Joel Finlay, KPMG in Canada, spoke with Professor Hugh Barton, former Director of the World Health Organization (WHO) Collaborating Centre for Healthy Urban Environments and the current Professor Emeritus of Planning, Health and Sustainability at the University of the West of England, about what infrastructure planners can do to help achieve a healthy society. Achieving a ‘health-supportive’ environment.
The aspiration of city leaders for ‘healthier’ cities is nothing new. Since the WHO first launched the Healthy Cities program in 1986, thousands of cities around the world have joined the network by committing to “improve their city’s environs” in order to create a health-supportive environment and achieve a good quality of life for their citizens.
What has changed over the past 25 years, however, is that the focus has shifted from building health facilities to building healthy environments. As Professor Hugh Barton, a former Director of the WHO Collaborating Centre for Healthy Urban Environments and the current Professor Emeritus of Planning, Health and Sustainability at the University of the West of England points out, “There has been a growing realization that pouring money into providing more health services to respond to the impacts of pollution and obesity-inducing environments is counter-productive; cities need to be investing in creating a better environment that reduces the need for health services in the first place.”
According to Professor Barton, who has co-authored numerous books on urban and spatial planning including Shaping Neighbourboods: For Local Health and Global Sustainability, Healthy Urban Planning, and Sustainable Communities, most cities evolve through three distinct levels of health planning. Those in the first level, often in the developing or emerging markets, are still focused on the delivery of basic health and sanitation services, air quality, water quality, sewage treatment and so on.
Most developing world cities – and an increasing number of those in the emerging markets – are currently operating at the second level where they are directly investing in health outcomes by building parks, recreation facilities and bike trails to encourage healthier living. This is a good thing, argues Professor Barton, but is not nearly enough to create truly healthy cities and societies.
“It’s only when you start thinking strategically and in an integrated way about the whole city or town, how it is going to evolve and how that will impact the health and welfare of people that you reach that third level of evolution in healthy cities,” added Professor Barton.
It is widely understood that the availability of efficient public transit improves the overall health of a city. But, as Professor Barton points out, a public transit system on its own is only one small part of the equation. Urban planners also need to think about how the land around the system will be developed, how city areas are activated for alternative transport usage, how land values are affected and how accessible the transit is from key facilities.
“If you think about it, transport isn’t about mobility, it’s about accessibility and physical activity; in other words it’s about people getting to places, not just about moving people around,” added Professor Barton. “And if you take that perspective, you start to see a whole new way for cities and towns to function where people choose to engage in more active and healthier forms of movement as a way to interact with their surroundings and the built environment.”
As a case in point, Professor Barton points to the town of Freiburg in South-West Germany, where city leaders combined regulation and planning with renewed investment in public transit and the ‘pedestrianization’ of the city center to create a more livable and healthy city. In some parts of the town center, car use is down to just 10 percent while almost 70 percent of people use more active forms of travel such as walking or cycling.
The knock-on benefits can be transformational. In towns and cities like Freiburg, fewer families need two cars, thereby reducing the cost of living; pollution drops with less car use, thereby improving the health of the population; society starts to bind closer together as people interact on city streets and patronize local stores.
“This is where the benefits start to roll up into a real evolution for cities,” noted Professor Barton. “But it’s often difficult to achieve; you need to have political will, public support and private sector support to really build up the level of commitment it takes to make these types of fundamental and holistic changes to a city.”
Based on Professor Barton’s experience, he suggests that one key to helping cities become more focused on creating healthy environments is to improve the power of local authorities to plan, purchase and use land more effectively. Progress in countries like Germany, Netherlands and the Scandinavian countries is outstripping that of the UK and the US is in large part because local authorities, working with local communities and investors, do not have the same ability to buy or control land use as in those countries.
“It does seem that high-quality places – those in which people love living and feel empowered to create wealth and live healthy lives – are those where city authorities have a good level of autonomy and freedom to do and achieve things,” added Professor Barton. “If they can put the population’s health and well-being at the top of their agenda then they can – with quite remarkable speed – create new environments in which people can live and be healthy.”