Bestselling author Deepak Chopra spoke at the Southbank on May 22 on his latest book The Healing Self that surrounds personal health. Chopra, a pioneer of integrative medicine among his many accomplishments, shares his insight into this new age of responsibility for our own health, and specifically our need to make conscious preventative daily choices to offset illnesses and diseases. To remind you, the top 5 non-communicable diseases (NCDs) afflicting the human race today are; cardiovascular disease, cancer, respiratory disease and diabetes, which account for 40 million deaths each year. However, add the fifth, depression, which “is the leading cause of ill health and disability worldwide” affecting 350 million or 4% of the global population, or one in 20 people, and you begin to see how health services really have their hands full. A talk at the LSE in February on The Future of Aging stated “someone is diagnosed with dementia every three seconds.” Both sources lament the statistics of non-communicative diseases but stress the power of prevention needing to be prioritised by all of us to age more humanely. Research has shown that those who remain connected to what is going on in society, remain productive and socially engaged, are those who offset diseases such as depression and many forms of cancer. This translates into more “people {being} better able to help themselves and others to stay well and get ill less often and for shorter periods of time.” The question is: how does this translate into our urban spaces and into our evolving economy?
 
The Royal Society of Art has been exploring manufacturing in the city and how the industry has evolved. The report highlights how manufacturing serves a diversity of sectors from multinational to self-employed suppliers. More importantly the location in which this sector finds itself is equally diverse depending on the scale and typology of the output. What is most pressing is the need for more affordable manufacturing units made available to be rented across London. Interestingly, in Richard Florida’s latest book The New Urban Crisis, among the rich body evidence he shares some delicious statistics on London’s recent rise among “leading global cities for Venture Capital Investment”. Florida, reminds readers that the evidence show us that “ the world’s most innovative and creative places are not the high-rise canyons of Asian cities but the walkable, mixed-use neighbourhoods of San Francisco, New York and London.” These are the places that are safer, have higher quality of living and support a mix of talent, age and use. The key here is the walkable space. If we go back to the earlier question about aging humanely, by enabling a sustainable existence whereby people can be a part of society via their walk to work and their productive lives, then really it comes down to the design of our cities. Bringing our cities back to a human scale a scale of resilience, not a scale of siloed development.
 
The new urban crisis is one that can be solved by providing more thought to sustainable health and adapting the way in which people actively evolve over their lives, as a design tool to guide what a development should look like but also by what it should provide. Many might argue this tool to be biomimicry – an approach to innovation that emulates nature to secure sustainable solutions. If you combined the investment from Venture Capital coming into London, with the lack of affordable manufacturing space, within all of the opportunity areas London has earmarked, more students and older employees could be given the chance to activate a sustainable preventative health model.

Interestingly, only yesterday I received the latest newsletter from the New Economic Foundation, which is urging Londoners to save our Railway arches “home to thousands of small businesses all over the country”. The archways are owned by Network Rail and provide ideal affordable, local spaces for small businesses to operate at a diversity of scale and employment. They are “powering local economies and giving life to local communities.” Network Rail is about to sell off these arches to global investment firms, which seems a missed opportunity. Brexit or not, London’s population is growing, the population is ageing and the combination of better health, productivity and sustainable jobs are needed for all ages and stages of our work force. We just need a more consistent system to realise it.
 
Filmmaker Luciana Kaplan’s latest film Rush Hour documents the commute of 3 people: a Mexican beautician, a Turkish mother working in a clothing store and an American engineer. She demonstrates the losses of life that take place due to the uncompromising commute many people in urban areas endure to afford their cost of life. It is a painful truth that even in London, many have to travel too far, for too long, to be paid so little, which translates into a huge cost of non-communicative diseases. The sad truth being told in this documentary is that none of the commuters shown could prevent their life choices without the intervention of more humanely designed cities.

In the space of a week, both London First and The London Society held talks on growth. The London Society talk included a panel of four: an academic Transport Planner from University College London, an economist from the Greater London Authority, a London Architect and a spokesperson from Shelter, a homeless charity. This panel of experts explored the many aspects of growth that need to be considered to meet the demand of London’s increase in population by 2050. The most eye opening aspect of this discussion was the evidence provided by Shelter regarding the plight of homelessness, and the impact the lack of affordable housing is having on the health of the working poor and displaced in the UK. “1 in 5 English adults (21%) said housing issues had negatively impacted upon their mental health in the last 5 years. 3 in 10 {…} said they had no issues with their mental health previously”. The evidence Shelter put forth showed how “coordinated reform and investment from a government willing to make housing a central priority” could address this. Shelter’s contribution was indeed a disturbing illustration of our staggering crisis of housing and mental health, but also a compelling explanation of how this can be ratified through design and a shift in local economic reform.
 
The London First talk was hosted by VuCity, a new software that has created “an accurate interactive digital city model”. This planning tool enables detailed information relating to individual development proposals to be evaluated in situ before consent is given. The tool, dependent on the accuracy of the information it is fed, is capable of determining impacts such as wind at street level, views from a neighbouring property, daylight shadow diagrams, the list goes on. Currently, the software has been adopted by The City of London, Westminster, Southwark, and Transportation for London. The aim is for adoption across the UK to support local authorities by providing more knowledge of possible impacts, and to test the viability of design quality of developments of all shapes and sizes.
 
On the same day as the London First talk, an APPG (all-party parliamentary group) met to discuss the role of tall buildings, whether they offer a solution or not. High quality design is always emphasised as critical; however the elephant in the room is universal health and it is never placed at the heart of the argument to shape the quality of design. Mise van der Rohe (actually Louis Sullivan) is often quoted “form follows function”, which is the argument that design must relate to its intended function. The reason issues of growth, high density and tall buildings have become so emotive across London and the world, is at the heart of this is our realization that our cities are devoid of a relationship to the majority of those who occupy them. The majority in London specifically, are struggling on £25K as a combined household income, they are working long hours, they are travelling longer distances between work and home, 1 in 3 of them have mental health issues and Shelter’s evidence would suggest 100% of this has some association with housing costs, poor urban quality and uncertainty. “There are millions of people every year struggling with bad housing or homelessness” yet this remains in the back drop of arguments over tall buildings and growth.
 
In the LSE’s (London School of Economics) Conference Report: Cities, Health and Well-Being, there is much discussion about using the “LSE Cities’ mapping of health outcomes at a fine grained spatial scale which could contribute to a better understanding of health risks in different areas.” Were this system of mapping layered with the Vu City model this could be a life changing way of bridging the function with the type of form. Public Health England, located in every borough across the country, has all of the up-to-date information on local health. Would it not be simple to combine this information with VuCity and each borough to bridge this gap? It would help if copies of The King’s Fund Housing and Health report 2018, was made available to the APPG, New London Architecture and to the Department of Housing, Communities and Local Government, to inform built environment professionals of what the need looks like to empower them to design accordingly. 

Last week, I was fortunate to attend the Government’s first Design Quality and Housing Conferences in over a decade. The Ministry of Housing, Communities & Local Government hosted the Design Quality Conference: Achieving Well-Design Places. The opening statement was made by Dominic Raab MP, Minister for Housing and the closing addresses were given by Lord Taylor of Goss and Sajid Javid MP, Secretary of State for Housing, Communities and Local Government. There were a wide range of attendees including: Housing Associations, Developers, The Design Council, Homes England, Historic England, Local Authorities. The representation at this conference reunited the UK’s built environment industry. The chosen format for the event consisted of four break-out sessions focused on different themes; Engagement, Innovation, Influence from Youth, and Tools. While the themes appeared to be diverse, there was a clear and over riding message that design quality was vital for the promotion of health and wellbeing of present and future generations. Unfortunately, it was evident that there is presently a general lack of cohesion across this sector, and poor communication over the last decade has led to a significant oversight of and appreciation for the built environment in the UK. Nevertheless, while it is useful to critically conduct a self examination, a Swedish delegate suggested that the successful marrying of the modern designs to historic ones made UK cities unique in their efforts to enrich culture and enshrine localism, that was worth replicating.
 
Generating strategies to improve health and well-being pervaded every aspect of the conference. A recent article in the Lancet on Shaping cities for health reminded readers that the WHO’S Healthy Cities movement was now 30 years old and nowhere had the influence of this movement been more effectively adapted than in China. “By 2015, 259 of the 769 cities in China achieved the national Hygienic Standard. {…} The health movement has contributed greatly to the increased life expectancy of the Chinese people, from 35 years in the 1950’s to {…} 76 years in 2015.” It is apparent that Chinese policy makers are well aware that “health must be integrated in urban policies by widening participation and considering the ramifications on health of all decisions.” Here in the UK, 10 NHS Healthy New Towns have been launched. In light of this, an influential health think tank, The King’s Fund, recently published an extensive report entitled “Housing and Health: opportunities for sustainability and transformation partnerships.” (4) In addition, a bold decision has been made by the NHS to move Public Health back into local authorities in 2012, with the intention of integrating health “in urban policies by widening participation and considering the ramifications on health of all decisions”.
 
Publications describing policies and initiatives appear to be a stronger in the NHS than in the built environment industry, the absence of health professionals from this conference merely demonstrated how behind the UK is with the take up of the WHO’s Healthy Cities movement. Furthermore, sustained efforts to follow up on the good intentions expressed in this conference are now needed. A combination of environmental and health professionals are now required to come together to design and implement a comprehensive response that will address such pressing issues as: the impact of an aging population, affordable housing for the young, etc. This conference was the perfect opportunity to make those introductions, fingers crossed it won’t be another ten years for the follow up.