Health: A fresh view on an age-old city problem
As the Great Plague stalked the streets of Restoration London, the diarist John Evelyn had a vision. The city was making people ill. It needed to be rebuilt, with the health of the people as its guiding principle.
A little over 350 years later, the visionaries are at it again. “Covid is a stark reminder that our future cities have to recognise the risk of overcrowding and infectious diseases, as they did in that bygone era,” says Legal & General’s group chief executive, Dr Nigel Wilson.
Speaking as part of the EG Future of UK Cities event, Wilson says we need to place the greatest emphasis on health.
As the Great Plague stalked the streets of Restoration London, the diarist John Evelyn had a vision. The city was making people ill. It needed to be rebuilt, with the health of the people as its guiding principle.
A little over 350 years later, the visionaries are at it again. “Covid is a stark reminder that our future cities have to recognise the risk of overcrowding and infectious diseases, as they did in that bygone era,” says Legal & General’s group chief executive, Dr Nigel Wilson.
Speaking as part of the EG Future of UK Cities event, Wilson says we need to place the greatest emphasis on health.
“Covid has been a shocking wake-up call,” he says. “It has been a health crisis for older people and an economic crisis for the young.”
The challenge for today’s planners and builders of our future cities, he says, must include adapting to the ageing demographic and mitigating health inequalities, whether those relate to physical or mental health.
That requires nothing less than a complete reimagining of the industry. “We have to look beyond the bricks and mortar,” says Wilson. “Even beyond the pounds and pence to forge communities, placing the utmost value on people and their health.”
We still need cities
Fears of the death of cities have been overstated. “We will still be wanting to congregate in cities,” says Louise Ellison, group head of sustainability at Hammerson, “though maybe more for entertainment and leisure than work.”
[caption id="attachment_1057067" align="alignright" width="150"] Nigel Wilson[/caption]
The UK’s cities will continue to attract people, and that’s a good thing for health, says Savills’ urban design director, Andrew Raven. Evelyn had a point that overcrowding was contributing to disease in 17th century London, and the current social distancing has certainly been a reminder of that. But, pandemics aside, density is actually good for your health. “There is a direct correlation between density and physical exercise,” he states. Mental health is also improved in denser environments. Sometimes – but it has to be the right sort of environment.
And to do that right, Shoosmiths real estate division head Kirsten Hewson says we need to deliberately design healthy spaces. “Health inequality has to be part of looking at how our future cities look to develop. Part of that is about creating healthy spaces and places for people to be part of.”
Global retiring population
One aspect of this concerns the UK’s ageing population.
The oldest of the old is the fastest-growing group of all, Wilson points out. Indeed, by 2050 there will be an additional 9m of them – although by then, them will be us. “If global retirees were a country, they would be the third-largest economy in the world.”
It is a demographic that urban planning largely ignores. “We need more housing and a better choice across all tenures for older people,” Wilson says. But the old don’t just want “seaside cottages” in dozy hamlets. Former MP Mark Prisk agrees. “They want something suitable that enables them to access the facilities, the friends, family members that they can engage with.” They want to be in cities, but they want those cities to cater to them.
To do that, the industry needs to build multi-generational housing, mixed-age communities, retirement villages, supported housing for early-stage care needs and more formal care settings. And they need to be properly integrated into the communities.
And, Wilson adds, there is a net gain for all from this seemingly altruistic endeavour. “If we can get this right, we can address the housing crisis for the young, by freeing up homes that are currently under-occupied by older people who have no other choice. There is a huge amount of housing stock that needs to be recycled.”
Fix the problem for the old, and we go some way to helping the young. But more needs to be done. “Too many people enter ill health young,” says Wilson. “The built environment is a major influence, not just for older people.” Life expectancies can vary by 30 years from one postcode to another, within the same city.
Mental health must also be tackled, with cities “boasting” almost 40% higher risk of depression, 20% more anxiety, double the risk of schizophrenia and more loneliness, isolation and stress than other parts of the country.
To tackle this, Ellison says, we need to focus on the public realm and how we use “space and green space” more generally. “That really ties into mental health.”
But it isn’t all about parks and piazzas. We need to build in “respect for creative people and the importance of that within our economy”, Ellison adds. “Because that is going to be the driving force in the future, and it is hugely important for our health and wellbeing as humans.”
And if we think Covid-19 has wreaked havoc, “climate change risks being worse”, Wilson warns. “Public health and climate must be part of urban regeneration.”
Back in 1666, Evelyn nearly got his wish. The plague ended in London as the City burned to the ground. Evelyn submitted his plan for a healthy city of boulevards and wide open spaces, but his vision was dismissed and the pestilential rookeries returned.
That cannot be allowed to happen again. “We need to ensure that any investment improves the health outcomes by design not by accident,” says Wilson.
“This isn’t a new idea, but it is a matter of life and death.”
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