A study by China's CDC shows that more than 100 million people in China have mental health problems and more than 16 million have severe mental illness. At the same time, China is experiencing fast urbanization and more than 100 Chinese cities now have more than 1 million residents. Can we promote people’s mental wellbeing through better design of our urban neighborhoods? In order to answer this question, our research team conducted a case study in Beijing, the capital city in China. The results of this study are published in Landscape and Urban Planning.

The survey
Our study focuses on 16 typical Beijing neighborhoods that were identified by senior urban planners from Beijing Municipal Government. Survey questionnaires were brought to the 16 neighborhoods at the end of 2015. Survey participants described their mental wellbeing and evaluated both the built and social environments of their neighborhoods. The survey results suggest that mental wellbeing varies widely in the studied neighborhoods (the neighborhood that reported the best mental wellbeing scored about 50% higher than the lowest).  Residents living in neighborhoods that are further away from the city center tended to have slightly better mental wellbeing.

So what explains such variation?

To answer this question, we measured and tested a series of factors that potentially influence people’s mental wellbeing:

1) Perceived neighborhood built environment, such as availability of green space, walkability, neighborhood safety, neighborhood accessibility to a variety of destinations, and easiness of driving and parking
2) Perceived neighborhood social cohesion which is measured based on whether and how people get along and help each other in a neighborhood
3) Observed neighborhood built environment such as land use density, mixed land use, and distance to the nearest park
4) a series of personal characteristics such as physical health, age, education, family structure, home and vehicle ownership, etc.

Neighbourhood social environment is most associated with mental wellbeing

It turns out that neighborhood social environment exerts a stronger influence on people’s mental wellbeing than neighborhood physical environment. People who reported better interpersonal relationships in their neighborhoods tended to have better mental wellbeing. Such a positive association, however, was weaker in newer neighborhoods that were built after 2000. We suspect that this is likely because social interactions and mutual assistance are declining when housing is being commercialized in newer neighborhoods. It could also be due to the fact that it takes time to form a close-knit neighborhood.

Living near a park was the main physical environment association with mental wellbeing

A few physical environment factors can also lead to better mental wellbeing. Consistent with previous findings, living close to a park helps to promote mental health. Land use density and mixed use, however, did not seem to have an impact on residents’ mental wellbeing, after taking into account of other variables. Satisfaction with neighborhood built environment had only a marginal positive effect on mental wellbeing. On the other hand, when asked if neighborhood built environment is important or very important, a majority of respondents said yes. This study found that neighborhood physical environment is important for residents, but has a minor role in determining their mental wellbeing. This finding is puzzling for us and may require more research.

The question of cars

Lastly, the study reveals a challenge that Beijing’s urban designers and planners have to face: with a quick increase of vehicle ownership, should neighborhoods be designed to be conducive for the use of private cars? Our study finds that residents who own cars tend to feel better when they live in neighborhoods that are conducive for driving and parking but vice versa for residents who don’t own cars. Designers and planners have to decide how to make a balance between walkability and easiness of driving in a neighborhood.

Note: Access to this journal paper requires payment

Dong, H., & B. Qin. 2017. Exploring the Link between Neighborhood Environment and Mental Wellbeing: A Case Study in Beijing, China. Landscape and Urban Planning, 164: 71-80. DOI: 10.1016/j.landurbplan.2017.04.005

The health and well-being of citizens is strongly associated with the living quality of the high-density urban environment, for example: crowdedness, compactness, pollution, and urban heat islands. Elderly people are particularly vulnerable as their mental health can be less resilient. We therefore need to know how our built environment affects the health and wellness of elderly people so that we can provide a better living environment for promoting active ageing in our society.

CUHK Jockey Club Institute of Ageing was established in 2014 and has been working towards making Hong Kong a global age-friendly city. We have been working on how the built environment affects mortality, geriatric depression, frailty and cognitive function. Based on a large-scale cohort study started in 2001, we obtained a wide variety of health outcomes for our research studies.

For urban designers, it is important to identify the features of our built environment that affect the health and well-being of elderly people so that we can design better living spaces for them to age healthily. We identified high risk areas for geriatric depression in Hong Kong based on the results of statistical modeling and spatial mapping.

The results of this research in brief

We found that areas experiencing rapid redevelopment have the highest association with risk of depression in older people because of the vastly changing physical and social landscape. The changing building form is associated with changes in the composition of community amenities and social environment.

Planning and design of future development will have to take into account such changes and prevent the deterioration of living quality of elderly people.

LEARN MORE

Read the full research study here: Spatial Variability of Geriatric Depression Risk in a High-Density City: A Data-Driven Socio-Environmental Vulnerability Mapping Approach

Read a South China Post article about designing an age-friendly Hong Kong.

October 10th is International Mental Health Day and this year's theme is mental health in the workplace. Unemployment is a major risk factor for mental health problems, and being employed usually protects our mental health. But since we spend a large portion of our days working, our work environment can have a wide range of effects on our wellbeing. This can affect how we feel, our relationships with friends and family, and importantly, our mental health. A challenging workplace can contribute to and exacerbate problems like stress, anxiety, depression, and drug and alcohol use, while a supportive environment can help staff thrive.

The World Health Organization says: "A negative working environment may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity. Workplaces that promote mental health and support people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains. "

Workplace design for better mental health

Many of mental health challenges at work stem from relations with colleagues, degree of support, and working hours - but design also plays a role. In developing a workplace that supports mental health, let's look at some of the opportunities for workplace design. Then at the end, watch architect, Shigeki Irie, discussing how he implemented these ideas in his design of the new Coca-Cola Japan HQ LEED Platinum building in Tokyo.

Nature: Natural settings are good for our mood and stress; they can also increase stamina and concentration, which may affect productivity. Nature can be integrated into the workplace in various ways, including views, plants and water features within the office, and nature analogues such as materials and patterns (e.g. use of wood) and other decor (e.g. artwork) that evoke nature.

Physical activity: Workplaces should be set up in ways that encourage regular physical activity in the course of people's ordinary workday, such as designing buildings that favor the use of stairways, and providing other exercise opportunities.

Social interaction: Workplaces should encourage appropriate social interaction, both formally and informally. This may involve routing decisions around the workplace, design of rest areas and meal areas, and also connect to community linkage. Being in an office building all day can create feelings of disconnection and isolation: how can designers counteract this and maintain a sense of place and connection to the local community?

Circadian lighting: Many workplaces are indoors and a lack of natural light can affect people's sleep. Since sleep is an important protective factor for mental health, and poor sleep can exacerbate mental disorders. Leigh Stringer, author of The Healthy Workplace, says: "Circadian lighting in workplaces takes into account natural and artificial light, a certain intensity of light at the desktop height level, and the presence of high light levels for a certain amount of time during the day.  Even if your workspace is lit at 500 lux, which is more than enough light for reading and most work tasks, it will not necessarily reset sleep schedule."

Choice and control: Feeling in control of your workplace environment reduces your risk of workplace stress. This includes being able to set up or select different styles of work spaces depending on individual preferences, for example providing multiple settings, or flexible use of individual work stations. It also includes being able to control noise - sometimes background noise can help people concentrate; other times it provides a stressful distraction.

CASE STUDY: Coca-Cola HQ, Tokyo

At our UD/MH Tokyo dialogue, Shigeki Irie, the architect in charge of the LEED Platinum Coca-Cola Japan HQ design, explained how he integratated principles of good mental health into the design of the building. To deliver nature exposure, physical activity, social interaction, circadian lighting, and community connection, he used a 'handshake design' to deliver a staircase running up the side of the building whose glass walls provide views of greenery and local streets. This staircase constitutes a venue in itself, with 'communication steps' to hold meetings,  to relax and to have lunch. Also for lunch, he brought the office's cafeteria, previously underground, to an area overlooking a park, so that the room is now bright and surrounded by nature. He further enhanced connection and communication through opening up the office to enable people to see each other, and by enacting the Japanese concept of engawa, creating a welcoming area where the outside and inside interact (a concept rather like the American porch). And increased physical activity opportunities by creating bike parking and showers - unusual for a Tokyo office building.

Designing for good mental health is the responsible choice - and it makes good business sense. Read more about mental health in the workplace.

Today, October 1st, is International Day of Older Persons. This year the theme is enabling and expanding the contributions of older people in their families, communities and societies at large. The World Health Organization recognizes that a key component of achieving this is through the creation of age-friendly environments:

Urban design for ageing populations?

From the perspective of architects, planners and other city designers, age-friendly environments contribute to good mental wellbeing by enabling older people to access nature, meet friends, get exercise, conduct useful tasks, and participate and contribute to their communities. By enabling these actions, good design can enable participation in the community for people of different abilities, improving quality of life, and reducing the risk of mental health problems like loneliness and depression, including for people with dementia.

Mind the GAPS

Urban designers and planners can particularly contribute by designing high quality spaces by 'Minding the GAPS':

• Green spaces: Provide access to well-maintained natural surroundings that older people can enjoy; these should include seating, public toilet facilities, and protection from the weather.
• Active spaces: Enable physical activity, particularly walking, through: barrier-free design, appropriate seating, toilet facilities, crossings that permit enough time for  all pedestrians to cross the road, and pavements that are wide and even with low curbs and wheelchair access points, and that are free of hazards.
• Pro-social spaces: Encourage positive, natural social interactions, including in multi-purpose inter-generational spaces, and in settings that facilitate affordable activities.
• Safe spaces: Are safe in terms of crime, traffic, falls, and wayfinding. A symptom of dementia is disorientation, so environments should be easy to navigate, e.g. make use of clear landmarks, clear signs at eye level at key decision points.
• Services: A range of services (shops, healthcare, library, banks, cafes, post offices, social options, etc) should be clustered near where older people live, and be easily accessible to enable people to conduct their activities of daily living. Transport should also be accessible.

Read more: Download the World Health Organization Global Age-Friendly Cities Guide (2007) and check out Wisconsin's example of a Dementia-Friendly Communities toolkit.

Join: Is your city an age-friendly city? Join the World Health Organization's network.