Journal of Urban Design and Mental Health 2018;4:9
FOCUS ON HONG KONG: CASE STUDY
Urban design and mental health in Hong Kong: a city case study
Layla McCay (1, 2) and Larissa Lai (1, 3)
(1) Centre for Urban Design and Mental Health, UK
(2) Asia Global Institute, Hong Kong University
(3) Pratt Institute
(1) Centre for Urban Design and Mental Health, UK
(2) Asia Global Institute, Hong Kong University
(3) Pratt Institute
UD/MH city case studies use our method of interviews and policy research to examine how a particular city applies the key principles of urban design for good population mental health, and identify opportunities for this city and lessons for other cities. If you wish to conduct a city case study, learn more here.
3 Urban planning/design lessons from Hong Kong for better public mental health
8 Urban planning/design steps to help improve Hong Kong’s public mental health
- First mile-last mile infrastructure: Promote walking and negate the need for cars
- Social infrastructure: Formal sitting out spaces encourage people to socialise, and to walk and rest
- Space sharing in dense cities: Where space is limited, the same location can have different uses at different times
8 Urban planning/design steps to help improve Hong Kong’s public mental health
- Urban nature and other public space: More in-city options will support better mental health (and clearer links to nearby greenery)
- Design work for better mental health: Improve settings for commutes, offices, and breaks during the day
- Pro-social homes: Increase opportunities for positive social interaction within housing
- Reduce car domination: Public transport and walking should occupy landscape commensurate with prevalence
- Sitting in AND out: Sitting out spaces should also exist within air conditioned indoor places
- Cross-sector collaboration: More collaboration between government sectors would deliver better health impact
- Inclusive planning: More formal effort to engage city residents and users will reap rewards
- Prioritise health: Shift decision-making priorities from mainly financial considerations to include health
Introduction
The World Health Organisation defines mental health as: “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” This definition is relevant for urban designers because it also reflects key components of a thriving, resilient urban population. Key urban design factors that can affect mental health include: access to natural (green and blue) spaces (Roe 2016, Gascon et al 2015), facilitating physical activity (Morgan et al 2013), pro-social activity (Francis et al 2012), safety (including wayfinding, crime, and traffic), and sleep quality (Clark et al 2006, Litman 2016). Hong Kong is a high-rise super-dense city surrounded by water and country parks. The population is ageing rapidly. The impact of urban design on mental health is starting to be recognised: ‘There are two unique things in Hong Kong. 1. It's a vertical city. 2. Terrain variability. Because of that, our neighbourhood built environment becomes more important’ – Urban health researcher
Overview of mental health in Hong Kong
'Mental health' or 'mental illness' are both terms that tend to be stigmatised and avoided by the Hong Kong population. ‘Stress’ is more socially acceptable, and is commonly discussed in the context of housing problems, density, long studying or working hours, and the super-ageing population. Currently 16% of Hong Kong’s population is over the age of 65; this is projected to increase to one third of the population by 2041.
The prevalence of common mental health problems for Chinese adults in Hong Kong is measured as 13.3% (Hong Kong Mental Morbidity Survey 2012-13), with the most common disorders being mixed anxiety and depressive disorder (6.9%), generalised anxiety disorder (4.2%), and depressive episode (2.9%); 4.8% of the general population have ‘non-severe psychological distress’ (Department of Health, 2015). One tenth of Hong Kong’s super-ageing population is considered to be affected by dementia (Department of Health, 2017). The Hong Kong population suicide rate is 12.6 per 100,000 people and while this rate has been generally falling over the past decade, the suicide rate for older people remains double that of the national average, and the suicide rate for young people is rising (HKJC Centre for Suicide Research and Prevention). Just one quarter of people with mental health problems in Hong Kong access formal mental health services (Lam, 2015), though the demand for child and adolescent services has grown by 50% over the past 5 years.
‘[Mental health problems are] fairly consistent across the board because of the pressure to succeed. Student suicide rates spike in January when they get their exam results’ – planner.
Planning in Hong Kong
‘The Department of Health recognises the need to ‘promote healthy lifestyle and mental wellbeing’ as an integral part of public health. There are no explicit built environment recommendations from the Department of Health other than for dementia: Social care infrastructure should be strengthened through developing dementia-friendly neighbourhood and providing more dementia-specific services in the community to facilitate persons with dementia to remain in the community for as long as possible’ (Department of Health, 2017).
Hong Kong is a compact city with limited flatland. It originated as a set of fishing villages as early as 700BC, with clans starting to build walled villages from 960AD. Hong Kong was initially developed as a trading port by Portugal in the 1500s, and then by Britain from the early 1800s, to whom Hong Kong Island and Kowloon Peninsula were ceded; the so-called New Territories were then leased to Britain, constituting Hong Kong today. The city developed rapidly into a global financial centre and in 1997 Hong Kong became a Special Administrative Region of the People’s Republic of China.
Hong Kong has always had a deficit of buildable land. Chinese immigration and colonisation has shaped planning in the city, which, along with its mountainous topography, has led to avoidance of urban sprawl. Today, Hong Kong’s population of 7.32-million people lives in a quarter of its total land area, comprising 250 km2. Most people live and work in high-density downtown areas without a great deal of private space; others live further from the city on islands and in the New Territories and commute into the city centre. Planning is generally considered ‘top down’ and is characterised by transit dependence.
The first line of Hong Kong’s longstanding Town Planning Ordinance states its objective: 'To promote the health, safety, convenience and general welfare of the community...’ And yet, despite naming health the first objective, in practice, Hong Kong’s planning decisions are more likely to be characterised by efficiency and economy. Design and planning decisions have traditionally centred on cost and profit. However, the SARS epidemic in 2013 brought particular attention to the role of the built environment in maintaining good public health: ‘Existing infrastructure was not designed with health in mind, but perhaps after SARS, there is more of a focus – they maintain hygiene, keen spaces clean, and there is a mandatory requirement for fresh air, ventilation… Urban design is a newcomer here – it is only recently gaining status’. – Urban planner. Hong Kong has yet to leverage the full range of public health opportunities associated with the built environment for physical or mental health. Beyond the new post-SARS housing regulations, an urban planner characterises the city’s perspective: ‘the meaning of health in the Ordinance has been simplified: tidy + clean = health.’ (Cap 131 Town Planning Ordinance).
That said, ‘The Planning Department has just started to think about what it means to have a liveable, walkable city in the new 2030 strategy.’ – Urban designer. The main health focus in the Hong Kong 2030+ strategic planning process is leveraging the built environment for the city’s super-ageing population. ‘In the 2030+ policy document there will be an increasing focus on the ageing population, which will include health. Ageing will become a policy focus because by 2030 one third of the population will be elderly. There will be an economic burden, so we are keen to prevent diseases’ – Environmental Scientist.
The focus on the ageing population is associated with an interest in barrier-free access which, by enabling people with different needs, from children to the elderly, to access the city could help prevent loneliness and depression. (This has been supported by statutory requirements on disabled access since 1984 and the Disability Discrimination Ordinance since 1996, Architectural Services Department 2004). The other main relevant area in which Hong Kong has recommendations and strategies is in increasing greenery.
'Mental health' or 'mental illness' are both terms that tend to be stigmatised and avoided by the Hong Kong population. ‘Stress’ is more socially acceptable, and is commonly discussed in the context of housing problems, density, long studying or working hours, and the super-ageing population. Currently 16% of Hong Kong’s population is over the age of 65; this is projected to increase to one third of the population by 2041.
The prevalence of common mental health problems for Chinese adults in Hong Kong is measured as 13.3% (Hong Kong Mental Morbidity Survey 2012-13), with the most common disorders being mixed anxiety and depressive disorder (6.9%), generalised anxiety disorder (4.2%), and depressive episode (2.9%); 4.8% of the general population have ‘non-severe psychological distress’ (Department of Health, 2015). One tenth of Hong Kong’s super-ageing population is considered to be affected by dementia (Department of Health, 2017). The Hong Kong population suicide rate is 12.6 per 100,000 people and while this rate has been generally falling over the past decade, the suicide rate for older people remains double that of the national average, and the suicide rate for young people is rising (HKJC Centre for Suicide Research and Prevention). Just one quarter of people with mental health problems in Hong Kong access formal mental health services (Lam, 2015), though the demand for child and adolescent services has grown by 50% over the past 5 years.
‘[Mental health problems are] fairly consistent across the board because of the pressure to succeed. Student suicide rates spike in January when they get their exam results’ – planner.
Planning in Hong Kong
‘The Department of Health recognises the need to ‘promote healthy lifestyle and mental wellbeing’ as an integral part of public health. There are no explicit built environment recommendations from the Department of Health other than for dementia: Social care infrastructure should be strengthened through developing dementia-friendly neighbourhood and providing more dementia-specific services in the community to facilitate persons with dementia to remain in the community for as long as possible’ (Department of Health, 2017).
Hong Kong is a compact city with limited flatland. It originated as a set of fishing villages as early as 700BC, with clans starting to build walled villages from 960AD. Hong Kong was initially developed as a trading port by Portugal in the 1500s, and then by Britain from the early 1800s, to whom Hong Kong Island and Kowloon Peninsula were ceded; the so-called New Territories were then leased to Britain, constituting Hong Kong today. The city developed rapidly into a global financial centre and in 1997 Hong Kong became a Special Administrative Region of the People’s Republic of China.
Hong Kong has always had a deficit of buildable land. Chinese immigration and colonisation has shaped planning in the city, which, along with its mountainous topography, has led to avoidance of urban sprawl. Today, Hong Kong’s population of 7.32-million people lives in a quarter of its total land area, comprising 250 km2. Most people live and work in high-density downtown areas without a great deal of private space; others live further from the city on islands and in the New Territories and commute into the city centre. Planning is generally considered ‘top down’ and is characterised by transit dependence.
The first line of Hong Kong’s longstanding Town Planning Ordinance states its objective: 'To promote the health, safety, convenience and general welfare of the community...’ And yet, despite naming health the first objective, in practice, Hong Kong’s planning decisions are more likely to be characterised by efficiency and economy. Design and planning decisions have traditionally centred on cost and profit. However, the SARS epidemic in 2013 brought particular attention to the role of the built environment in maintaining good public health: ‘Existing infrastructure was not designed with health in mind, but perhaps after SARS, there is more of a focus – they maintain hygiene, keen spaces clean, and there is a mandatory requirement for fresh air, ventilation… Urban design is a newcomer here – it is only recently gaining status’. – Urban planner. Hong Kong has yet to leverage the full range of public health opportunities associated with the built environment for physical or mental health. Beyond the new post-SARS housing regulations, an urban planner characterises the city’s perspective: ‘the meaning of health in the Ordinance has been simplified: tidy + clean = health.’ (Cap 131 Town Planning Ordinance).
That said, ‘The Planning Department has just started to think about what it means to have a liveable, walkable city in the new 2030 strategy.’ – Urban designer. The main health focus in the Hong Kong 2030+ strategic planning process is leveraging the built environment for the city’s super-ageing population. ‘In the 2030+ policy document there will be an increasing focus on the ageing population, which will include health. Ageing will become a policy focus because by 2030 one third of the population will be elderly. There will be an economic burden, so we are keen to prevent diseases’ – Environmental Scientist.
The focus on the ageing population is associated with an interest in barrier-free access which, by enabling people with different needs, from children to the elderly, to access the city could help prevent loneliness and depression. (This has been supported by statutory requirements on disabled access since 1984 and the Disability Discrimination Ordinance since 1996, Architectural Services Department 2004). The other main relevant area in which Hong Kong has recommendations and strategies is in increasing greenery.
Methods
Literature review
A search was conducted on Hong Kong government websites to identify relevant policy documents. These were retrieved and assessed, and relevant sections were identified and extracted. Further policies mentioned by interviewees were also examined.
Interviews
Seventeen Hong Kong-based academics, public health specialists, mental health specialists, urban planners, urban designers, developers and architects were identified using snowball sampling. Semi-structured interviews were conducted with each person. Each subject was asked about what they considered to be urban design factors that support good mental health, the priority given to mental health in urban design policies and plans, and barriers to prioritisation using the Centre for Urban Design and Mental Health protocol.
A search was conducted on Hong Kong government websites to identify relevant policy documents. These were retrieved and assessed, and relevant sections were identified and extracted. Further policies mentioned by interviewees were also examined.
Interviews
Seventeen Hong Kong-based academics, public health specialists, mental health specialists, urban planners, urban designers, developers and architects were identified using snowball sampling. Semi-structured interviews were conducted with each person. Each subject was asked about what they considered to be urban design factors that support good mental health, the priority given to mental health in urban design policies and plans, and barriers to prioritisation using the Centre for Urban Design and Mental Health protocol.
Results
Built environment factors that respondents believed can impact mental health in Hong Kong
‘The second you wake up in the morning you’re surrounded by an environment that affects your mental health’ – planner
A connection with nature was the factor that most people identified could affect mental health: ‘Breeze, sunshine, birds, animals – they give you a feeling of life; bring you out from yourself’ – landscape architecture researcher. This includes views of nature: ‘When we’re perched up on the 20th floor in a small 200 square foot apartment, our view matters. If it’s the ocean, for instance, it’s preferable. If it’s the wall of the building next door… that’s less good’ – urban health researcher. Other factors included the lack of affordable housing, long working hours and a crowded commute. Additionally, the links between Hong Kong's design and an authentic identity was discussed. ‘We’re losing our sense of identity... Our urban environment has become very homogenous, generic. You won’t look up and say ‘oh this looks like Hong Kong’. This has longer term identity issues – you lose your sense of self, become isolated,’ said one planner. ‘Our visual reference is anime. We’re turning our real space into cyberspace… Everything that surrounds us is artificial. We’ve even lost texture…. Younger people are craving authenticity. We need to wake up in the morning surrounded by reality.’
‘The second you wake up in the morning you’re surrounded by an environment that affects your mental health’ – planner
A connection with nature was the factor that most people identified could affect mental health: ‘Breeze, sunshine, birds, animals – they give you a feeling of life; bring you out from yourself’ – landscape architecture researcher. This includes views of nature: ‘When we’re perched up on the 20th floor in a small 200 square foot apartment, our view matters. If it’s the ocean, for instance, it’s preferable. If it’s the wall of the building next door… that’s less good’ – urban health researcher. Other factors included the lack of affordable housing, long working hours and a crowded commute. Additionally, the links between Hong Kong's design and an authentic identity was discussed. ‘We’re losing our sense of identity... Our urban environment has become very homogenous, generic. You won’t look up and say ‘oh this looks like Hong Kong’. This has longer term identity issues – you lose your sense of self, become isolated,’ said one planner. ‘Our visual reference is anime. We’re turning our real space into cyberspace… Everything that surrounds us is artificial. We’ve even lost texture…. Younger people are craving authenticity. We need to wake up in the morning surrounded by reality.’
Urban density and mental health
‘Hong Kong doesn’t have enough space – physical space, or mental space’ – suicide prevention specialist
With 7.24 million residents, 6958 persons per square kilometre (2015), and most of the residents living in just a quarter of the land, Hong Kong has the highest population density of any city the world (Information Services Department). Since new town development did not start until the 1970s, and 40% of the land is country parks, the majority of the population is clustered in downtown areas. Some downtown areas reportedly house up to 400,000 people per square kilometre. According to an urban planner, this leads to a situation where ‘Hong Kong is a city without ground. It is a dense and vertical city. There’s a lot of high rises and underground development. There’s behaviour changes that this sort of architecture will impose’. Many agree that ‘Hong Kong is well-organised extreme density living – in other cities high density living is often informal and disorganised’.
According to an urban designer, ‘Density affects how people behave and perceive the environment, and whether people feel like they have some control of their environment’. But people diverge on whether this results in positive or negative impact on mental health:
‘Building height can be seen as negative in the West but positive in the East. In Europe, high rise is associated with social housing, but here it is associated with booms.’ – Architect
Some argue that the city’s density contributes to its safety: ‘Hong Kong is safe because it’s dense – there are no dark alleys, the towers where people live are secure’ – Urban designer, while others cite a lack of personal space: ‘The built environment here doesn’t offer respite when you’re stressed. There is a lack of privacy – you’re surrounded by people all the time and it’s not easy to escape. Your place to escape is the shopping mall’ – Urban designer. ‘High density can work both ways – on the one hand people crowd into your personal space; on the other hand, people are not so isolated’ – Architect
Others note that density of building can create feelings of claustrophobia. ‘In the post-war era there was such a population boom that high density was allowed. So we ended up with canyon-like streets that trap car pollution…. The city feels cloistered and claustrophobia-inducing.’ – Journalist. ‘In the 90s, housing blocks were built with not enough space between towers. It created these huge walls. The ambient temperature on the waterfront nearby could be 30 degrees; in these estates it was 35 degrees.’
With 7.24 million residents, 6958 persons per square kilometre (2015), and most of the residents living in just a quarter of the land, Hong Kong has the highest population density of any city the world (Information Services Department). Since new town development did not start until the 1970s, and 40% of the land is country parks, the majority of the population is clustered in downtown areas. Some downtown areas reportedly house up to 400,000 people per square kilometre. According to an urban planner, this leads to a situation where ‘Hong Kong is a city without ground. It is a dense and vertical city. There’s a lot of high rises and underground development. There’s behaviour changes that this sort of architecture will impose’. Many agree that ‘Hong Kong is well-organised extreme density living – in other cities high density living is often informal and disorganised’.
According to an urban designer, ‘Density affects how people behave and perceive the environment, and whether people feel like they have some control of their environment’. But people diverge on whether this results in positive or negative impact on mental health:
‘Building height can be seen as negative in the West but positive in the East. In Europe, high rise is associated with social housing, but here it is associated with booms.’ – Architect
Some argue that the city’s density contributes to its safety: ‘Hong Kong is safe because it’s dense – there are no dark alleys, the towers where people live are secure’ – Urban designer, while others cite a lack of personal space: ‘The built environment here doesn’t offer respite when you’re stressed. There is a lack of privacy – you’re surrounded by people all the time and it’s not easy to escape. Your place to escape is the shopping mall’ – Urban designer. ‘High density can work both ways – on the one hand people crowd into your personal space; on the other hand, people are not so isolated’ – Architect
Others note that density of building can create feelings of claustrophobia. ‘In the post-war era there was such a population boom that high density was allowed. So we ended up with canyon-like streets that trap car pollution…. The city feels cloistered and claustrophobia-inducing.’ – Journalist. ‘In the 90s, housing blocks were built with not enough space between towers. It created these huge walls. The ambient temperature on the waterfront nearby could be 30 degrees; in these estates it was 35 degrees.’
Housing and mental health
Density is closely tied to housing. Hong Kong is the most expensive housing market in the world. Housing cost and availability is one of the biggest concerns for Hong Kong residents and people can wait more than a decade for government housing. A geographer noted: ‘The first priority is affordable housing – it’s very, very high on the list. A lot of people are depressed that they can never own their own house’ and according to an economist, ‘developers are public enemy number one.’
The majority of people in Hong Kong live in small apartments within tower blocks which can be expensive and as one urban planner observes: ‘the rooms are too small, the buildings are too crowded together, there’s not enough space in which to spend time’. Often people must live with their extended families as they cannot afford their own homes, and live in very cramped conditions. The Hong Kong Housing Society Universal Design Guidelines (2005) note that ‘the dimension of living space can affect the psychological health and wellbeing of residents, particularly those who spend long periods at home.’ They make recommendations for headroom (not less than 2.5 metres) and room areas (living room should be at least 3.5m x 4m). However, 47% of homes in Hong Kong have a floor area under 40 m2; a further 43.4% have 40–70 m2 of floor area (Hong Kong Housing Authority, 2014).
Some of those seeking to avoid the steep housing prices in central Hong Kong or seeking more space move to the New Territories. They may enjoy more nature and modern planning, but they also have little time to reap these benefits: fewer jobs are available in these places, rendering them commuter suburbs. ‘Flexible working is not popular. They have to commute every day, and it can be far’ – urban health researcher.
For some of those committed to living more centrally, the challenge of high-cost, small living spaces has spawned a range of creative responses, including shared homes where several families may live in one small residence. Over 200,000 people live in a sub-divided apartment of some type. The most infamous of these is the so-called ‘cage homes’ where one apartment is split into several tiny living spaces or ‘cages’. Many people have concerns about the mental health impact of this extremely compact type of living, which they link to challenges of sufficient provision of social housing. However, for those who cannot afford larger or more private spaces, it does allow people to assert a small degree of privacy they might otherwise not be able to access. Houses are also sometimes built on rooftops, which according to an architect is ‘the only place to find squatters in Hong Kong’.
This type of compressed, vertical living affects people’s relationships with place. One urban planner notes: ‘people need to overcome psychological barriers to living in tower blocks. These towers create physical distance to the activity area, and change the residential acoustic environment – less noise from nature, such as birds, and more elevator noise, for instance.’ An urban health researcher adds: ‘Because you are living in this tiny little apartment and it might be 20 storeys high, you are more reliant on the design of your local environment’ and a feng shui master notes 'views are very important. You need to have scenery and natural light.'
Tower blocks also enable the most common method of suicide in Hong Kong. Jumping from a tower block is much more likely to result in death than suicide attempts by other methods such as overdose of medication. This means that a suicide attempt in Hong Kong is particularly likely to result in death compared with attempts in some other countries.
Until recently, health was not an explicit priority for housing design. The 2003 SARS epidemic changed that: ‘SARS completely changed popular perception of the health impacts of housing. Since SARS people have recognised poor housing ventilation as one of the reasons for the spread of disease’ – Environmental scientist. This has spawned various regulations, but this awareness has not formally extended to mental health. Only one feng shui principle was cited that applied to buildings for mental health: 'Build in a square shape. If a building is too weird in shape, it makes people think weirdly.'
The majority of people in Hong Kong live in small apartments within tower blocks which can be expensive and as one urban planner observes: ‘the rooms are too small, the buildings are too crowded together, there’s not enough space in which to spend time’. Often people must live with their extended families as they cannot afford their own homes, and live in very cramped conditions. The Hong Kong Housing Society Universal Design Guidelines (2005) note that ‘the dimension of living space can affect the psychological health and wellbeing of residents, particularly those who spend long periods at home.’ They make recommendations for headroom (not less than 2.5 metres) and room areas (living room should be at least 3.5m x 4m). However, 47% of homes in Hong Kong have a floor area under 40 m2; a further 43.4% have 40–70 m2 of floor area (Hong Kong Housing Authority, 2014).
Some of those seeking to avoid the steep housing prices in central Hong Kong or seeking more space move to the New Territories. They may enjoy more nature and modern planning, but they also have little time to reap these benefits: fewer jobs are available in these places, rendering them commuter suburbs. ‘Flexible working is not popular. They have to commute every day, and it can be far’ – urban health researcher.
For some of those committed to living more centrally, the challenge of high-cost, small living spaces has spawned a range of creative responses, including shared homes where several families may live in one small residence. Over 200,000 people live in a sub-divided apartment of some type. The most infamous of these is the so-called ‘cage homes’ where one apartment is split into several tiny living spaces or ‘cages’. Many people have concerns about the mental health impact of this extremely compact type of living, which they link to challenges of sufficient provision of social housing. However, for those who cannot afford larger or more private spaces, it does allow people to assert a small degree of privacy they might otherwise not be able to access. Houses are also sometimes built on rooftops, which according to an architect is ‘the only place to find squatters in Hong Kong’.
This type of compressed, vertical living affects people’s relationships with place. One urban planner notes: ‘people need to overcome psychological barriers to living in tower blocks. These towers create physical distance to the activity area, and change the residential acoustic environment – less noise from nature, such as birds, and more elevator noise, for instance.’ An urban health researcher adds: ‘Because you are living in this tiny little apartment and it might be 20 storeys high, you are more reliant on the design of your local environment’ and a feng shui master notes 'views are very important. You need to have scenery and natural light.'
Tower blocks also enable the most common method of suicide in Hong Kong. Jumping from a tower block is much more likely to result in death than suicide attempts by other methods such as overdose of medication. This means that a suicide attempt in Hong Kong is particularly likely to result in death compared with attempts in some other countries.
Until recently, health was not an explicit priority for housing design. The 2003 SARS epidemic changed that: ‘SARS completely changed popular perception of the health impacts of housing. Since SARS people have recognised poor housing ventilation as one of the reasons for the spread of disease’ – Environmental scientist. This has spawned various regulations, but this awareness has not formally extended to mental health. Only one feng shui principle was cited that applied to buildings for mental health: 'Build in a square shape. If a building is too weird in shape, it makes people think weirdly.'
Housing block in Quarry Bay, Hong Kong
Green space and access to nature in Hong Kong
‘Hong Kong has a socioeconomic and terrain-based gradient in access to greenness. As you go up the hill, there is more greenness – and the property prices rise.’ – Urban health researcher
40% of Hong Kong's 1,000 square-kilometre landmass is green space, largely protected country parks that extend towards the urban edge. However, Hong Kong also has one of the world’s lowest concentrations of urban green space at <3 m2/person (compared to 10 m2/person in Mainland China, and a minimum of 25 m2/person in many European cities). (Audit Commission Hong Kong, 2013). Hong Kong’s standard for provision of open space is a minimum of 2m2 per person, split evenly between local and district open space (Planning Department, 2017). Public open space incorporates: formal parks and gardens (46%); open spaces in public housing estates (36%); private residential areas, and the grounds of government and non-government organizations (15%); and beaches (3%). (Jim and Chan 2016). This standard is lower than in other Asian cities; a recent report on open space in Hong Kong identified that Tokyo, Seoul, Shanghai and Singapore residents get 5.8 m2 to 7.6 m2. (Lai, 2017).
Much of Hong Kong's in-city green space is manicured, private and paved, with featured greenery selected for its neatness and ability to survive in shallow soil (such as planters and podiums) and its lack of leaf-shedding. There is a socioeconomic open space gap: richer residents have more than 8 m2 per person (eg at The Peak); poorer people have just 0.6 m2, (eg at Mong Kok) (Lai, 2017). A recent survey found that 56% of Hong Kong residents were dissatisfied or very dissatisfied with the provision of ‘good quality parks and green spaces’ in the city (Degolyer, 2016).
In many cities, ‘green space’ and ‘nature’ are synonymous. However, according to one planner: ‘green space in Chinese translates directly to the colour green. It doesn’t mean nature. People don’t care about the diversity within green space.’ This means that while greenness is prioritised, diversity of species is not. Indeed, Hong Kong tends to select a limited number of species for its green spaces, and have a preference for nature that looks so perfect as to be artificial. One urban planner believes that this is a result of the encroachment of the digital world: ‘In cyberspace a tree doesn’t die or age or grow older. It creates an expectation of nature – people expect perfection... These trees: they’re perfect. Single species. They don’t even have bark. They’re anime trees.’ More diverse species may not be appreciated by residents unused to urban nature. According to a landscape architect: ‘If people see insects in parks, they complain. A student saw a butterfly on a field trip and she screamed. People are nervous – they’re afraid of allergies, of bird flu…’ A landscape architecture researcher concludes: ‘Education is the first priority. I don’t think people here really understand nature. They need to see the beauty. Plants can show you the passage of time, landscapes can trigger the space for freedom in your mind. Children can be taught, then educate parents.’ There are several public parks, and greenery that surrounds housing estates, but these spaces often feature partitions such as fences separating people from nature: ‘In Hong Kong you can see natural elements but it doesn’t mean you can touch them. The public are educated not to touch – it’s very controlled. To improve the healing aspect of natural landscapes, you need to interact with them. If it could be freer, we would be happier’ – Landscape Architect.
However, there is general recognition (and some investment) in the wellbeing potential of nature. One feng shui master explained: 'About 80-90% of businesses would consider consulting a feng shui master when planning a new building, with the main purpose of increasing money. For residences, about half would consider it, but the purpose is both money and health... One thing we suggest is plants, making places more natural... another thing is views of mountains and water'
The benefits of access to nature were widely referenced. ‘Greenery is important as it offers the ability to escape from crowds’ – Urban designer. ‘Parks are important to provide sensory stimulation and seasonal change’ – Landscape Architect. The Architectural Services Department (2007) supports this assessment: ‘Contact with nature and appreciation of the outdoor scenery will provide natural cues to the passage of time. Having a sense of diurnal, seasonal and weather changes is integral to a quality life in terms of psychological well-being, especially in a high density built-up area.’ The guideline goes on to note: ‘Genius Locus (sense of a place) of our green spaces should be interpreted and enjoyed by the widest spectrum of users, by and beyond the Five Senses.’ The guideline explicitly notes that ‘there have been quite a few empirical studies from overseas countries with consistent findings showing a positive correlation between natural greenery and the emotional/ physiological recovery rate of patients. Outdoor landscaped spaces have marked contribution towards other restorative and therapeutic functions inside hospital grounds and other health care facilities… visual and/or physical access to quality outdoor landscaped spaces could bring emotional and/or physiological benefits to all types of users — patients, staff, families, friends and visitors.’
However, there is a lack of recognised city-wide guidance. The Hong Kong government aims to “bring about noticeable improvements in urban greenery, to enhance existing greened areas, and to enhance opportunities of quality greening during the planning and development of public works projects”. There has been a Greening, Landscape and Tree Management (GLTM) Section within the Works Branch of the Development Bureau in since 2010, but while they aim to drive strategic policy towards a greener Hong Kong, this focuses on government buildings; we found low awareness of this body and its Greening Master Plans. The Green Building Council also has guidelines, though these are voluntary. The Buildings, Land and Planning Departments issued a Joint Note that encourages greening though does not explicitly link this to health and wellbeing.
Several respondents wondered if Hong Kong’s extensive country parks actually deterred investment in urban nature: ‘Hong Kong is surrounded by greenery. This could be a reason that there’s less interest in city centre greenery. But it’s not easy for everyone to access country parks.’ – landscape architect. The Planning Department’s aspires to ensure good access to country parks (2017): ‘the general principle in a fringe area is to respect the natural environment, create an appropriate edge, and to provide visual and physical linkages between urban and rural areas.’ However, despite this aspiration, the key barriers to using these country parks are identified as accessibility and time: ‘Country parks are not that accessible. You have to take MTR, then a bus, maybe a taxi. For Hong Kong people, 1 hour of travelling time is too much.’ – geographer. ‘Country parks, when you go, are beautiful. We just don’t have the time. People work too late, study too hard… if they have any time they catch up on their sleep deprivation. We should do more promotion of country parks’ – suicide prevention specialist. ‘It’s a city of extremes – ten minutes from the urban core you can be in a jungle. But how it integrates with the city is quite poor. There is a huge density of towers on podiums – they create a wall effect, so there’s not really a direct link to the harbour or the mountains’ – urban designer.
40% of Hong Kong's 1,000 square-kilometre landmass is green space, largely protected country parks that extend towards the urban edge. However, Hong Kong also has one of the world’s lowest concentrations of urban green space at <3 m2/person (compared to 10 m2/person in Mainland China, and a minimum of 25 m2/person in many European cities). (Audit Commission Hong Kong, 2013). Hong Kong’s standard for provision of open space is a minimum of 2m2 per person, split evenly between local and district open space (Planning Department, 2017). Public open space incorporates: formal parks and gardens (46%); open spaces in public housing estates (36%); private residential areas, and the grounds of government and non-government organizations (15%); and beaches (3%). (Jim and Chan 2016). This standard is lower than in other Asian cities; a recent report on open space in Hong Kong identified that Tokyo, Seoul, Shanghai and Singapore residents get 5.8 m2 to 7.6 m2. (Lai, 2017).
Much of Hong Kong's in-city green space is manicured, private and paved, with featured greenery selected for its neatness and ability to survive in shallow soil (such as planters and podiums) and its lack of leaf-shedding. There is a socioeconomic open space gap: richer residents have more than 8 m2 per person (eg at The Peak); poorer people have just 0.6 m2, (eg at Mong Kok) (Lai, 2017). A recent survey found that 56% of Hong Kong residents were dissatisfied or very dissatisfied with the provision of ‘good quality parks and green spaces’ in the city (Degolyer, 2016).
In many cities, ‘green space’ and ‘nature’ are synonymous. However, according to one planner: ‘green space in Chinese translates directly to the colour green. It doesn’t mean nature. People don’t care about the diversity within green space.’ This means that while greenness is prioritised, diversity of species is not. Indeed, Hong Kong tends to select a limited number of species for its green spaces, and have a preference for nature that looks so perfect as to be artificial. One urban planner believes that this is a result of the encroachment of the digital world: ‘In cyberspace a tree doesn’t die or age or grow older. It creates an expectation of nature – people expect perfection... These trees: they’re perfect. Single species. They don’t even have bark. They’re anime trees.’ More diverse species may not be appreciated by residents unused to urban nature. According to a landscape architect: ‘If people see insects in parks, they complain. A student saw a butterfly on a field trip and she screamed. People are nervous – they’re afraid of allergies, of bird flu…’ A landscape architecture researcher concludes: ‘Education is the first priority. I don’t think people here really understand nature. They need to see the beauty. Plants can show you the passage of time, landscapes can trigger the space for freedom in your mind. Children can be taught, then educate parents.’ There are several public parks, and greenery that surrounds housing estates, but these spaces often feature partitions such as fences separating people from nature: ‘In Hong Kong you can see natural elements but it doesn’t mean you can touch them. The public are educated not to touch – it’s very controlled. To improve the healing aspect of natural landscapes, you need to interact with them. If it could be freer, we would be happier’ – Landscape Architect.
However, there is general recognition (and some investment) in the wellbeing potential of nature. One feng shui master explained: 'About 80-90% of businesses would consider consulting a feng shui master when planning a new building, with the main purpose of increasing money. For residences, about half would consider it, but the purpose is both money and health... One thing we suggest is plants, making places more natural... another thing is views of mountains and water'
The benefits of access to nature were widely referenced. ‘Greenery is important as it offers the ability to escape from crowds’ – Urban designer. ‘Parks are important to provide sensory stimulation and seasonal change’ – Landscape Architect. The Architectural Services Department (2007) supports this assessment: ‘Contact with nature and appreciation of the outdoor scenery will provide natural cues to the passage of time. Having a sense of diurnal, seasonal and weather changes is integral to a quality life in terms of psychological well-being, especially in a high density built-up area.’ The guideline goes on to note: ‘Genius Locus (sense of a place) of our green spaces should be interpreted and enjoyed by the widest spectrum of users, by and beyond the Five Senses.’ The guideline explicitly notes that ‘there have been quite a few empirical studies from overseas countries with consistent findings showing a positive correlation between natural greenery and the emotional/ physiological recovery rate of patients. Outdoor landscaped spaces have marked contribution towards other restorative and therapeutic functions inside hospital grounds and other health care facilities… visual and/or physical access to quality outdoor landscaped spaces could bring emotional and/or physiological benefits to all types of users — patients, staff, families, friends and visitors.’
However, there is a lack of recognised city-wide guidance. The Hong Kong government aims to “bring about noticeable improvements in urban greenery, to enhance existing greened areas, and to enhance opportunities of quality greening during the planning and development of public works projects”. There has been a Greening, Landscape and Tree Management (GLTM) Section within the Works Branch of the Development Bureau in since 2010, but while they aim to drive strategic policy towards a greener Hong Kong, this focuses on government buildings; we found low awareness of this body and its Greening Master Plans. The Green Building Council also has guidelines, though these are voluntary. The Buildings, Land and Planning Departments issued a Joint Note that encourages greening though does not explicitly link this to health and wellbeing.
Several respondents wondered if Hong Kong’s extensive country parks actually deterred investment in urban nature: ‘Hong Kong is surrounded by greenery. This could be a reason that there’s less interest in city centre greenery. But it’s not easy for everyone to access country parks.’ – landscape architect. The Planning Department’s aspires to ensure good access to country parks (2017): ‘the general principle in a fringe area is to respect the natural environment, create an appropriate edge, and to provide visual and physical linkages between urban and rural areas.’ However, despite this aspiration, the key barriers to using these country parks are identified as accessibility and time: ‘Country parks are not that accessible. You have to take MTR, then a bus, maybe a taxi. For Hong Kong people, 1 hour of travelling time is too much.’ – geographer. ‘Country parks, when you go, are beautiful. We just don’t have the time. People work too late, study too hard… if they have any time they catch up on their sleep deprivation. We should do more promotion of country parks’ – suicide prevention specialist. ‘It’s a city of extremes – ten minutes from the urban core you can be in a jungle. But how it integrates with the city is quite poor. There is a huge density of towers on podiums – they create a wall effect, so there’s not really a direct link to the harbour or the mountains’ – urban designer.
Victoria Peak Country Park, Hong Kong
City parks
‘Park distribution is uneven – towards the north of Kowloon there are more’ – Landscape Architecture researcher
The first public park in Hong Kong was opened in 1903. Today, according to a geographer: ‘the government aims to have a ‘open space within reach’ every 100m. I find it’s more like every 300m.’ This experience may be because these areas are not characterised by nature. As one urban health researcher noted: ‘we have parks but the funny thing is most of them are paved.’ It may also be because of their small size: ‘In Hong Kong we have ‘pocket parks’ – one tree is officially a pocket park.’ – Geographer. Yet ‘People like pocket parks because with all this compact development, it’s the next best thing to a big park. Underneath even one tree it’s so much cooler.’ The Development Bureau guidelines for privately-owned public spaces specifies that a ‘public green’ should have at least 50% greenery; the proportion is 30% for ‘pocket spaces’.
There are two main challenges cited with Hong Kong parks. The first challenge is the quality and usability of the space: ‘Public green space in Hong Kong is managed by the Leisure and Cultural Services Department (LCSD) – they are forced by budgets to have minimal, easy to maintain landscapes. That means concrete, no shelter… really quite bleak places’ – urban designer. 'Everything's designed to be cleaned with bleach' - architect. ‘In parks, LCSD manages trees and hygiene, and that’s about it. So they don’t want any fun or interesting things happening to add to their workload. They don’t want a kid to fall off something and sue the government’ – Urban planner.
The second challenge is the abundance of rules that governs their use: ‘The Government usually wants to manage public space, whether or not it’s developed by private companies. Anyone can use it but it’s highly regulated – there are lots of rules against things like eating, using a scooter, playing with a ball, pets, etc. And it’ll be low-maintenance’ – urban designer. ‘We have a very ‘managerial’ approach. We inherited the same old system [from British colonial rule] and there are thirteen ‘not allowed’ signs in every park’ – Urban planner. The Development Bureau issues guidelines for privately-owned public space that specifies how privately-owned public spaces should be set: ‘In general, the uses of [these spaces] should not cause obstructions… nuisance and disturbance to security and privacy of [affect] other members of the public in their enjoyment of the [space]’ (Development Bureau, 2011). In addition to restricting use, these rules can result in a homogenised park experience: ‘Public spaces just look similar to each other so you don’t have a sense of place. The configuration, the organisation, the paving materials… so similar. The guidelines are too specific. It’s difficult to compare what works’ – Landscape Architect.
Additionally, several respondents voiced frustration about privately-owned green spaces on public land that are not available for public use, such as private clubs and school playgrounds. ‘Green space in the city is a very scarce commodity – private clubs on government land charge a huge amount of money to members but it deprives the public of this space’ – suicide prevention specialist. Researchers have suggested that government, office and school buildings that would be otherwise empty on evenings and weekends could be opened for public use (Jim and Chan, 2016). ‘When students are not using school playgrounds the public could use them but there are problems about the schools’ liability, so usually they close doors outside school hours. The universities are more generous.’ – urban planner.
These challenges have led to a situation where people seek informal spaces. ‘The places that are open – there’s nothing going on. People use unplanned spaces… the planned spaces are soulless’ – policy specialist. ‘Instagram pier – it belongs to the maritime authority – it’s not a formal public space. But you go there and there’s tai chi, there’s K-pop groups, dog walkers… it’s really being used by the local community.’ Members of the public also use landscaped university spaces for activities like group exercises.
‘Park distribution is uneven – towards the north of Kowloon there are more’ – Landscape Architecture researcher
The first public park in Hong Kong was opened in 1903. Today, according to a geographer: ‘the government aims to have a ‘open space within reach’ every 100m. I find it’s more like every 300m.’ This experience may be because these areas are not characterised by nature. As one urban health researcher noted: ‘we have parks but the funny thing is most of them are paved.’ It may also be because of their small size: ‘In Hong Kong we have ‘pocket parks’ – one tree is officially a pocket park.’ – Geographer. Yet ‘People like pocket parks because with all this compact development, it’s the next best thing to a big park. Underneath even one tree it’s so much cooler.’ The Development Bureau guidelines for privately-owned public spaces specifies that a ‘public green’ should have at least 50% greenery; the proportion is 30% for ‘pocket spaces’.
There are two main challenges cited with Hong Kong parks. The first challenge is the quality and usability of the space: ‘Public green space in Hong Kong is managed by the Leisure and Cultural Services Department (LCSD) – they are forced by budgets to have minimal, easy to maintain landscapes. That means concrete, no shelter… really quite bleak places’ – urban designer. 'Everything's designed to be cleaned with bleach' - architect. ‘In parks, LCSD manages trees and hygiene, and that’s about it. So they don’t want any fun or interesting things happening to add to their workload. They don’t want a kid to fall off something and sue the government’ – Urban planner.
The second challenge is the abundance of rules that governs their use: ‘The Government usually wants to manage public space, whether or not it’s developed by private companies. Anyone can use it but it’s highly regulated – there are lots of rules against things like eating, using a scooter, playing with a ball, pets, etc. And it’ll be low-maintenance’ – urban designer. ‘We have a very ‘managerial’ approach. We inherited the same old system [from British colonial rule] and there are thirteen ‘not allowed’ signs in every park’ – Urban planner. The Development Bureau issues guidelines for privately-owned public space that specifies how privately-owned public spaces should be set: ‘In general, the uses of [these spaces] should not cause obstructions… nuisance and disturbance to security and privacy of [affect] other members of the public in their enjoyment of the [space]’ (Development Bureau, 2011). In addition to restricting use, these rules can result in a homogenised park experience: ‘Public spaces just look similar to each other so you don’t have a sense of place. The configuration, the organisation, the paving materials… so similar. The guidelines are too specific. It’s difficult to compare what works’ – Landscape Architect.
Additionally, several respondents voiced frustration about privately-owned green spaces on public land that are not available for public use, such as private clubs and school playgrounds. ‘Green space in the city is a very scarce commodity – private clubs on government land charge a huge amount of money to members but it deprives the public of this space’ – suicide prevention specialist. Researchers have suggested that government, office and school buildings that would be otherwise empty on evenings and weekends could be opened for public use (Jim and Chan, 2016). ‘When students are not using school playgrounds the public could use them but there are problems about the schools’ liability, so usually they close doors outside school hours. The universities are more generous.’ – urban planner.
These challenges have led to a situation where people seek informal spaces. ‘The places that are open – there’s nothing going on. People use unplanned spaces… the planned spaces are soulless’ – policy specialist. ‘Instagram pier – it belongs to the maritime authority – it’s not a formal public space. But you go there and there’s tai chi, there’s K-pop groups, dog walkers… it’s really being used by the local community.’ Members of the public also use landscaped university spaces for activities like group exercises.
Street nature
‘There are certain regulations around big trees, for example to plant less leafy trees so that the government doesn’t have to sweep up leaves.’ – Geographer
In many places there is a paucity of street trees: pavements are insufficiently wide to accommodate street trees, and underground utilities run under the pavements. Further, trees can create hazards if they fall during typhoons, and residents seek their removal for safety reasons, and indeed for aesthetic reasons. For example, ‘In Kennedy Town, residents complained about three big trees blocking views so the government chopped them down. Then the residents complained again: they hadn’t understood the trees provided shade and without the trees it was so hot, the shops were no longer sheltered. People here can’t see it’s worth keeping a tree. Education is needed about why trees are good’ – Geographer.
Investment is evident in plants and flowers on urban walkways. However, the investment is generally considered to be driven more by aesthetics than by nature. One landscape architect lamented: ‘It’s not sustainable. [The Government] don’t see them as plants; they see them more as decoration. They can’t live and grow there. They’re changed easily and sent to landfill.’ – Landscape Architecture researcher
‘There are certain regulations around big trees, for example to plant less leafy trees so that the government doesn’t have to sweep up leaves.’ – Geographer
In many places there is a paucity of street trees: pavements are insufficiently wide to accommodate street trees, and underground utilities run under the pavements. Further, trees can create hazards if they fall during typhoons, and residents seek their removal for safety reasons, and indeed for aesthetic reasons. For example, ‘In Kennedy Town, residents complained about three big trees blocking views so the government chopped them down. Then the residents complained again: they hadn’t understood the trees provided shade and without the trees it was so hot, the shops were no longer sheltered. People here can’t see it’s worth keeping a tree. Education is needed about why trees are good’ – Geographer.
Investment is evident in plants and flowers on urban walkways. However, the investment is generally considered to be driven more by aesthetics than by nature. One landscape architect lamented: ‘It’s not sustainable. [The Government] don’t see them as plants; they see them more as decoration. They can’t live and grow there. They’re changed easily and sent to landfill.’ – Landscape Architecture researcher
Pedestrian walkway networks in central Hong Kong
Incentives for green features
‘There are measures being taken – new developments have to be designed with more greenery but it’s not for health or wellbeing – a lot of greening is done for ecological reasons, to reduce the heat island effect. Or it’s because we want to be a ‘world class city’ – we know that this involves urban greenery, but it’s more checking boxes than thinking about why it’s necessary.’ – Journalist
Incentives to provide open green space in Hong Kong tend to be financially driven. ‘You build an open space if it brings extra value for nearby commercial premises, or if the government can make money on the land lease. Commercial interests are prioritised and the open space in which people spend most of their time is shopping malls’ – Urban planner. However, ‘there is Bonus GFA [gross floor area] – if you provide greenery, publicly available green space, you are allowed to build taller. An example is One Island East in Quarry Bay’ – Urban designer. Features that earn the incentives include communal sky gardens and communal podium gardens (Building Department Joint Note 1 and 2). However, this does not always work as planned. ‘In individual developments, if a developer puts in a garden they get extra GFA (gross floor area) – it’s in the building code. But sometimes it’s on the roof so not publicly accessible, or it’s a green wall that dies after a few years because it’s not maintained properly’ – Journalist. However, the risk of regular typhoons reduces the potential for creativity in features such as rooftop greenery, and people also complain of the space being overly restrictive, for instance no access to the grass, no places to eat or exercise, or simply being allowed to interpret a ‘garden’ as a few plants in pots.
Public access to parks suffers not just from physical barriers but time barriers. ‘If you have a full time job it doesn’t matter if you have access to green space. You work long hours, you work at the weekends… green space access is for students, homemakers and retired people.’ psychiatric epidemiologist. ‘Most research focuses on neighbourhoods around people’s dwellings but people spend most of their time in vertical offices – how the buildings are connected and exposure to salutogenic factors is also important.’ – Urban health researcher
‘There are measures being taken – new developments have to be designed with more greenery but it’s not for health or wellbeing – a lot of greening is done for ecological reasons, to reduce the heat island effect. Or it’s because we want to be a ‘world class city’ – we know that this involves urban greenery, but it’s more checking boxes than thinking about why it’s necessary.’ – Journalist
Incentives to provide open green space in Hong Kong tend to be financially driven. ‘You build an open space if it brings extra value for nearby commercial premises, or if the government can make money on the land lease. Commercial interests are prioritised and the open space in which people spend most of their time is shopping malls’ – Urban planner. However, ‘there is Bonus GFA [gross floor area] – if you provide greenery, publicly available green space, you are allowed to build taller. An example is One Island East in Quarry Bay’ – Urban designer. Features that earn the incentives include communal sky gardens and communal podium gardens (Building Department Joint Note 1 and 2). However, this does not always work as planned. ‘In individual developments, if a developer puts in a garden they get extra GFA (gross floor area) – it’s in the building code. But sometimes it’s on the roof so not publicly accessible, or it’s a green wall that dies after a few years because it’s not maintained properly’ – Journalist. However, the risk of regular typhoons reduces the potential for creativity in features such as rooftop greenery, and people also complain of the space being overly restrictive, for instance no access to the grass, no places to eat or exercise, or simply being allowed to interpret a ‘garden’ as a few plants in pots.
Public access to parks suffers not just from physical barriers but time barriers. ‘If you have a full time job it doesn’t matter if you have access to green space. You work long hours, you work at the weekends… green space access is for students, homemakers and retired people.’ psychiatric epidemiologist. ‘Most research focuses on neighbourhoods around people’s dwellings but people spend most of their time in vertical offices – how the buildings are connected and exposure to salutogenic factors is also important.’ – Urban health researcher
Physical activity in Hong Kong
Regular daily physical activity supports good mental health, but ‘deliberate promotion of outdoor physical activity is not explicit’ in Hong Kong – urban planner. And yet, a combination of public transport predominance and small homes nudge the Hong Kong population into achieving regular physical activity as they move around the city. ‘It’s hard to be a couch potato when your couch is only so big… and you live in 50 square metres with three generations of family.’ – Journalist. Furthermore, outdoor physical activity is facilitated because ‘Hong Kong is one of the safest cities in the world – you can actually walk at night anywhere without fear of being mugged’ – psychiatric epidemiologist.
However, Hong Kong also has particular barriers to casual physical activity. Part of the city are very hilly, which deters walking and cycling. And the climate and air quality can also be challenging: ‘It’s Catch 22 - outdoor activity is not popular in summer due to the heat… and discouraged in winter due to bad air quality.’ – Geographer. ‘Buildings trap the air – it’s hot, humid, dirty, noisy’ – suicide prevention specialist. But according to a psychiatric epidemiologist, the city’s customary long working hours means ‘the chief reason is we don’t have time to actually enjoy these facilities.’ As such, active transport can be an effective way of achieving regular physical activity.
Public transport
Around 8% of residents in Hong Kong own cars – car ownership is expensive, particularly parking. Car-focused infrastructure dominates the cityscape, creating air pollution, noise, and dangerous streets, and splitting places. However, Hong Kong is a public transport city. Over 41% of the city population lives within half a mile of a MTR rail station and the company’s real estate strategy encourages walkability combined with public transit systems; the MTR is even run by real estate companies. This is successful: just 11% of vehicle journeys are made by car (although large roads predominate in the cityscape – 0.286km of road per 1000 population); 89% of journeys are made by public transport, the majority of which by MRT rail and franchised buses. (Legislative Council Secretariat, 2017, Urban Mobility Index 2017). ‘The MTR is efficient, well run and profitable… and its design makes people walk a lot to access it.’ – Urban planner. However, ‘MTR boast that you can go to work and home again without having to walk more than 200m or having to see the sun or the rain. This is held as an example of good planning’ – Urban planner. However, it can also be disorienting.
Walking
One journalist noted about Hong Kong: ‘It’s not a city that lends itself to walking for pleasure… walkability is not built into the identity here.’ Walking deterrents cited include narrow (and often blocked) or discontinuous pavements, heavy traffic (and prioritisation of cars over pedestrians), lack of shade, heat island effect (particularly where there are restaurants and air conditioners), and most importantly, air pollution: ‘The streets are hot and polluted, so it’s hard even to go for a walk comfortably’ – urban designer. ‘It's designed for cars – the cars have more priority than the people’ – policy specialist.
Conversely, Hong Kong has some key features that make the city more walkable than many residents realise: ‘In Hong Kong you can walk a lot… inadvertently’ – Journalist. This can include walkways, footbridges, and escalators: ‘If you live near Central you have good walkability: on elevated walkways, routes through buildings’ – urban health researcher. 'The [elevated] walkways are nice because you don’t have to walk next to cars – but they are above roads so you do get the traffic fumes.’ – Geographer. However, the elevation does reduce the concentration of fumes compared to sidewalks. And they are required to be wide enough to enable a wheelchair to turn. (Architectural Services Dept, 2004). Walkways often move pedestrians through different buildings and spaces. As the Government’s Architectural Services Department notes, ‘A sense of disorientation may sometimes occur when one passes from one space to the next.’ This guideline recommends the use of greenery and water features to help orient people. Further adaptive pedestrian infrastructure is the pedestrian escalators that help facilitate journeys by foot around Hong Kong’s steep hilly terrain. ‘After escalators were established, travel patterns changed and street vitality increased’ – urban planner. Areas around the escalators have become pedestrianized and developed into new public spaces surrounded by businesses benefiting from the flow of pedestrians.
Since the city’s residents depend on public transport, an infrastructure has emerged to support first mile-last mile journeys. ‘Nobody wants to walk… but they have to walk. The way the MTR is set up means they have to walk to get anywhere.’ – Geographer. Respondents reported routinely walking an hour a day or more as part of their commute to and from work by rail, train and boat. ‘Hong Kong’s public transport motivates people to walk. It can be a 5 to 10 minute walk from a train to an exit. People may not consider it exercise but stations can involve high intensity walking over substantial distances, for example changing lines from Hong Kong Station to Central Station.’ – Geographer.
However, Hong Kong also has particular barriers to casual physical activity. Part of the city are very hilly, which deters walking and cycling. And the climate and air quality can also be challenging: ‘It’s Catch 22 - outdoor activity is not popular in summer due to the heat… and discouraged in winter due to bad air quality.’ – Geographer. ‘Buildings trap the air – it’s hot, humid, dirty, noisy’ – suicide prevention specialist. But according to a psychiatric epidemiologist, the city’s customary long working hours means ‘the chief reason is we don’t have time to actually enjoy these facilities.’ As such, active transport can be an effective way of achieving regular physical activity.
Public transport
Around 8% of residents in Hong Kong own cars – car ownership is expensive, particularly parking. Car-focused infrastructure dominates the cityscape, creating air pollution, noise, and dangerous streets, and splitting places. However, Hong Kong is a public transport city. Over 41% of the city population lives within half a mile of a MTR rail station and the company’s real estate strategy encourages walkability combined with public transit systems; the MTR is even run by real estate companies. This is successful: just 11% of vehicle journeys are made by car (although large roads predominate in the cityscape – 0.286km of road per 1000 population); 89% of journeys are made by public transport, the majority of which by MRT rail and franchised buses. (Legislative Council Secretariat, 2017, Urban Mobility Index 2017). ‘The MTR is efficient, well run and profitable… and its design makes people walk a lot to access it.’ – Urban planner. However, ‘MTR boast that you can go to work and home again without having to walk more than 200m or having to see the sun or the rain. This is held as an example of good planning’ – Urban planner. However, it can also be disorienting.
Walking
One journalist noted about Hong Kong: ‘It’s not a city that lends itself to walking for pleasure… walkability is not built into the identity here.’ Walking deterrents cited include narrow (and often blocked) or discontinuous pavements, heavy traffic (and prioritisation of cars over pedestrians), lack of shade, heat island effect (particularly where there are restaurants and air conditioners), and most importantly, air pollution: ‘The streets are hot and polluted, so it’s hard even to go for a walk comfortably’ – urban designer. ‘It's designed for cars – the cars have more priority than the people’ – policy specialist.
Conversely, Hong Kong has some key features that make the city more walkable than many residents realise: ‘In Hong Kong you can walk a lot… inadvertently’ – Journalist. This can include walkways, footbridges, and escalators: ‘If you live near Central you have good walkability: on elevated walkways, routes through buildings’ – urban health researcher. 'The [elevated] walkways are nice because you don’t have to walk next to cars – but they are above roads so you do get the traffic fumes.’ – Geographer. However, the elevation does reduce the concentration of fumes compared to sidewalks. And they are required to be wide enough to enable a wheelchair to turn. (Architectural Services Dept, 2004). Walkways often move pedestrians through different buildings and spaces. As the Government’s Architectural Services Department notes, ‘A sense of disorientation may sometimes occur when one passes from one space to the next.’ This guideline recommends the use of greenery and water features to help orient people. Further adaptive pedestrian infrastructure is the pedestrian escalators that help facilitate journeys by foot around Hong Kong’s steep hilly terrain. ‘After escalators were established, travel patterns changed and street vitality increased’ – urban planner. Areas around the escalators have become pedestrianized and developed into new public spaces surrounded by businesses benefiting from the flow of pedestrians.
Since the city’s residents depend on public transport, an infrastructure has emerged to support first mile-last mile journeys. ‘Nobody wants to walk… but they have to walk. The way the MTR is set up means they have to walk to get anywhere.’ – Geographer. Respondents reported routinely walking an hour a day or more as part of their commute to and from work by rail, train and boat. ‘Hong Kong’s public transport motivates people to walk. It can be a 5 to 10 minute walk from a train to an exit. People may not consider it exercise but stations can involve high intensity walking over substantial distances, for example changing lines from Hong Kong Station to Central Station.’ – Geographer.
A busy MTR walkway connecting the trains to Hong Kong University
Small blocks filled with fine-grained shopfronts may further encourage walking. ‘Hong Kong has a lot of points of intersection. The higher the number, the more motivated people are to walk. Having a choice of route is important.’ – Geographer. This is particularly helpful for older people, who typically prefer to walk in order to save money. ‘Elderly people can walk around – everything they need is nearby’ – Urban designer. This benefit may be foiled by a more current trend to limit route choice: ‘We are designing exact routing –dictating 90% of pedestrian routes along defined corridors.’ – Urban planner.
Attempts are also being made to widen pavements and increase walkability. ‘Urban renewal projects require a certain amount of wide walkways – sometimes this means they tear down two rows of buildings but can only replace it with one’ – Geographer. As for the country parks, these are increasingly used for walking, though not routinely, as a trip involves preparation. ‘Hiking has become a lot more popular, but it’s not a casual thing to do.’ – Urban designer.
Biking
‘Officially the government policy only sees cycling as recreation; not as a form of transportation.’ – Journalist
‘In view of the safety consideration, the Government does not encourage the public to use the bicycle as a transport mode in urban areas. Compared with urban areas, new towns in the New Territories or new development areas, where density is relatively low, have better conditions for using bicycle for short-distance travel.’ (Government of Hong Kong, 2011)
There is minimal cycling in Hong Kong mainly due to safety concerns, air quality and, in many places, very steep terrain. The roads in the centre of the city are jammed with traffic and are considered too narrow to support protected lanes, rendering cycling a risky undertaking. This means that offices tend not to offer bike facilities like parking and showers. However, new harbourfront projects are starting to include bike routes, and new developments in the New Territories are increasingly incorporating protected bike lanes, though these tend not to extend between developments. ‘There has been a recent change in attitude to cycling, from it being a danger, to how we can facilitate it’ – Urban designer
Other physical activity
According to one urban designer, ‘If you want to exercise you have to be willing to climb mountains or afford a gym’. There is an abundance of sports facilities, such as soccer fields, basketball courts, tennis courts and swimming pools, though many of these are private and there is less flexibility for informal activities. Many people avoid swimming in the sea due to concerns about water quality. And there is a consensus that physical activity is curtailed in public spaces due to an excess of rules around the use of these spaces. ‘Parks are managed by LCSD so there are a lot of restrictions about what you’re allowed to do. Actually there’s even an old ‘pleasure ordinance’. People laugh at the signs restricting everything from ball games to playing music.’ – Journalist. One area, Discovery Bay, does not allow cars: ‘Most of Discovery Bay is private and many westerners live there. The western culture there has pushed the company to let people do activities on the beach.’ – Geographer.
The Hong Kong Housing Society’s Universal Design Guidebook (2005) includes specific recommendations to increase physical activity within residential areas. This includes ensuring residential stairways are kept clean and have natural light and ventilation; foot massage pathways, ‘self-planting corners’ and exercise stations in common outdoor and indoor areas to encourage exercise.
Exercise for young people
There is a wide range of sporting facilities in Hong Kong but children have less access to spaces designed to facilitate informal physical activity: ‘Hong Kong just doesn’t have enough playspace – so children are deprived of play. They play with their phones all day. They don’t go out’ – Geographer. Rooftop playspace is one opportunity currently being explored, though both safety and accessibility are concerns. Some people also expressed concerns about the type of physical activity offered to young people: ‘Playgrounds have slides, swings, protective flooring – but that’s all. LCSD is scared of putting tools that challenge children, that allow risk taking and the experience of failure. I think this affects the youth suicide rates. They cannot face failure.’ – Geographer. Older youth have access to sports facilities. ‘Basketball courts are very highly utilised wherever you go’ – psychiatric epidemiologist. The use of playspace is also limited by the weather.
Exercise for older people
In Hong Kong, group exercise is embedded in older people’s culture, and delivers mental health benefits through not just physical activity, but through access to nature and social interaction. ‘Older people do a lot of group activities – swimming, dancing, tai chi, tea groups.’ – Urban planner.
Planning Department guidelines (2017) state ‘indoor facilities such as badminton courts, table tennis rooms, multi-purpose activity rooms, and fitness rooms should be designed to cater for users of all ages including the elderly. Appropriate outdoor facilities such as fitness stations with equipment suitable for use by elderly, Tai Chi areas with rain shelter and seating, etc. should be incorporated in gardens and parks where they make frequent visits’. This includes ‘signage, handles, handrails, knobs, and grab bars… [and] firm and slip-resistant materials.’
There are two main ways in which older people use the built environment for physical activity, which they tend to do in the early morning or late evening due to the high temperatures during the day. First, they use formal exercise spaces. In addition to swimming pools, and the use of sitting out spaces to rest during walks in the country parks and trails of the city, ‘The Department of Health collaborates with Leisure and Cultural Services Department to install exercise parks with exercise equipment for older people. The official term is elderly fitness corner. We found the people use these for an average of 72 minutes per visit’ – Sports health scientist. Secondly, they congregate in public spaces such as parks and university plazas to participate in informal group exercises in the early morning and late evening. ‘If you go to a housing estate, you’ll see stretching exercises as a group activity every morning.’ – psychiatric epidemiologist. According to a sports health scientist, this is ‘usually tai chi or chi qigong. There is not much movement, but inside the breathing is dynamic. We call it mind-body exercise…. Even when people have private exercise places in their buildings, we found they want to exercise outdoors because of fresh air and greenery’ – Sports health scientist. Another form of group exercise is dancing in the evenings, commonly enjoyed by male and female migrants from China’s mainland who have a culture of occupying parks and pedestrian streets for dances. ‘All of them do the same dance. In Hong Kong we don’t have the culture of dancing in public. People complain that the music is too loud. Hong Kong is just too busy – we don’t allow noisy activities.’ – Urban planner
Attempts are also being made to widen pavements and increase walkability. ‘Urban renewal projects require a certain amount of wide walkways – sometimes this means they tear down two rows of buildings but can only replace it with one’ – Geographer. As for the country parks, these are increasingly used for walking, though not routinely, as a trip involves preparation. ‘Hiking has become a lot more popular, but it’s not a casual thing to do.’ – Urban designer.
Biking
‘Officially the government policy only sees cycling as recreation; not as a form of transportation.’ – Journalist
‘In view of the safety consideration, the Government does not encourage the public to use the bicycle as a transport mode in urban areas. Compared with urban areas, new towns in the New Territories or new development areas, where density is relatively low, have better conditions for using bicycle for short-distance travel.’ (Government of Hong Kong, 2011)
There is minimal cycling in Hong Kong mainly due to safety concerns, air quality and, in many places, very steep terrain. The roads in the centre of the city are jammed with traffic and are considered too narrow to support protected lanes, rendering cycling a risky undertaking. This means that offices tend not to offer bike facilities like parking and showers. However, new harbourfront projects are starting to include bike routes, and new developments in the New Territories are increasingly incorporating protected bike lanes, though these tend not to extend between developments. ‘There has been a recent change in attitude to cycling, from it being a danger, to how we can facilitate it’ – Urban designer
Other physical activity
According to one urban designer, ‘If you want to exercise you have to be willing to climb mountains or afford a gym’. There is an abundance of sports facilities, such as soccer fields, basketball courts, tennis courts and swimming pools, though many of these are private and there is less flexibility for informal activities. Many people avoid swimming in the sea due to concerns about water quality. And there is a consensus that physical activity is curtailed in public spaces due to an excess of rules around the use of these spaces. ‘Parks are managed by LCSD so there are a lot of restrictions about what you’re allowed to do. Actually there’s even an old ‘pleasure ordinance’. People laugh at the signs restricting everything from ball games to playing music.’ – Journalist. One area, Discovery Bay, does not allow cars: ‘Most of Discovery Bay is private and many westerners live there. The western culture there has pushed the company to let people do activities on the beach.’ – Geographer.
The Hong Kong Housing Society’s Universal Design Guidebook (2005) includes specific recommendations to increase physical activity within residential areas. This includes ensuring residential stairways are kept clean and have natural light and ventilation; foot massage pathways, ‘self-planting corners’ and exercise stations in common outdoor and indoor areas to encourage exercise.
Exercise for young people
There is a wide range of sporting facilities in Hong Kong but children have less access to spaces designed to facilitate informal physical activity: ‘Hong Kong just doesn’t have enough playspace – so children are deprived of play. They play with their phones all day. They don’t go out’ – Geographer. Rooftop playspace is one opportunity currently being explored, though both safety and accessibility are concerns. Some people also expressed concerns about the type of physical activity offered to young people: ‘Playgrounds have slides, swings, protective flooring – but that’s all. LCSD is scared of putting tools that challenge children, that allow risk taking and the experience of failure. I think this affects the youth suicide rates. They cannot face failure.’ – Geographer. Older youth have access to sports facilities. ‘Basketball courts are very highly utilised wherever you go’ – psychiatric epidemiologist. The use of playspace is also limited by the weather.
Exercise for older people
In Hong Kong, group exercise is embedded in older people’s culture, and delivers mental health benefits through not just physical activity, but through access to nature and social interaction. ‘Older people do a lot of group activities – swimming, dancing, tai chi, tea groups.’ – Urban planner.
Planning Department guidelines (2017) state ‘indoor facilities such as badminton courts, table tennis rooms, multi-purpose activity rooms, and fitness rooms should be designed to cater for users of all ages including the elderly. Appropriate outdoor facilities such as fitness stations with equipment suitable for use by elderly, Tai Chi areas with rain shelter and seating, etc. should be incorporated in gardens and parks where they make frequent visits’. This includes ‘signage, handles, handrails, knobs, and grab bars… [and] firm and slip-resistant materials.’
There are two main ways in which older people use the built environment for physical activity, which they tend to do in the early morning or late evening due to the high temperatures during the day. First, they use formal exercise spaces. In addition to swimming pools, and the use of sitting out spaces to rest during walks in the country parks and trails of the city, ‘The Department of Health collaborates with Leisure and Cultural Services Department to install exercise parks with exercise equipment for older people. The official term is elderly fitness corner. We found the people use these for an average of 72 minutes per visit’ – Sports health scientist. Secondly, they congregate in public spaces such as parks and university plazas to participate in informal group exercises in the early morning and late evening. ‘If you go to a housing estate, you’ll see stretching exercises as a group activity every morning.’ – psychiatric epidemiologist. According to a sports health scientist, this is ‘usually tai chi or chi qigong. There is not much movement, but inside the breathing is dynamic. We call it mind-body exercise…. Even when people have private exercise places in their buildings, we found they want to exercise outdoors because of fresh air and greenery’ – Sports health scientist. Another form of group exercise is dancing in the evenings, commonly enjoyed by male and female migrants from China’s mainland who have a culture of occupying parks and pedestrian streets for dances. ‘All of them do the same dance. In Hong Kong we don’t have the culture of dancing in public. People complain that the music is too loud. Hong Kong is just too busy – we don’t allow noisy activities.’ – Urban planner
Older people meet every morning for group exercise at this Hong Kong University plaza
Social Activity
‘The built environment influences the social environment, which becomes the mediator of mental health – family support, neighbourhood cohesion, social capital… we need more accessible communal areas’ – psychiatric epidemiologist.
Hong Kong’s urban space has elements that constrain and promote social interaction opportunities. The city's climate limits the popularity of outdoor space for socialising: ‘There’s a relationship between perceived thermal comfort and public space use… People tend to stay away from sun exposure, which limits the use of public spaces, especially in summer’ – Environmental scientist. Another limitation is the small size of people’s living spaces which limits socialising in each others’ homes. ‘Everyone lives in this tiny flat… when you live in such a small space there’s more chance of conflicts’ – suicide prevention specialist. But conversely, as a psychiatric epidemiologist notes, there is also more opportunity for interpersonal support.
However, in a city of tower blocks, socialising with neighbours also tends to be limited: ‘Tower blocks are not designed to facilitate staying and talking to each other: the corridors are designed to get people from A to B as quickly as possible’ – Planner. The suicide prevention specialist notes: ‘we are very isolated. Everyone shuts their door, closes themselves away into their own small area – there is not much community space in tower blocks.’ The Hong Kong Housing Society’s universal design guidelines (2005) encourage a focus on social interaction in residence design, and ‘you’ll see older adults hanging out in these communal areas in housing estates’. ‘Housing estates have communal parks… and a lot of them have clubhouses, or rooms to read papers, study, play mah jong…’ psychiatric epidemiologist. Outdoors, the guidelines recommend provision of seating and social areas, plus ‘features [that] are able to act as a social focus, such as chess tables, and can be provided in open area’. Indoors, explicitly to encourage family activity and interaction with neighbours, they recommend quality indoor communal space within residential blocks, with comfortable seating and social corners and other facilities to encourage social activities. The guidelines also recognise the value of pets for psychological health.
While people tend to meet outside of their homes, Hong Kong’s built environment provides limited settings for doing so. According to one urban designer, ‘There is a lack of easily accessible places to relax. There’s a lot of privatisation of space.’ An urban planner confirms: ‘Hong Kong people don’t know how to use outdoor public space… There is less design facilitating street life – all the strategies move people into shopping malls.’ This is confirmed by another urban planner: ‘Spaces in Hong Kong are not designed for conversation: stations are designed to evacuate people quickly, without a stampede, and to entice the population into shopping destinations – they are not designed for people to slow down or to talk to neighbours. This makes it hard to build social networks.’ – Planner
Hong Kong’s urban space has elements that constrain and promote social interaction opportunities. The city's climate limits the popularity of outdoor space for socialising: ‘There’s a relationship between perceived thermal comfort and public space use… People tend to stay away from sun exposure, which limits the use of public spaces, especially in summer’ – Environmental scientist. Another limitation is the small size of people’s living spaces which limits socialising in each others’ homes. ‘Everyone lives in this tiny flat… when you live in such a small space there’s more chance of conflicts’ – suicide prevention specialist. But conversely, as a psychiatric epidemiologist notes, there is also more opportunity for interpersonal support.
However, in a city of tower blocks, socialising with neighbours also tends to be limited: ‘Tower blocks are not designed to facilitate staying and talking to each other: the corridors are designed to get people from A to B as quickly as possible’ – Planner. The suicide prevention specialist notes: ‘we are very isolated. Everyone shuts their door, closes themselves away into their own small area – there is not much community space in tower blocks.’ The Hong Kong Housing Society’s universal design guidelines (2005) encourage a focus on social interaction in residence design, and ‘you’ll see older adults hanging out in these communal areas in housing estates’. ‘Housing estates have communal parks… and a lot of them have clubhouses, or rooms to read papers, study, play mah jong…’ psychiatric epidemiologist. Outdoors, the guidelines recommend provision of seating and social areas, plus ‘features [that] are able to act as a social focus, such as chess tables, and can be provided in open area’. Indoors, explicitly to encourage family activity and interaction with neighbours, they recommend quality indoor communal space within residential blocks, with comfortable seating and social corners and other facilities to encourage social activities. The guidelines also recognise the value of pets for psychological health.
While people tend to meet outside of their homes, Hong Kong’s built environment provides limited settings for doing so. According to one urban designer, ‘There is a lack of easily accessible places to relax. There’s a lot of privatisation of space.’ An urban planner confirms: ‘Hong Kong people don’t know how to use outdoor public space… There is less design facilitating street life – all the strategies move people into shopping malls.’ This is confirmed by another urban planner: ‘Spaces in Hong Kong are not designed for conversation: stations are designed to evacuate people quickly, without a stampede, and to entice the population into shopping destinations – they are not designed for people to slow down or to talk to neighbours. This makes it hard to build social networks.’ – Planner
Indoor pro-social environments
The shopping mall is the most commonly cited accessible and popular public space for social interaction in Hong Kong. This risks marginalising people who cannot afford to shop, or do not wish to. But the drive to find air-conditioned public space fosters other creative solutions. There is a culture of providing access to a wide range of publicly accessible private space. ‘Office lobbies are popular. Older people come in for the day, bring their oxygen tanks… their newspapers… and it’s nice because the companies let them stay. Poorer people might hang out in in McDonalds, which is infamous in Hong Kong for having people staying there all day, or even living there. It’s nice that they are allowed to stay’ – urban designer.
Another indoor option frequently used, particularly by groups of younger people, is the temporary rental of spaces for social interaction. ‘Some groups of people rent out old industrial units. It’s like renting a living room – friends split the rent and use the space for bands, or just to sit around on sofas.’ – architect. ‘Younger people will book holiday houses in the New Territories. Or you can rent industrial spaces with big kitchens – you can basically have food, have a party’ – journalist. The culture of commuting by ferry for those who live on nearby islands also provides a natural indoor setting for community-building and social interaction. ‘Every morning I take the ferry as part of my commute. I get to see the same commuters every day – so we socialise a bit’ – urban health researcher.
Outdoor pro-social environments
Sitting-out areas are designated places with benches that maintained by the LCSD and intended to encourage rest and socialisation, particularly for older people. In theory this supports positive social interaction and physical activity, but the quality and planning of these spaces are often criticised. ‘Even if you have buildings with a narrow space, the government may put one bench and call it a sitting out area.’ – Geographer. ‘Sitting out areas tend not to have as many restrictions as parks – but I don’t know if they’re designed for the end user. There’s a lot of concrete, benches in a row… a focus on making the spaces as quickly and cheaply as possible…’ – Journalist. ‘The way the chairs are – you can’t actually lie down, you can’t cuddle’ – policy specialist.
Location is also important. ‘The locations of sitting out spaces are often in left-over, residual areas. So they’re not well-connected, or well-appointed… this might deter their use.’ – Urban planner. Special attention is given to sitting areas for older people: ‘Sufficient sitting facilities, under shade and/or shelter, should be provided close to the exercise area not only for resting purpose but also for facilitating social interaction among the users’ (Planning Department, 2017).
Other outdoor socialising is based in country parks and beaches: ‘Barbequing is very popular here – people will go to public barbeque sites.’ – Journalist. However, ‘these places are all away from the city centre and you have to travel quite far’ – Geographer. Spending time travelling by ferry to beaches on the islands around Hong Kong was discussed as more acceptable than long bus journeys, particularly for families. ‘There’s almost 25% more people using beaches in the last decade’ – Journalist.
The shopping mall is the most commonly cited accessible and popular public space for social interaction in Hong Kong. This risks marginalising people who cannot afford to shop, or do not wish to. But the drive to find air-conditioned public space fosters other creative solutions. There is a culture of providing access to a wide range of publicly accessible private space. ‘Office lobbies are popular. Older people come in for the day, bring their oxygen tanks… their newspapers… and it’s nice because the companies let them stay. Poorer people might hang out in in McDonalds, which is infamous in Hong Kong for having people staying there all day, or even living there. It’s nice that they are allowed to stay’ – urban designer.
Another indoor option frequently used, particularly by groups of younger people, is the temporary rental of spaces for social interaction. ‘Some groups of people rent out old industrial units. It’s like renting a living room – friends split the rent and use the space for bands, or just to sit around on sofas.’ – architect. ‘Younger people will book holiday houses in the New Territories. Or you can rent industrial spaces with big kitchens – you can basically have food, have a party’ – journalist. The culture of commuting by ferry for those who live on nearby islands also provides a natural indoor setting for community-building and social interaction. ‘Every morning I take the ferry as part of my commute. I get to see the same commuters every day – so we socialise a bit’ – urban health researcher.
Outdoor pro-social environments
Sitting-out areas are designated places with benches that maintained by the LCSD and intended to encourage rest and socialisation, particularly for older people. In theory this supports positive social interaction and physical activity, but the quality and planning of these spaces are often criticised. ‘Even if you have buildings with a narrow space, the government may put one bench and call it a sitting out area.’ – Geographer. ‘Sitting out areas tend not to have as many restrictions as parks – but I don’t know if they’re designed for the end user. There’s a lot of concrete, benches in a row… a focus on making the spaces as quickly and cheaply as possible…’ – Journalist. ‘The way the chairs are – you can’t actually lie down, you can’t cuddle’ – policy specialist.
Location is also important. ‘The locations of sitting out spaces are often in left-over, residual areas. So they’re not well-connected, or well-appointed… this might deter their use.’ – Urban planner. Special attention is given to sitting areas for older people: ‘Sufficient sitting facilities, under shade and/or shelter, should be provided close to the exercise area not only for resting purpose but also for facilitating social interaction among the users’ (Planning Department, 2017).
Other outdoor socialising is based in country parks and beaches: ‘Barbequing is very popular here – people will go to public barbeque sites.’ – Journalist. However, ‘these places are all away from the city centre and you have to travel quite far’ – Geographer. Spending time travelling by ferry to beaches on the islands around Hong Kong was discussed as more acceptable than long bus journeys, particularly for families. ‘There’s almost 25% more people using beaches in the last decade’ – Journalist.
A sitting out space in central Hong Kong
Domestic workers and the social environment
Hong Kong has a particular phenomenon of home workers using central public space en masse at weekends. Middle-class women working outside of the home has triggered an influx of over 330,000 domestic workers to Hong Kong. These young, low-income women come mainly from the Philippines and Indonesia, live in their employers’ houses, and are allocated one weekend day off per week. On their non-working days, these domestic workers congregate in public spaces to enjoy a day of socialising and rare privacy from their employers. They transform Hong Kong’s public spaces into informal sitting areas where they chat, play games, relax, and create hair salons, eating places, dances, unofficial businesses, and other useful services spring up, and then vanish again, as the women return to their places of work for another week. (Koh C, 2009). They also gather for protests, for instance calling for wage increases, or justice for abused migrants.
‘They sit on cardboard boxes in parks or streets or underpasses. There’s always lots of covered public space when it rains… There’s a real diversity of activity. For six days a week you’re isolated, living with a family. This one day you get to see your friends. You make good use of public space – really joyful, innovative use of public space.’ – Journalist
This large scale appropriation of public space has occurred every weekend for decades. Much of the general public tends to consider their presence a ‘public nuisance’, obstructing the streets and walkways and creating noise and litter (Koh, 2009). ‘They take up all the greenery in the weekend so nobody else can use the park’ – urban planner. There has been a range of campaigns to remove these workers, famously the ‘Battle of Chater Street’ in 1992. At one point a levy was charged for use of the space. However, NGOs condemned the proposed removal of the workers to lower quality spaces such as underground carparks as inhumane. Furthermore, in Hong Kong’s dense setting, no alternative satisfactory solutions have been identified. As one urban health researcher notes, ‘Hong Kong doesn’t have an infrastructure solution so everyone turns a blind eye’ and law enforcement now protects the workers’ right to use these public spaces (Koh, 2009), though does intervene when too many structures become formal, such as implementing a ban on tent use. Owners of the appropriated spaces have different approaches. According to a planner: ‘The company that manages a street with some of the most expensive shops in Hong Kong closes that street on Sundays for domestic workers to sit, which is really nice – they know their customers can just enter through the shopping mall side. But others, like some banks, have defensive architecture, taping over windowsills, for example, so that nobody can sit on them.’
Domestic workers’ use of space outside of their homes is not confined to outdoor public space – some share the rental costs of apartments or other facilities within the city where they can store personal belongings during the week, then at the weekends, they can socialise, deliver classes, cook, and run small businesses.
From a mental health perspective, this practice of weekly socialising is very positive: it builds community, connection, and social capital, and allays homesickness and loneliness; it promotes rest and relaxation, and empowers these otherwise isolated workers. However, it also creates a two-tiered city system. Some residents express resentment that these workers are allowed to congregate, eat, and play music in public places where these activities would otherwise be disallowed. Others argue that these migrant workers deserve proper facilities that are weather-appropriate and more dignified.
Hong Kong has a particular phenomenon of home workers using central public space en masse at weekends. Middle-class women working outside of the home has triggered an influx of over 330,000 domestic workers to Hong Kong. These young, low-income women come mainly from the Philippines and Indonesia, live in their employers’ houses, and are allocated one weekend day off per week. On their non-working days, these domestic workers congregate in public spaces to enjoy a day of socialising and rare privacy from their employers. They transform Hong Kong’s public spaces into informal sitting areas where they chat, play games, relax, and create hair salons, eating places, dances, unofficial businesses, and other useful services spring up, and then vanish again, as the women return to their places of work for another week. (Koh C, 2009). They also gather for protests, for instance calling for wage increases, or justice for abused migrants.
‘They sit on cardboard boxes in parks or streets or underpasses. There’s always lots of covered public space when it rains… There’s a real diversity of activity. For six days a week you’re isolated, living with a family. This one day you get to see your friends. You make good use of public space – really joyful, innovative use of public space.’ – Journalist
This large scale appropriation of public space has occurred every weekend for decades. Much of the general public tends to consider their presence a ‘public nuisance’, obstructing the streets and walkways and creating noise and litter (Koh, 2009). ‘They take up all the greenery in the weekend so nobody else can use the park’ – urban planner. There has been a range of campaigns to remove these workers, famously the ‘Battle of Chater Street’ in 1992. At one point a levy was charged for use of the space. However, NGOs condemned the proposed removal of the workers to lower quality spaces such as underground carparks as inhumane. Furthermore, in Hong Kong’s dense setting, no alternative satisfactory solutions have been identified. As one urban health researcher notes, ‘Hong Kong doesn’t have an infrastructure solution so everyone turns a blind eye’ and law enforcement now protects the workers’ right to use these public spaces (Koh, 2009), though does intervene when too many structures become formal, such as implementing a ban on tent use. Owners of the appropriated spaces have different approaches. According to a planner: ‘The company that manages a street with some of the most expensive shops in Hong Kong closes that street on Sundays for domestic workers to sit, which is really nice – they know their customers can just enter through the shopping mall side. But others, like some banks, have defensive architecture, taping over windowsills, for example, so that nobody can sit on them.’
Domestic workers’ use of space outside of their homes is not confined to outdoor public space – some share the rental costs of apartments or other facilities within the city where they can store personal belongings during the week, then at the weekends, they can socialise, deliver classes, cook, and run small businesses.
From a mental health perspective, this practice of weekly socialising is very positive: it builds community, connection, and social capital, and allays homesickness and loneliness; it promotes rest and relaxation, and empowers these otherwise isolated workers. However, it also creates a two-tiered city system. Some residents express resentment that these workers are allowed to congregate, eat, and play music in public places where these activities would otherwise be disallowed. Others argue that these migrant workers deserve proper facilities that are weather-appropriate and more dignified.
Domestic workers use cardboard boxes to turn streets and plazas into an informal weekend mini-town
Sleep
Sleep is a protective factor for mental health, and noise, light and crowdedness are particular factors that can affect sleep. Hong Kong is frequently described as a noisy city: ‘Because you have these multi-storey buildings that are close together, the reflection and deflection of noise is more’ – Urban health researcher. It is also recognised as being a bright city, with neon signs cited as a particular intrusion, though ‘there are noise controls, and people have to shut down lit signage at certain times… Hong Kong is just too small. In quiet neighbourhoods, even if you talk very softly, people on the 10th floor will hear’ – urban planner. The government offers Gross Floor Area and/or Site Coverage incentives under the Building Ordinance to developers who include noise-reducing design features. (Building Department Joint Note 1 and 2). Meanwhile, people who are homeless have different challenges, with different types of defensive architecture used to deter sleeping: ‘You might see a park with lots of planting and think ‘look at that lovely green park’ but in fact it’s designed that way so homeless people can’t sleep there. A lot of public spaces have defensive design’ – planner.
Case Study - Tin Shui Wai - City of Sadness
Tin Shui Wai, in the far northwest New Territories in Hong Kong, is a planned suburb opened in the 1990s and intended for Hong Kong workers wanting to live near new employment zones that were planned nearby. But as mainland Chinese cities developed as industrial centres, factories moved north and the expected local employment opportunities did not materialise. Instead, the town became a byword for migrants, poverty, and social problems. Nearly 300,000 people lived in dense, homogenous tower blocks of public housing. The suburb was stigmatised for its concentration of new migrants from mainland China following relaxation of migration rules after Hong Kong was returned to China in 1997. These migrants often did not speak Cantonese, and many had difficulties assimilating, leading to marginalisation of the community. Positioned distant from the downtown core, with only expensive transport options to access central opportunities, Tin Shui Wai isolated its residents with limitations on commercial development, a lack of employment, amenities, basic services such as healthcare, and social opportunities. Social and mental health problems proliferated, the town became notorious for high rates of suicide, mental illness, and domestic violence. The former Director of Social Welfare Department, Carrie Lam, dubbed Tin Shui Wai the ‘city of sadness’, a label seized by the media. Slowly, investment in community services, parks, and employment opportunities has enabled Tin Shui Wai to shed its ‘sadness’ label.
Tin Shui Wai, in the far northwest New Territories in Hong Kong, is a planned suburb opened in the 1990s and intended for Hong Kong workers wanting to live near new employment zones that were planned nearby. But as mainland Chinese cities developed as industrial centres, factories moved north and the expected local employment opportunities did not materialise. Instead, the town became a byword for migrants, poverty, and social problems. Nearly 300,000 people lived in dense, homogenous tower blocks of public housing. The suburb was stigmatised for its concentration of new migrants from mainland China following relaxation of migration rules after Hong Kong was returned to China in 1997. These migrants often did not speak Cantonese, and many had difficulties assimilating, leading to marginalisation of the community. Positioned distant from the downtown core, with only expensive transport options to access central opportunities, Tin Shui Wai isolated its residents with limitations on commercial development, a lack of employment, amenities, basic services such as healthcare, and social opportunities. Social and mental health problems proliferated, the town became notorious for high rates of suicide, mental illness, and domestic violence. The former Director of Social Welfare Department, Carrie Lam, dubbed Tin Shui Wai the ‘city of sadness’, a label seized by the media. Slowly, investment in community services, parks, and employment opportunities has enabled Tin Shui Wai to shed its ‘sadness’ label.
Case study: Innovations
Hong Kong seeks to promote walking, cycling and access to nature in new developments. For example, the new West Kowloon art city development routes cars underground – the area is car-free and offers arts buildings, a park, and many bike and walking paths. In Kowloon East, pedestrian networks including footbridges, subways and landscaped walkways are being developed to increase walkability, and better connections between the MTR and the waterfront. New towns enable Hong Kong to innovate. Hung Shui Kiu is a new development area that focuses on living in balance with nature. It is walking and cyclist-friendly, with breezeways, green spines and open spaces creating links between green and blue features, like the nearby country park.
Hong Kong seeks to promote walking, cycling and access to nature in new developments. For example, the new West Kowloon art city development routes cars underground – the area is car-free and offers arts buildings, a park, and many bike and walking paths. In Kowloon East, pedestrian networks including footbridges, subways and landscaped walkways are being developed to increase walkability, and better connections between the MTR and the waterfront. New towns enable Hong Kong to innovate. Hung Shui Kiu is a new development area that focuses on living in balance with nature. It is walking and cyclist-friendly, with breezeways, green spines and open spaces creating links between green and blue features, like the nearby country park.
Video case studies: happiness, green places, suicide and accessibility
What does happiness look like in Hong Kong?
IAN RALPH
Chartered planner and urban designer, Lead8
Green places and older people's mental health in Hong Kong
KEVIN LAU
Environmental scientist, Institute of Future Cities and HKJC Institute of Ageing, The Chinese University of Hong Kong
Space and suicide in Hong Kong
PAUL YIP
Director, HKJC Centre for Suicide Research and Prevention, The University of Hong Kong
Walking with wheels: accessibility and mental health in Hong Kong
PAUL ZIMMERMAN
Designing Hong Kong CEO and Pokfulam District Councilor
What does happiness look like in Hong Kong?
IAN RALPH
Chartered planner and urban designer, Lead8
Green places and older people's mental health in Hong Kong
KEVIN LAU
Environmental scientist, Institute of Future Cities and HKJC Institute of Ageing, The Chinese University of Hong Kong
Space and suicide in Hong Kong
PAUL YIP
Director, HKJC Centre for Suicide Research and Prevention, The University of Hong Kong
Walking with wheels: accessibility and mental health in Hong Kong
PAUL ZIMMERMAN
Designing Hong Kong CEO and Pokfulam District Councilor
Barriers to mental health prioritisation in Hong Kong
As one urban planner put it: ‘The question is: why do we not discuss relationships between mental health and the planning and design of the environment?’ Several reasons were proposed:
Stigma
Stigma around mental illness remains prevalent: ‘Mental health is very reluctantly talked about. There is denial.’ – urban designer. ‘Not [discussed] in Hong Kong. It’s often said mental health is still taboo in Greater China’ – architect. One architect noted: ‘There is a stigma… but also an absence of an open cultural platform for discussing these things’ and a planner confirmed ‘There are cultural stigmas around mental health in Asian countries, which makes it difficult to form policy – if you don’t recognise a problem, why would you service it with a solution?’
Awareness
Lack of awareness regarding preventative mental health measures also plays a role, as people like to invest in projects that deliver rapidly quantifiable results rather than in prevention. ‘Resources are limited and people are concerned about how the government spends. If you see a problem and solve it, you can immediately see results. If you prevent a problem, it’s harder to see outcomes.’ – Landscape Architecture researcher.
Knowledge
A frequently cited reason is lack of knowledge around mental health and the challenge of incorporating mental health into building and planning considerations. Two urban planners noted: ‘We can’t manage environments for physical health – we dare not talk about mental health’ and ‘in terms of something as intangible as mental health, it’s less obvious for urban design…’ This is exacerbated by a view that for mental health, there are other sectors where action is more pressing. As one planner noted, ‘you can change the environment, but if there’s no increase in services [for mental health] and reductions in working hours, there won’t be impact.’ Hong Kong’s unusual vertical layout creates unique urban challenges. ‘We haven’t worked out how to balance commercial and public spaces to enable innovation. It’s easier for other cities to manage at ground level, but Hong Kong is a vertical city. It’s buzzing at every level’ – urban designer.
Economics
The economic imperative is the primary driver for design and planning decisions in such a space-constrained environment: ‘We always go for the least-cost option’ – urban planner. ‘All development is very much for private gain. Land is always given to the highest bidder – how the design benefits society isn’t relevant’ said an urban designer. Many note the ‘one-size-fits-all approach to design in Hong Kong. A suicide prevention specialist observed: ‘some of the buildings, every school, every hospital, are exactly the same. They maximise the use of space. There is so much constraint – space, financial... Creating something unique, special, is a luxury’. ‘There’s no real incentive… property development is so driven by commercial values’. An architect elaborated: ‘not unless they’re philanthropic in some way. Development decisions need to fit with marketing and branding. If you want to influence the design, you have to work at client level.’ One urban planner notes: ‘Most decisions depend on money and not bending the rules.’ Another reflects: ‘We are still measuring things using efficiency. If you want to design for mental health, what’s the profit, what’s the opportunity cost?’
Politics
Doing things differently comes with political risk. As one planner noted: ‘If we cede to one district or legislative councillor, the others will become jealous.’
Legacy policies and systems
Hong Kong also has strict and specific rules and regulations, which date back for decades, to the time of British colonial rule, and there is a lack of appetite to update these to reflect more current thinking around urban placemaking. One landscape architect mused: ‘Society is moving forward but our policies stay in the same place – it’s strange.’ An urban designer elaborated: ‘We use colonial laws. Like the road manual is from the 1970s. It’s nobody’s job to update them – nobody wants to be responsible if the updates go wrong.’ And a journalist noted: ‘the colonial-era systems and policies are still in place, but now without the previous latitude to change things. They’re calcified.’ This is important because ‘Hong Kong building is very highly regulated – there’s not much scope for doing things differently. Building is a routine process.’ – Architect. ‘It’s almost like a city stuck in the 80s – people want to invest and innovate but there isn’t a structure there to support it’ – Urban designer.
Several respondents identified challenges in achieving cross-sector initiatives, and even simple-seeming projects that involve more than one department: ‘Every inch of each street is managed by a different department so it’s hard to get things agreed. You have to define what parts of land belongs to what department –if you want a tree planter, who owns it? Highways owns the hole in the road… LCSD has to clean the leaves, so they choose leaves that don’t fall in winter’ –planner. ‘Because of the bureaucratic system, your responsibility is upward – you don’t talk across lines.’ An architect elaborated: ‘Planners working with the health department would be impossible – everyone’s in their bureaucratic boxes in Hong Kong, which are fiercely protected’
Governmental guidelines direct the specific health focus, and tend not to include mental health. ‘They are amending the Building Department Design Manual constantly. The manual is focused on disabled people, barrier-free access, and access to health facilities. But there isn’t much thinking about mental health’ –planner. Indeed, one environmental scientist suggests: ‘everything related to health is quite sensitive – and guidelines would involve a lot of changes. It would be hard to persuade government departments to do more.’ – Environmental scientist
However, while the government rarely explicitly addresses the links between urban design and mental health, there is a keen academic interest in the topic in Hong Kong – which in turn influences the government: ‘It’s not a government priority, but research is going on in the universities here – and a lot of the planners studied at these universities’ – Urban designer. ‘We’re very fortunate that the universities are very interested in healthy urban density’, noted one psychiatric epidemiologist. Yet according to an urban planner, ‘a lot of research is done in the universities, but it is not translational… We need more funding for Hong Kong-based research.’
Community input challenges
Another is the question of participatory planning for site development and management. ‘You see people advocating for a more community-led approach to urban planning’ but urban planners have responded that the community lacks ‘money, authority and skills’ to manage places. There are few formal routes by which the community can input and participate into place development in Hong Kong, and some conclude that this leads to versions of one solution being applied across the city rather than developing the most appropriate solutions for each place. Minorities in the city have particular challenges in contributing.
Stigma
Stigma around mental illness remains prevalent: ‘Mental health is very reluctantly talked about. There is denial.’ – urban designer. ‘Not [discussed] in Hong Kong. It’s often said mental health is still taboo in Greater China’ – architect. One architect noted: ‘There is a stigma… but also an absence of an open cultural platform for discussing these things’ and a planner confirmed ‘There are cultural stigmas around mental health in Asian countries, which makes it difficult to form policy – if you don’t recognise a problem, why would you service it with a solution?’
Awareness
Lack of awareness regarding preventative mental health measures also plays a role, as people like to invest in projects that deliver rapidly quantifiable results rather than in prevention. ‘Resources are limited and people are concerned about how the government spends. If you see a problem and solve it, you can immediately see results. If you prevent a problem, it’s harder to see outcomes.’ – Landscape Architecture researcher.
Knowledge
A frequently cited reason is lack of knowledge around mental health and the challenge of incorporating mental health into building and planning considerations. Two urban planners noted: ‘We can’t manage environments for physical health – we dare not talk about mental health’ and ‘in terms of something as intangible as mental health, it’s less obvious for urban design…’ This is exacerbated by a view that for mental health, there are other sectors where action is more pressing. As one planner noted, ‘you can change the environment, but if there’s no increase in services [for mental health] and reductions in working hours, there won’t be impact.’ Hong Kong’s unusual vertical layout creates unique urban challenges. ‘We haven’t worked out how to balance commercial and public spaces to enable innovation. It’s easier for other cities to manage at ground level, but Hong Kong is a vertical city. It’s buzzing at every level’ – urban designer.
Economics
The economic imperative is the primary driver for design and planning decisions in such a space-constrained environment: ‘We always go for the least-cost option’ – urban planner. ‘All development is very much for private gain. Land is always given to the highest bidder – how the design benefits society isn’t relevant’ said an urban designer. Many note the ‘one-size-fits-all approach to design in Hong Kong. A suicide prevention specialist observed: ‘some of the buildings, every school, every hospital, are exactly the same. They maximise the use of space. There is so much constraint – space, financial... Creating something unique, special, is a luxury’. ‘There’s no real incentive… property development is so driven by commercial values’. An architect elaborated: ‘not unless they’re philanthropic in some way. Development decisions need to fit with marketing and branding. If you want to influence the design, you have to work at client level.’ One urban planner notes: ‘Most decisions depend on money and not bending the rules.’ Another reflects: ‘We are still measuring things using efficiency. If you want to design for mental health, what’s the profit, what’s the opportunity cost?’
Politics
Doing things differently comes with political risk. As one planner noted: ‘If we cede to one district or legislative councillor, the others will become jealous.’
Legacy policies and systems
Hong Kong also has strict and specific rules and regulations, which date back for decades, to the time of British colonial rule, and there is a lack of appetite to update these to reflect more current thinking around urban placemaking. One landscape architect mused: ‘Society is moving forward but our policies stay in the same place – it’s strange.’ An urban designer elaborated: ‘We use colonial laws. Like the road manual is from the 1970s. It’s nobody’s job to update them – nobody wants to be responsible if the updates go wrong.’ And a journalist noted: ‘the colonial-era systems and policies are still in place, but now without the previous latitude to change things. They’re calcified.’ This is important because ‘Hong Kong building is very highly regulated – there’s not much scope for doing things differently. Building is a routine process.’ – Architect. ‘It’s almost like a city stuck in the 80s – people want to invest and innovate but there isn’t a structure there to support it’ – Urban designer.
Several respondents identified challenges in achieving cross-sector initiatives, and even simple-seeming projects that involve more than one department: ‘Every inch of each street is managed by a different department so it’s hard to get things agreed. You have to define what parts of land belongs to what department –if you want a tree planter, who owns it? Highways owns the hole in the road… LCSD has to clean the leaves, so they choose leaves that don’t fall in winter’ –planner. ‘Because of the bureaucratic system, your responsibility is upward – you don’t talk across lines.’ An architect elaborated: ‘Planners working with the health department would be impossible – everyone’s in their bureaucratic boxes in Hong Kong, which are fiercely protected’
Governmental guidelines direct the specific health focus, and tend not to include mental health. ‘They are amending the Building Department Design Manual constantly. The manual is focused on disabled people, barrier-free access, and access to health facilities. But there isn’t much thinking about mental health’ –planner. Indeed, one environmental scientist suggests: ‘everything related to health is quite sensitive – and guidelines would involve a lot of changes. It would be hard to persuade government departments to do more.’ – Environmental scientist
However, while the government rarely explicitly addresses the links between urban design and mental health, there is a keen academic interest in the topic in Hong Kong – which in turn influences the government: ‘It’s not a government priority, but research is going on in the universities here – and a lot of the planners studied at these universities’ – Urban designer. ‘We’re very fortunate that the universities are very interested in healthy urban density’, noted one psychiatric epidemiologist. Yet according to an urban planner, ‘a lot of research is done in the universities, but it is not translational… We need more funding for Hong Kong-based research.’
Community input challenges
Another is the question of participatory planning for site development and management. ‘You see people advocating for a more community-led approach to urban planning’ but urban planners have responded that the community lacks ‘money, authority and skills’ to manage places. There are few formal routes by which the community can input and participate into place development in Hong Kong, and some conclude that this leads to versions of one solution being applied across the city rather than developing the most appropriate solutions for each place. Minorities in the city have particular challenges in contributing.
SWOT Analysis
Strengths |
Weaknesses |
Hong Kong has excellent country parks providing green space close to the city, and blue space at the heart of the city The city already invests in social settings such as 'sitting out spaces' The excellent public transport system encourages walking and enables access to health services, green spaces and exercise |
Density and car infrastructure predominance makes it challenging to create new public and green spaces Inadequate affordable housing Mental health has not been a high priority in planning and design |
Opportunities |
Threats |
The city's concern about stress and youth suicide could be leveraged as a way into discussions about investing in mental health promotion at the built environment level The government already incentivises private developers to integrate green space; they could extend incentives to drive other design factors that improve mental health. New developments such as Kowloon East and the Harbourfront can prioritise green and blue space, walkability and cycling Hong Kong could learn from its domestic worker population about the design and use of pro-social space |
Mental health promotion is not commonly discussed in Hong Kong so policymakers may be less likely to access the research and invest in implementing recommendations. Prioritising clear and rapid financial return for built environment investment prejudices decisionmakers against mental health Planning and development policies are becoming outdated and are perceived to constrain innovation Super-ageing population will lead to increased mental health needs for older people |
Conclusions
3 Lessons from Hong Kong that could be applied to promote good mental health through urban planning and design in other cities
- Walking infrastructure: Despite the terrain and climate, Hong Kong is a walkable city. This has been achieved through a combination of efficient, sustainable public transit systems with good connections to different buildings, alongside well-designed pedestrian routes and substantial public and private investment in other first mile-last mile solutions: outdoor public escalators in steep areas; elevated walkways; and routes through air conditioned buildings make walking a fully integrated mode of transport in Hong Kong and relative safety from crime further facilitates walking.
- Designating spaces for social interaction: Hong Kong invests in ‘sitting out areas’ and exercise areas for older people, placed all over the city. While design and access are not always refined, and these spaces are informal, this provides locations for older people to meet and talk, and to rest in between exercising. Hong Kong’s housing guidelines also expect indoor and outdoor social and exercise areas in housing blocks. This creates a culture of social interaction and helps mitigate the potential isolation of tower block living.
- Creative public space sharing for positive social interaction: With a densely developed urban core and very limited home-based social spaces, Hong Kong’s residents are creative in providing, accessing and appropriating social spaces. Older people use university plazas for daily group exercises and office lobbies for social gatherings; younger people rent industrial spaces by the hour for recreation; and migrant domestic workers set up al fresco living rooms alongside city streets. High-density cities can think creatively about how to facilitate more positive social interaction through use of available space, both in terms of physical infrastructure but also ensuring that regulations help facilitate appropriate creative social uses of space for physical activity and social interaction.
10 Recommendations for Hong Kong to improve public mental health through urban planning and design
- Shift the value priority balance of profit and health: With cost currently being the primary driver for development decisions in Hong Kong, achieving investment in health-promoting environments would need more explicit prioritisation through integration into policy, and the value proposition, including more public-private partnerships and incentives for private developers to deliver functional healthy designs. Post-SARS lessons in improving housing can be applied to the wider public health opportunities in the built environment.
- Enable different sectors to work together: Increased interdisciplinary collaboration and coordination between departments, particularly those that manage public space, could help achieve shared goals of integrating mental health into the built environment. This could start with shared education about delivering healthy environments.
- Narrow the property ownership gap: As the most expensive housing market in the world, Hong Kong has evolved into a two-tiered system of wealth and opportunity separating property owners and non-property owners, and substantial challenges in moving between these. This risks creating frustration, resentment, hopelessness and low self-esteem. Addressing this would need more affordable housing options. This could include creating more affordable solutions in downtown areas, but also exploring how to boost desirability of more affordable homes in the New Territories (and with the imminent express rail, in neighbouring mainland cities). This could include investments in liveability, and developing these areas into fully fledged towns, including attracting companies to place jobs o outside of downtown areas.
- Improve homes for better mental health: In very small living spaces, private areas should be secure, quiet and comfortable, ideally with views of nature and natural light, and communal spaces should be maximised for access to nature, physical activity and social interaction. Bike parking facilities will help promote physical activity.
- Improve the work experience for better mental health: In Hong Kong people work for long hours, which limits their opportunities for protective activities like nature access, exercise, and social interaction. Reducing working hours would benefit mental health. A range of built environment opportunities could also contribute to improving workers’ mental health and wellbeing. First, optimising the commute, including views of natural settings, facilitating walking and cycling where possible, including with bike parking, showers and lockers where appropriate, and redesigning waiting areas and ferry seat layouts to promote sociability with fellow commuters. Also, considering whether commuting can be reduced, for instance through enacting flexible working patterns, or relocating offices outside of the downtown core. Also important is optimising the office space, integrating nature (and views of nature), choice of workspaces, places for social interaction, circadian lighting, and relaxing places for lunch with options of spending this time socially or privately.
- Increase the quality of urban nature: In this vertical city, nature has a particular opportunity to orient people to time and place and provide respite and relaxation. Much of Hong Kong’s population does not spend its spare time in country parks, so the city must beware of complacency around urban greenery provision while encouraging use of this natural resource. Similarly, Hong Kong has a tendency to invest in flower and tree planters in otherwise built settings. This does provide beneficial nature access but may not untap the full opportunities of nature exposure. Despite the extra costs of upkeep, regular access to wilder, more diverse and immersive greenery (more ‘natural nature’) would be beneficial for mental health and wellbeing, and expansion of open spaces will facilitate this, for instance accessing the land that has been zoned for open space but not developed.
- Modernise community-driven participatory planning processes: Colonial era laws, regulations and systems, and perhaps even the absence of the city mayor role may slow the leadership needed for integration of health as part of innovation in placemaking and liveability in Hong Kong. These create complex restrictions, for instance in how public space can be used, that may not always be necessary, but have the effect of precluding full access to potential health benefits. Review and modernisation of urban planning and design regulations in line with other global cities, embedding a philosophy of community participation, could further identify specific neighbourhood needs and empower shared solutions for better mental health and wellbeing. Inspiration may be taken from how domestic workers use public space at the weekends to promote good mental health, including relaxation, stress reduction, and positive social interaction, building social capital and strengthening resilience. Of note, community involvement should involve all communities, including minorities and migrants.
- Reduce car domination: Just 8% of Hong Kong residents own cars yet car infrastructure dominates the landscape, creating air pollution and traffic danger, taking up pedestrian space, and obliterating potential cycle routes; a gradual reduction of car-focused infrastructure, potentially alongside initiatives like ‘car-free days’ would liberate public space for nature, walking, cycling and social opportunities.
- Design for ‘sitting in’ as well as ‘sitting out’: Hong Kong’s combination of heat, humidity and air quality challenges nudges many people indoors, which means investments in healthy public spaces should be both indoors and outdoors. Developers and other private entities can be encouraged to innovate in the design of healthy indoor public spaces, for example public spaces in shopping malls for socialising and physical activity. These spaces should be designed consciously with their purposes in mind, rather than current sitting out area design, which can feature less-social design such as rows of chairs facing a concrete wall.
- Enhance connections to healthy places: Green spaces and bikeways can seem relatively disconnected from many people’s daily lives – these could be better integrated; for example green connections from residences, shopping areas workplaces to parks; or bike lanes and parking that seamlessly integrate with public transit as riders approach congested areas where cycling is less safe. Further healthy neighbourhoods spaces could also be opened up to increase public access, for instance school playgrounds or some of the publicly-owned grounds of private clubs.
References
Architectural Services Dept (2004). Universal Accessibility Best Practices and Guidelines
Buildings Department (BD), Lands Department and Planning Department Joint Practice Note No. 1, Green and Innovative Buildings (JPN No. 1). Buildings Ordinance (BO)
Degolyer M (2016). Asian Urban-Wellbeing Indicators Hong Kong Report. Wyng Foundation and Civic Exchange.
Department of Health (2015). Behavioural Risk Factor Survey (April 2014). Hong Kong: Department of Health.
Development Bureau (2011). Public Open Space in Private Developments Design and Management Guidelines.
Food and Health Bureau (2017). Mental Health Review Report. Hong Kong Special Administrative Regional Government.
Government of Hong Kong (2011). Promotion of cycling safety (Council Meeting Date: 19-Oct-2011; Question No. Q.17) Press release. and "Bicycle friendly" policy (Council Meeting Date: 21-Nov-2012; Question No. 2) Press Release.
HKJC Centre for Suicide Research and Prevention, HKU (2017). 1981-2015 Suicide Statistics.
Hong Kong Housing Authority, 2014. Housing in Figs. 2014. Hong Kong SAR Government, Hong Kong.
Hong Kong Housing Society (2005). Universal Design Guidebook for Residential Development in Hong Kong.
Information Services Department, Census and Statistics Department Website:
Hong Kong Special Administrative Region Government. Population factsheet.
Jim CY, Chan MWH. Urban greenspace delivery in Hong Kong: Spatial-institutional limitations and solutions. Urban Forestry & Urban Greening 2016; 18: 65-85.
Koh C (2009). Dissertation: The Use of Public Space by Foreign Female Domestic Workers in Hong Kong, Singapore and Kuala Lumpur. Massachusetts Institute of Technology.
Lai C (2017). Unopened space: mapping equitable availability of open space in Hong Kong. Civic Exchange.
Lam LC et al. Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS) Social Psychiatry and Psychiatric Epidemiology 2015; 50(9):1379–1388.
Planning Department (2017). Hong Kong Planning Standards and Guidelines. Chapter 4.
Buildings Department (BD), Lands Department and Planning Department Joint Practice Note No. 1, Green and Innovative Buildings (JPN No. 1). Buildings Ordinance (BO)
Degolyer M (2016). Asian Urban-Wellbeing Indicators Hong Kong Report. Wyng Foundation and Civic Exchange.
Department of Health (2015). Behavioural Risk Factor Survey (April 2014). Hong Kong: Department of Health.
Development Bureau (2011). Public Open Space in Private Developments Design and Management Guidelines.
Food and Health Bureau (2017). Mental Health Review Report. Hong Kong Special Administrative Regional Government.
Government of Hong Kong (2011). Promotion of cycling safety (Council Meeting Date: 19-Oct-2011; Question No. Q.17) Press release. and "Bicycle friendly" policy (Council Meeting Date: 21-Nov-2012; Question No. 2) Press Release.
HKJC Centre for Suicide Research and Prevention, HKU (2017). 1981-2015 Suicide Statistics.
Hong Kong Housing Authority, 2014. Housing in Figs. 2014. Hong Kong SAR Government, Hong Kong.
Hong Kong Housing Society (2005). Universal Design Guidebook for Residential Development in Hong Kong.
Information Services Department, Census and Statistics Department Website:
Hong Kong Special Administrative Region Government. Population factsheet.
Jim CY, Chan MWH. Urban greenspace delivery in Hong Kong: Spatial-institutional limitations and solutions. Urban Forestry & Urban Greening 2016; 18: 65-85.
Koh C (2009). Dissertation: The Use of Public Space by Foreign Female Domestic Workers in Hong Kong, Singapore and Kuala Lumpur. Massachusetts Institute of Technology.
Lai C (2017). Unopened space: mapping equitable availability of open space in Hong Kong. Civic Exchange.
Lam LC et al. Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS) Social Psychiatry and Psychiatric Epidemiology 2015; 50(9):1379–1388.
Planning Department (2017). Hong Kong Planning Standards and Guidelines. Chapter 4.
About the Authors
Layla McCay is Director of the Centre for Urban Design and Mental Health. A psychiatrist, international public health and health systems specialist, and adjunct professor of international health at Georgetown University, she set up UD/MH in 2015 to help increase interest, knowledge sharing and translational research to improve population mental health through smart urban design. Trained at the Maudsley Hospital and Institute of Psychiatry in London, Layla has a keen interest in the determinants of mental health, and a passion for the built environment and helping people love the places they live.
@LaylaMcCay and @urbandesignmh |
Larissa Lai is a licensed social worker and researcher based in New York. She holds a Master's in Social Work from New York University. Larissa currently works as a psychotherapist and also in program design and evaluation for multiple social services and mental health agencies in the city. Her academic and research interests include critical theory, diversity issues, best practices and programming models for mental health, community impact, and innovative housing solutions. She is an Associate at the Centre for Urban Design and Mental Health.
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