Designing a Healthier City

ETHOS Issue 26, Nov 2023

HOW URBAN DESIGN CONTRIBUTES TO PUBLIC HEALTH

In the context of many countries, when we speak of public health, what we mean is health in the city. The evolution of city design began in the 1900s precisely because the Industrial Revolution had brought about various health hazards, due to poor sanitation, pollution, poor infrastructure and so on. It led to thinking about how cities could be better planned.

Since then, cities such as Singapore have taken the notion of urban planning forward. When then Prime Minister Lee Kuan Yew advocated the Garden City concept, it wasn’t new, but it had not been implemented before on the city scale. He had argued that it was not only a way to attract investors but was also a way to care for citizens. This is something that we who live in this beautiful city take for granted today. We enjoy beautiful greenery and the convenience of good infrastructure. We know that human experience is shaped by our environment. But exactly how it does so is not really looked at or discussed. There is a science behind how our environment affects our health that we need to look at.

For instance, we are developing a research lab to look into the correlation between sustainability and human wellbeing. Envisioned as a ‘Positive City Lab’, our research highlights the potential of environmental design and systems to yield medium-term incentives and long-term positive impacts, and to achieve balance and prosperity in both ecological and human health.

TOWARDS A POSITIVE CITY LAB

Our lab's research encompasses three domains:

	Data Science Unravelling correlations between environmental attributes, sustainable planning, and physical, mental and social wellbeing.
	Citizen Science Engaging in design ethnography to assess communities practising climate positive actions and their wellbeing impacts.
	Generative Design Crafting radical design proposals and future scenarios planning embodying Positive Urbanism, informed by insights from the data and citizen science.

We cannot talk about environment wellness without first addressing the issue of sustainability, which is more urgent and complex than just trying to create a beautiful urban setting. We can no longer discuss development as an output that costs how many billion dollars to build, because we also have to consider the carbon emissions involved in building. Ultimately, we would want to lower emissions for people’s good. So, we have to address sustainability at the same time as trying to talk about enhancing our urban environment. In the past, we built non-stop to achieve development in a short time, and also built up our carbon footprint rapidly. Today, we have to balance that.

DESIGNING FOR HUMAN WELLBEING AT DIFFERENT SCALES

How might we apply urban design to enhance human wellbeing and health? We can think of it as a series of challenges to work on at different scales.

First, the overall city scale. In the past, it was all well and good to separate our urban functions based on zoning, with industry separate from housing and so on. But one outcome of this separation was also to create more carbon emissions from road traffic and transport. So urban planners, including private sector developers who handle large tracts of land, should think about what new paradigm or model can be created to strike a balance between the separation of functions or users and lowering the carbon emissions from the movement of goods and services.

Next, we can look at design at the building scale. In 2017, Harvard T. H. Chan School of Public Health did a study on the impact of green buildings' indoor environment on cognitive function.¹ The study found that those working in high performing certified green buildings had 26.4% higher cognitive test scores. There were also other significant benefits: including better sleep, thermal comfort and lower sickness symptoms. Since my transition from industry to the Singapore University of Technology and Design, I have seen the great potential of using science-based approaches to evaluate the outcome of sustainability features in a building on its human occupants. It would be timely to resume such studies now, particularly with the development of better, smarter environmental sensors and better ways with which to measure human performance in spaces. We could look at the impact of factors such as lighting, ventilation, air-conditioning and so on, on human performance and wellbeing. This is paramount because we spend over 90% of our time inside buildings: we should consider how best to ensure we function optimally in them.

Finally, we can go down to the product scale. There are many things we can do to improve health and performance with innovation. For example, you have phone accessibility functions to increase the legible size of text, or to support hearing. There could be devices to help people struggling to bring strollers or wheelchairs up stairs, sidewalks or buses. The list goes on.

DESIGNING FOR HEALTH: KEY PRINCIPLES

One general principle we need to bear in mind in our innovations is human centricity. In other words, we start with the human needs to be met, instead of with the cost in mind. Thinking about cost is a common mindset, especially where profit is a key driver. That is not to say that it is not an important consideration. But without having human centricity at the core of whatever we are trying to achieve, our reasoning becomes lopsided.

We often also forget there are alternative paradigms to the status quo. For instance, the COVID pandemic taught us that we can in fact abandon the city and work from home on a massive scale. Since that is the case, we should perhaps take stock of our actual office space needs. We may save a lot of resources instead of building offices unnecessarily.

A third principle is that being human centric could bring benefits across the board, because people are healthier and work more optimally if their unique individual needs are catered to, rather than making them adopt a one-size-fits-all model of living or working. The problem has been that the technology to viably meet all these different needs at scale was not available in the past.

We should look carefully at how to harness the potential of powerful new tools, such as artificial intelligence, to meet these diverse needs more readily. This means that instead of adopting human centricity for a small, select group of people, we could use AI to provide very detailed mass customisation, so that the system as a whole is efficient and less wasteful. For example, with the right use of AI, we might now be able to generate hundreds or thousands of design possibilities quickly, that could be coupled with robotics and rapid prototyping to make personalised products—say, shoes or furniture—that are tailored to the specific needs of thousands of different users.

In terms of urban design, we are accustomed to thinking of buildings in terms of fixed and moveable assets—but what if we could apply AI and robotics so buildings themselves adapt to human needs? It is now possible to consider how we might thus make buildings safer, more comfortable, and more supportive of human health, wellbeing and performance. Indeed, SUTD started a degree course called Design & AI two years ago, and while the batch has yet to graduate, we are starting to see experiments to use AI to help achieve better sustainability and health outcomes. For example, some students designed an app powered by AI that lets users self-examine their posture when lifting weights in order to make corrections for better health. In another project, students will be using AI to design more sustainable and better performance indoor spaces for a human-centric outcome.

INNOVATING URBAN DESIGN FOR HUMAN WELLBEING IN THE PUBLIC SECTOR

Today, there are thousands of cities in the world, with potentially 60% to 70% of the global population living in them. While the prospect of creating brand new cities as testbeds for new ideas is exciting, the more practical and meaningful move is to innovate within existing urban environments.

There are many possibilities in urban innovation, but many are challenging for a number of reasons. For example, the concept of car-free or car-light cities requires drastic change in transport behaviour connected to zoning. I personally favour firstly a significant improvement of human spaces or the pedestrian realm. Despite the value of nature, not many cities have embarked on total greening of their physical environment. Successful partial examples are usually found in first world economies. But for cities that do not have the financial means to transform themselves, greening pedestrian spaces is a good place to start.

For instance, in Singapore, the successful implementation of Park Connectors by NParks demonstrates a simple and yet effective way to achieve a few objectives synergistically. It combines under-utilised remnant spaces in a linear fashion to join different parts of the city, resulting in hundreds of kilometres of park spaces. Today, many use the park connectors as alternative ways to commute between home and work. If we can extend the same concept to dramatically improve all walking spaces in a city by turning them into park-like settings, it will fundamentally alter urban ambience and behavioural patterns. Spaces that could be connected in a park-like fashion include sidewalks, tunnels, overhead bridges and any spaces likely to be used by people. As more people are enticed to walk, run or cycle, human health is likely to improve significantly. The urban environment will be more conducive for human beings to live, work and play.

To further improve health and wellbeing, the park-like concept could be extended to buildings, which are microcosms of cities. Buildings comprise occupied spaces and movement spaces such as corridors and stairs. At present, most of these spaces are sparsely utilitarian. Without compromising on function, we could create healthier buildings by making these neutral spaces greener. Such initiatives could start with public sector buildings such as schools, hospitals, transport hubs and public housing. I would go so far to say that environments that are conducive for plants are also conducive for human wellbeing.

The above are suggestions on how we could, in small ways, revolutionise our built environment. These efforts do not require excessive budget increases or fundamental alterations of urban structure. Such efforts are more often held back by legacy mindsets. It is time to set aside the outmoded notion that cities are most vibrant when there is no nature in sight. Instead, nature should be seen as a force multiplier for the growth of a city in terms of the three aspects of sustainability: social, economic and environmental.

It may be a stretch to try for holistically human-centric cities overnight. Hence, I propose small, fast and effective changes at a system level like what Singapore’s pioneers have opted for—integrating the city with nature, with a range of immediate and longer-term benefits, and ultimately happier, healthier inhabitants.