RICS insight: healthier space

Fitter cities

15 October 2018

With health and well-being an increasingly important consideration in towns and cities, Yvonne Rydin and Helen Pineo discuss an RICS insight paper showing how surveyors can contribute to healthier lives

While high-income and low- to middle-income countries face very different health and well-being problems – with issues of clean water and sanitation pressing for the latter group – there are a range of shared priorities. These include:

  • the lack of opportunities for physical activity in daily life;
  • noise and air pollution;
  • limited access to affordable housing;
  • ill-preparedness for the impacts of climate change;
  • poor thermal comfort and air quality inside buildings;
  • restricted access to green spaces;
  • the importance of designing for groups with special needs such as children, the elderly and disabled people; and
  • the value of learning from communities about their perceptions of health and place.

Cities and health

Figure 1: Physical urban environment factors affecting health and well-being

The first important point is that much of the work of surveyors has implications for health and well-being in towns and cities. Design, development and management of the built environment can help improve health in a variety of ways (see Figure 1).

  • It can reduce pollution of all kinds – such as airborne pollutants and noise – both indoors and outdoors.
  • Active transport – cycling and walking – can be promoted and the conditions for use of public transport fostered, rather than reinforcing reliance on the car.
  • Better land-use mix in and connectivity across urban developments can become a way to generate a sense of local community.
  • Green spaces and parks can be incorporated, bringing physical and mental benefits, while the associated greenery and water features can combat the urban heat island effect that exacerbates heatwaves in cities.
  • Incorporating elements of urban agriculture may tackle problems of access to fresh fruit and vegetables and promote better diets.

Almost all the elements of a development proposal and management plan can be interrogated for their potential contribution to improved health and well-being. There are many cases where an alteration will even bring multiple benefits, as with the creation of pedestrianised, landscaped areas at the heart of new developments, which encourage walking and sociability, provide shade during heatwaves, allow moments of peaceful reflection and minimise the impact of polluting road vehicles.

Design for health

But it is not just that surveyors could contribute in theory: there are also compelling reasons why they ought to do so. For instance, there is increasing evidence – particularly among prime property – that the incorporation of features contributing to health and well-being also brings a financial return in terms of rental and capital values.

This link can be seen, for instance, in the way that productivity in office environments is boosted by features such as views of greenery, use of natural materials and natural light and ventilation. Property owners and tenants alike are increasingly recognising the benefits of design for health and well-being and this is influencing market prices and rents.

Ensuring that a development or building meets high standards of design, construction and management for health and well-being is also relatively easy. Indeed, well-established building and development standards such as BREEAM and Leadership in Energy and Environmental Design (LEED) already incorporate criteria to assess this.

Healthier standards

The Cities, health and well-being insight paper compared these standards with the WELL Building Standard and found that more than a third of the issues covered in the latter were already present in BREEAM and LEED. The main deficiencies in the broader standards were in issues concerned with water, nourishment and mental well-being.

If a developer, investor or occupier wishes to move beyond these well-established criteria for buildings, they could consider adopting the WELL or Fitwel standards. Using such standards not only demonstrates commitment to health and well-being but also provides a structured means of ensuring that the different dimensions of this agenda are taken on board.

At the broader scale of neighbourhoods or local authorities, there is also scope for using health impact assessments to consider how plans, policy and strategies might affect health and well-being and the extent to which this agenda is being adopted. Mirroring systems such as environmental assessment, these are generic methods for systematically considering health and well-being impacts for proposed urban development pathways. The advantage is that the earlier that health and well-being are incorporated into the planning of a locality, the easier it will be to achieve beneficial outcomes and avoid incurring costs. New facilities such as transport networks, energy supplies, water and green infrastructure can all be more readily integrated at an early stage of planning, and this can then guide specific development and building projects.

Positive projects

The insight paper highlights some recent development projects in France, the USA, Singapore and the UK at multiple scales that incorporate health-promoting design features. For example, the Paya Lebar Quarter is a Lendlease development in Singapore that integrates sustainability and health features. The project includes 3 office towers, a retail mall and 3 residential towers with 429 apartments, surrounded by public space, and aims to provide trees, green walls and roofs and urban farming to reduce the urban heat island effect, support biodiversity, manage rainwater and encourage community gardening. The project also includes plans for active transport, social interaction, indoor air-quality improvements and biophilic design. The 3 office towers are registered for the WELL Core & Shell Certification, which they aim to fulfil with, for instance, the provision of showers, lockers and bicycle storage facilities.

Parkroyal on Pickering hotel in Singapore

Figure 2: The Parkroyal on Pickering hotel in Singapore. Many urban planners now weave greenery throughout the city, using strategies such as green roofs, vertical gardens or green walls

On a smaller level, the insight paper also gives examples of health-promoting design in buildings or at street scale. For example, offices and public buildings may encourage occupants to be more physically active by ensuring that stairs are visible and providing sit–stand or treadmill desks. In London, Southwark Council’s Tooley Street office and the NHS Health Education England office have signage encouraging the use of stairs, with the former offering details on calories burned per floor, and the latter playful art to remind occupiers of the benefits of using stairs rather than the lift.

Six steps

So how can surveyors engage with this agenda in their next project? The insight paper suggests 6 steps.

  1. Understand your clients and their requirements for health and well-being. This may involve gathering and consulting public health evidence, looking at employer’s survey data and engaging with residents and other occupants, giving a new perspective on the way public health is important to your clients.
  2. Remember that some residents or building occupants are more vulnerable and require special consideration. This involves thinking about how design standards could meet different needs in a building and development; vulnerability in this case may relate to age, physical or mental health and other disabilities.
  3. Determine the appropriate policies, design strategies, materials and technologies taking health and well-being into account. There may be a variety of ways in which changes to the details of a development can enhance health and well-being. Incorporating them early on during the planning and design process can make them easier to adopt and will reduce costs. There may also be benefits for other objectives such as energy efficiency.
  4. Arm yourself with data about the costs and benefits. It is always important to remember the financial implications, although many ways of contributing to health and well-being are cost-neutral or can be achieved with a short payback period. Demonstrating this will reassure clients that they are making a worthwhile investment.
  5. Consider using a building standard. Such standards are already part of normal business practice in urban development, and adopting a standard with a clear health and well-being perspective is a simple way of taking the public health agenda on board.
  6. Identify metrics to measure your success. Maintaining a record of how contributions to health and well-being have been achieved, their costs and their benefits can help build the case for further engagement with the public health agenda.

Yvonne Rydin is Professor of Planning, Environment and Public Policy at the Bartlett School of Planning, University College London

Helen Pineo is Associate Director, Cities at BRE, and from September has been a lecturer in Sustainable and Healthy Built Environments at the Bartlett Faculty of the Built Environment, University College London

Further information