“…It will need to build up to 600,000 new homes each year just to keep pace. The market ought to provide them, but governments distort it. Corruption and mismanagement of land is a problem. Builders must cope with burdensome regulations and antiquated zoning laws.” (The Economist, June 16th 2018) 
 
The above is an excerpt from an article about Cairo. Interestingly, it was the exact sentiment echoed at all of the talks and conferences I attended on the UK’s Built Environment this past week. As the anniversary of the Grenfell tower fire passes, the regulations and policies that form the foundation for housing the UK’s population, seem to be demonstrating above all else that a new inclusive growth model is needed to make places function, and to bring us into the future.
 
Interestingly the UK’s Draft National Planning Policy Framework’s (NPPF) “purpose {…} is to contribute to the achievement of sustainable development.” Sustainable development is defined in terms of an economic model and its achievement  across most of London and most globalised cities demonstrated by the  number of tall buildings that dominate these urban centres. Among the talks I attended this week, one on Land Values was held by a small interest group. The audience included developers, economists and those involved in planning and housing policy. What was clear was the frustration among all attendees regarding the lack of authority against the predominance of traders' “gaming tactics” that dominate residential high density delivery, due to the impairment of current planning policies, regulations and taxing.

While in attendance at the Vision 2019: The Future of the Built Environment event, the emphasis on well-being was endlessly recurring. The takeaway was that the sustainability agenda had now been replaced with wellbeing. What has struck me is the disconnect. Health and the built environment hold the power to create a more resilient economic model for today and the future - information we’ve known for decades. History is riddled with examples of lessons learned from residential high density. Red Roads Flats in Glasgow, Hong Kong’s Kowloon Walled City, Pruitt-Igoe in St Louis, all demonstrated the ineffectiveness of mono estates. Yet, our cities are repeating these projects and inventing new ones, as seen in blocks of absentee residents occupying the centre and the most vulnerable moving into the suburbs, exacerbating growth and health inequality. Professor Robert Gifford’s 2007 article The Consequences of Living in High-Rise Buildings provides an important reminder as to the cause and effects of environment on health. Beyond the caveats is the knowledge of what fails to serve as acceptable urban form due to its impacts on mental health, social connectivity and mobility. We are in a state of crisis, a statement echoed at many of these events this week, we are on the verge of riots in the streets because we have ignored the majority of residents who are struggling economically. This struggle cannot be ignored, because it sits at the core of local epidemics of mental and physical health, manifested by the pervading patterns of exclusion reinforced across our emerging built environment.
 
How might we change this? First, all built environment practitioners; planners, developers, architects, urban designers, engineers, need a crash course in environmental psychology. Behaviour theory explains how environment is the most influential force in human evolution. It is not a mystery why over 60% of the world’s population is dying from preventable diseases such as cancer and diabetes, nor is it a wonder why depression is the leading cause of disability worldwide. We are living in cities that are not designed for most to live in - they are designed for people to invest in.

This is what sustainable development creates: places, but not for people to live in. We need to stop being ignorant of the fact that we have NOT outgrown our biological DNA, we still possess all the characteristics of animals living in natural settings. We have only been living in an urban setting for 1% of our biological history and it is very clear this current design will lead to our extinction. A clearer understanding of the impact environment has on health, needs to be at the core of how we deliver all aspect of our urban environments.
 
Second, we need a new model, one that adapts both the environmental and economic elements in balance with human health, one Judith Rodin refers to as Urban Resilience. The Lancet review on planetary health 2015 states “the resilience approach is system oriented, take a more dynamic view, and sees adaptive capacity as a core feature of resilient social-ecological systems.”  NPPF lacks reference to personal health. It does mention community health but it does not support individual health, and this is what separates public health from planning. Public Health is focused on prevention, and the reduction of threat on the lives of individuals who vary in their (emotional, physical, educational and economic) asset base. Urban development possesses the possibility for creating not just health equality but economic justice as well, and that is the message missing from the NPPF.

The problem with a sustainable development-led purpose is it is an economic purpose that excludes human relevance, and this is at the core of our societal disconnect.  The definition of Sustainable Development is: “economic development that is conducted without depletion of natural resources”, humans are not present in this concept. The definition of urban resilience however, is “the capacity of individuals, communities, institutions, businesses, and systems within a city to survive, adapt, and grow no matter what kinds of chronic stresses and acute shocks they experience.” It is a model that enables an equilibrium of environment and health along-side growth and prosperity.
 
Marianna Mazzucato, one of the most important economic minds of our time, says in her new book: “assumptions about the generation of wealth have become entrenched, and have gone unchallenged. As a result, those who claim to be wealth creators have monopolised the attention of governments with the now well-worn mantra of: give us less tax, less regulation, less state and more market.” Our current regulations, policies and designs, clearly demonstrate a widespread obliviousness to the daily struggle of the majority of those living in urban settings, such as London, and the relationship of health issues caused by the lack of affordable, inclusive, healthy environments.
 
In conclusion I wish to share some examples that I am exploring as models for urban resilience that seem to demonstrate the Health –Environment –Economic paradigm.

Golden Lane Estate, London
Built in 1957 in the heart of the City of London, with a density of 200 persons per acre, a mixed tenure, with 60% of the site devoted to open space. Golden Lanes includes its own grocery store run by a resident who travels to the Covent Garden market daily to supply residence with fresh produce. The development includes tennis courts, a swimming pool and maintains a thriving social capital that extends generations, economic classes and cultural backgrounds.
 
Lancaster Cohousing, Halton Mill
Developed around the revitalization of a Mill supplying a source of Jobs, while generating its own energy supply, qualifying it with the highest standard of energy efficiency. Those living in the development have access to employment via a working mill and within the development which serves as a centre for wellbeing, offering services and spaces for the practice of health and wellbeing.

“If a place can be defined as relational, historical and concerned with identity, then a space which cannot be defined as relational, or historical, or concerned with identity will be a non-place.” - Marc Augé, 1995

Marc Augé’s 1995 book Non-places: Introduction to an Anthropology of Supermodernity provides a helpful articulation of the difference between space and place. Space being one that is moved through with frequency, versus a place where the built form actively participates in the animation by providing a draw for human interchange, what Augé refers to as “places of memory’. 

I found myself contemplating “space” and “place” while in attendance at The City Centre talk on “City Briefing: Public Realm” (30.05.2018) in London. Simon Glynn, the Assistant Director (City Public Realm) City of London, provided an overview of development in the City from a public realm perspective and an overview of the changes to come. Many interesting statistics were shared including the fact that the The City of London is home to 10 of the capital’s streets with the highest pedestrian volumes. Currently, these volumes reach up to 2000 pedestrians per hour. Another interesting fact was that 90% of those occupying the City are SMEs and a growing market. Let us not forget though there is a well-established residential community in The City.

The talk revolved around research on pedestrian comfort levels in the City. Over the past two years, pedestrian volumes have increased by 25% which has motivated a drastic rethink as to how the public realm needs an adaptable system to accommodate these sudden increases. The work is very much in its infancy - the first stage of consultation will take place in June 2018. None the less, the limitations presented in the City of London are unique. Mr Glynn reported that changes in built environment due to new developments take place every 18 months, which means any improvement to the public realm, beyond the paving will need to be temporary and moveable. This constraint fascinates me.
 
Environmental psychologist Lily Bernheimer’s book The Shaping of Us aptly reminds us that the early formation of our cities was made from raw materials such as wood and mud, and were designed to follow the movements of our natural geography, but also took shape in a time line that enabled us to adapt to new landmarks. The need to navigate, to adapt, never ceases in an urban setting, where our senses are continually in a state of receptive defence and our minds are continually processing. Therefore, to create a perpetual pop-up as response to the rate of change, begs the question is this a ‘space’ or a ‘place’? Could this be the next stage of urban design where every inch is fluid and belongs to no one and no point in time?
 
Scientific America published the evidence of German researchers who discovered residents of large cities have a higher measure of activity in their amygdala, the part of the brain to serve emotional intelligence and memory. Critically, the amygdala “regulates the assessment of threats and generating fear”. This evidence shows us the effect of social stress and physiological impacts on our bodies. Exposure to social stress is linked to the development of mental disorders including schizophrenia. This area of research demonstrates the biological adaptation to those who have grown up in urban settings who have adapted a different perception to threats either physical or social. Therefore, an urban dweller will have a well-developed amygdala due to prolonged activation compared to those growing up or living in “smaller cities”. 

The research highlights sensory loading on the brain. Evidence shows us there is a negative impact of being in a crowded place as it triggers our bodies to release more dopamine which it does under stress. However, couple this with feelings of loneliness or depression (which affects 350 million or 4% of the global population) the research that links urban settings and schizophrenia seem like common sense.

I recently visited The Crystal in London, home to the world’s largest exhibition on the future of cities, an essential visit for all built environment professionals. One of the animated stations illustrated the way in which smart technology will demand that we program our every move, renting and selling space on transport, access to electricity, renting all forms of space on an hour to hour basis, effectively a fluid existence in the non-place. Perhaps the City of London’s perpetual pop-up public realm is a human scale transition into the future’s faster changing pace of spaces and places? Considering the sensitivity of the human biology in regards to the unfamiliar, and reliance on memory for navigation purposes, my concerns are as follows:

1. Richard Florida’s latest book The New Urban Crisis provides some essential statistics on urban growth projections, namely that the world’s population is going to triple to 10billion, where today we have 28 cities with populations of more than 10 million, by 2150 we will have 50 or so cities of 200million. How will our brains cope with more people and more “spaces” rather than “places”?
   
2. There is a disturbing lack of understanding into the role environment plays in shaping the health of human beings. Green spaces stimulate social cohesion and facilitate social interaction - what level of quality will be possible in the non-space?
   

I am keen to see what solutions the City will find to balance the rate of change with the already faltering human health of our urban dwellers. Watch this space…

The correlation between exposure to nature and mental health benefits is arguably one of the more well-supported topics in literature that discuss links between health and the environment. Close proximity to greenery has been demonstrated to lower levels of stress and have positive impact towards users’ wellbeing, with studies have also suggesting that people living near green urban areas can help encourage more physical activity, thereby exerting a positive impact for people suffering with anxiety and depression (Cohen-Cline et. al, 2015). As I pursue my case study of Perth’s urban design in relation to mental health, this post hopes to serve as a snapshot and explore different ways green space is being implemented in one of Perth’s phoenix suburbs, otherwise known as Fremantle.
 
BOTTOM-UP GREEN SOLUTIONS AND PARTICIPATION

The place close to my heart is the City of Fremantle, 22kms south of the Perth CBD in Western Australia. Situated as a port city at the intersection of the Swan River and the Indian Ocean, Fremantle was officially recognised as a leader in sustainability in 2015 when it became the world’s second city to achieve international One Planet Certification, which is an initiative offering a framework to drive sustainable living and green, circular economies.
 
Fremantle’s Strategy 2020 recognises the benefits that green urban environments have towards community cohesion and wellbeing. With an objective to aim that “every resident and worker to have access to public open space within a 400mm walkable catchment”, the Fremantle council have adopted a number of methods and urban design tools to improve better mental health, such as:
 

• Verge Beautification Program: encouraging community engagement residents to planting native, water-wise shrubs on unused verges, offering access to free mulch and subsidised plants
• Community engagement and participation to develop pocket parks on disused pieces of land
• Ongoing contributions towards revegetation, wellbeing grants, community gardens and volunteer support.

 
Not only are these bottom-up methods developing quick, efficient green solutions in the city, but they are also helping foster social connectivity and cohesion within Fremantle’s urban community – an incredibly important factor in benefitting individual mental health. Encouraging volunteering/community participation offers a sense of wholeness and purpose within their home and thus can offer positive well-being effects. The mere act of getting community members out and about in the sun can benefit mental wellbeing through boosting vitamin D supply, regulating the circadian rhythm and improve quality of sleep.
 
By promoting community engagement as a tool to improve and encourage access to green space, Fremantle’s greening strategies have proven to be successful and continue to improve the opportunities that urban design can bring towards mental health in the area.
 
 
BARRIERS TO GREEN SPACES IN THESE CITIES
 
However, urban design plays a significant role in the level of access urban communities have to green space; factors such as time, money, distance, and transport accessibility can serve as barriers for green space access. Throughout the urban sprawl of major Australian cities, studies have shown socially-disadvantaged areas had a lesser access to green space, and thereby had less opportunities for the mental health benefits that green space provides. Australia. To combat this spatial inequality, cities such as Perth urgently need to implement improved access towards transit-oriented development and encourage more positive attitudes towards higher-density development. Fremantle has a long way to go in integrating affordable and good-quality higher-density developments with the abundance of green space it offers.
 
BLUE HEALTH = MENTAL HEALTH

As a port city, Fremantle is fortunate enough to be situated by both the ocean and river. Along the harbour there are restaurants, cafes, breweries and galleries that offer views over the water. This weekend I found myself having a coffee by the beach, sitting on an innovative piece of urban design that had reused Fremantle’s historic train lines. The water’s edge had attracted everyone from all sorts of age groups; kids dashing around in the sand, students along the benches in the sun, or the elderly peacefully strolling along the boardwalk. Intrigued by the success of Fremantle’s public activity as a low-density suburb, I had to further research into how the use of water in urban design can benefit one’s mental health or wellbeing.
 
Dr. Timothy Beatley, professor at University of Virginia and author of “Handbook of Biophilic City Planning and Design”, has discussed a lot about links between the sea, the city and mental health – terming the idea “Blue Urbanism”. It is no surprise that Fremantle, as a major port town, benefits from its adjacency to the Indian Ocean.
 
One of our UD/MH fellows, Jenny Roe, recently wrote for the Biophilic Cities Journal exploring this idea of blue health within the built environment (Roe 2018). Below I am going to briefly reiterate some of the literature Roe has discussed.
 
Studies have found that people living near coastal environments have lower Body Mass Index compared to people living inland (Wood et al. 2016; Witten et al. 2008). This evidence suggests that increasing users’ accessibility to water can improve one's chances of being physically active, which can have a range of benefits including reducing risk of obesity, diabetes, anxiety and depression. Living in marine or coastal areas has further shown people to report greater levels of happiness (MacKerron and Mourato, 2013); improved life satisfaction (Brereton et al. 2008); and better mental wellbeing (Alcock et al. 2015).
 
Access to blue space has also demonstrated its ability to reduce stress and benefit levels of wellbeing. This is supported from research done by Happy City, Street Plans, Space Syntax, and University of Virginia, which measured heart rate variability and self-reports from subjects who took a walk along a downtown waterfront in West Palm Beach (2015). The study found further positive impacts for water accessibility towards social well-being indicators (social trust and sense of belonging). The mixture of people evident during my brief time down by the Fremantle foreshore most certainly supported these results.
 
If you’d like to learn more about how green space accessibility and mental health go hand in hand, there’s a great literature review called Quality Green Space Supporting Health, Wellbeing and Biodiversity: A Literature Review. Written by Davern et al. (2017), the report offers a succinct summary of the factors involved in the design and delivery of green spaces that promote the health and wellbeing for people, with particular reference towards Australia cities. Another helpful report is Cities, Green Space and Mental Wellbeing by Jenny Roe. In terms of a specific focus on blue space, Beatley’s “Blue Urbanism” book and Roe’s feature article in the BCJ report on evidence-based studies that demonstrate how access to water within urban design can create positive mental health benefits.
 
 
REFERENCES
 
Astell-Burt, T, Feng, X, Mavoa, S, Badland, HM, & Giles-Corti, B 2014, 'Do low-income neighbourhoods have the least green space? A cross-sectional study of Australia's most populous cities', BMC Public Health, vol. 14, p. 292. Available from: 10.1186/1471-2458-14-292. [20 May 2018].
 
Badland, H, Whitzman, C, Lowe, M, Davern, M, Aye, L, Butterworth, I, Hes, D, & Giles-Corti, B 2014, 'Review: Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health', Social Science & Medicine, vol. 111, pp. 64-73. Available from: 10.1016/j.socscimed.2014.04.003. [20 May 2018].
 
Beatley, T 2014, Blue urbanism : exploring connections between cities and oceans, Washington, DC : Island Press, [2014].
 
Brereton, F., Clinch, J.P., Ferreira, S. (2008). Happiness, geography and the environment. Ecol. Econ. 65: 386-396. https://doi.org/10.1016/j.ecolecon.2007.07.008.
 
Duncan, G, Cohen-Cline, H, Cohen-Cline, H, Duncan, GE, & Turkheimer, E 'Access to green space, physical activity and mental health: a twin study', JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, vol. 69, no. 6, pp. 523-529.
 
Happy City, University of Virginia, Street Plans Collaborative and Space Syntax (2017). Happier by Design. https://thehappycity.com/wp-content/uploads/2017/04/STC-reportfinal-version-v.5.pdf.
 
MacKerron, G., Mourato, S. (2013). Happiness is greater in natural environments. Glob. Environ. Chang. 23: 992–1000. https://doi.org/10.1016/j.gloenvcha.2013.03.010.

Roe J (2018). Blue Cities for Better Health. Biophilic Cities Journal.
 
Witten, K., Hiscock, R., Pearce, J., Blakely, T. (2008). Neighbourhood access to open spaces and the physical activity of residents: a national study. Prev. Med. 47: 299–303. https://www.ncbi.nlm.nih.gov/pubmed/18533242.
 
Wood, S.L., Demougin, P.R., Higgins, S., Husk, K., Wheeler, B.W., White, M. (2016). Exploring the relationship between childhood obesity and proximity to the coast: a rural/ urban perspective. Health Place 40: 129–136. https://doi. org/10.1016/j.healthplace.2016.05.010.