals of the importance of affordable housing. In the Guardian article there was reference to an example in Gothenburg where city leaders are addressing their shortage of affordable housing using innovative funding models. I’m not sure the link between health and affordable housing was explained in the article, but it certainly came out in the roundtable as a major problem for London.

At BRE we continue to develop the science behind our emerging Healthy Cities Index which is an ongoing research programme funded by the BRE Trust. The aim of this index is to help city policy and decision-makers easily understand the impact of the built environment on health and wellbeing. Stay tuned for further updates as this progresses.