#54 - 13 November 2020

Active and healthy cities?

Protect: the city was built first and foremost as a rampart, against enemies from the outside and against a hostile nature... but also against enemies from the inside, such as epidemics. Leprosy, cholera, smallpox, measles, scarlet fever, typhoid, the plague, tuberculosis… These have shaped urban planning and city architecture, long seen as tools in the service of public health. The current health situation marked by the Covic-19 epidemic should not make us forget that modern medicine, its therapeutic innovations and its advanced technology have been remarkably effective in removing the danger of epidemics from the horizon. Neither should it lead us to underestimate the weight of a new type of epidemic, that of non-communicable and chronic diseases, known as “civilizational” diseases which can also represent co-morbidity factors likely to aggravate an infectious disease. The treatment of allergies, cancer, obesity, diabetes, cardiovascular and pulmonary diseases, mental disorders and mental illness represents a challenge both for medicine (the curative approach is proving insufficient) and for national economies, while the economic burden of these diseases is estimated to double over the next twenty years.

This new horizon of danger requires us to reexamine the link between health and the environment. Health is a complex concept that depends both on factors inherent to the individual (physiology, biology, mental or emotional state) and on factors related to his interactions with his environment (social, economic, cultural and spatial). Several socio-environmental and epidemiological studies have shown the role played by urbanization and associated lifestyles in the emergence of civilizational diseases. How can the environment be rethought to compensate for the potentially pathogenic effects of city life? The shift from a curative to an environmental health approach opens up some very interesting and promising avenues for action that are at the origin of a new way of considering urban planning and architecture: reduction of pollutants, nuisances and other deleterious agents, promotion of healthy behaviors in individuals (physical activity and healthy eating), facilitation of social cohesion, reduction of health inequalities and support for vulnerable people, strengthening of interdisciplinarity (particularly between urban planners, physicians and sociologists), involvement of all stakeholders, including citizens and, finally, synergy between different public policies (environmental, planning, health). However, can health be reduced to the mere absence of disease? Since 1946, the World Health Organization has defined it as “a state of complete physical, mental and social well-being” and as “a resource for daily life”. Can the ambition to compensate for the deleterious effects of urbanization be sufficient? Would not it be necessary to promote an approach no longer focused solely on pathology and risk factors, but rather a holistic and above all positive one? Could not work on urban morphology, the redevelopment of public spaces, the invention of new architectural forms, the construction of infrastructures and the development of new technical processes enable cities to be healthy?

While everyone agrees on the fact that we wish to live in an environment that will not harm health, more proactive positions should encourage caution: on the one hand because it is in fact difficult to establish proven mechanisms of positive causality between city and health; on the other hand, because the link between health and the environment is anything but neutral. At its heart lies a tension between the objective of preserving health and a hygienist injunction to the “good life”. The actions carried out in favor of indoor air quality clearly show this: centered on the adoption by the user of “good gestures” and “good behaviors”, the questions of industrial policies at the origin of indoor air pollution, of inequalities in the face of this public health problem as well as the question of our lifestyles leading to prolonged exposure to this risk factor are not addressed.

The issue raised by the question of healthy cities is that of the inhabitant. What is their place and role when we move away from a strictly individual conception of health to take into account that the influence of the environment on each individual’s health has a collective dimension? – Chloë Voisin-Bormuth, Director of Studies and Research

→ Related: our report about active and healthy cities just came out: discover it on our website (in French).


No time to read? La Fabrique de la Cité has got you covered.

A POLARIZED NATION – The results of the US presidential election show a widening political gap between large cities and rural areas in America. “Heavily urban areas have long been associated with larger shares of Democratic voting”, writes City Monitor, “but the results of this year’s election show that this relationship is becoming more extreme, with bigger swings in the vote towards the Democrats tending to occur in more densely populated counties.” – Marie Baléo, Head of Studies and Publications

– In response to the COVID-19 pandemic, the Dutch city aims not only to manage the health crisis but also to “boost the economy, strengthen climate resilience and enhance Rotterdammers’ health and well-being”. To this end, the city has designed seven new green public spaces, which will be presented during an upcoming seminar by the Centre for Liveable Cities on 19 November 2020. – Sarah Cosatto, Research Officer

→ Related: our interview of Carola Hein, professor at TU Delft, who analyzed the mechanisms of regional resilience in the Randstad, the metropolitan region of Rotterdam, Amsterdam, The Hague, and Utrecht.

FROM ONE METROPOLIS TO ANOTHER – In recent months, the possibility of an exodus of expats and executives from their homes in metropolises to the so-called “zoom towns” and other smaller cities has been debated. However, all global metropolises are not equally affected: when Singapore “has seen the biggest drop in luxury house prices, of 6.1% over the 12 months to October” mostly due to travel restrictions, Auckland, Zurich, or Manila have bucked the trend by gaining a lot of interest from wealthy buyers. – Sarah Cosatto

HEAT DATA FOR COOLER CITIES – This summer, the French city of Bordeaux witnessed over 50°F temperature gaps between its city-center and its parks. Urban heat islands also affect the city’s periphery and their business parks; however, the space between buildings as well as their size appear to have a mitigation effect. In that regard, digital measurement tools, like the one implemented in Bordeaux, which uses satellite data, may play a role in the elaboration of urban strategies for healthier cities. – Romain Morin, Research assistant

→ Related: our project about active and healthy cities.

CITIES AND TELECOMMUTING – In the United States, the generalization of remote work is the largest and fastest transformation the labor market has seen since World War II, and will produce massive change in cities. Most people are not simply moving out to the closest suburb near the office: instead, distances are growing between individuals’place of residence and place of work. – Camille Combe, Project Manager

→ Related: our issue brief “Behind the words: telecommuting”.

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