Benefits Beyond Health

When it comes to urban planning, we tend to look at competing interests: environmentalism versus economic development or affordability versus gentrification. But a building and design approach that prioritizes health can act as an entry point for promoting many other interests at the same time, said several speakers at the April 22 Urban/Health symposium. “It’s certainly my impression that health is one of those universal values—across cultures, across countries. How do we then take advantage of that?” asked Sandro Galea, MD, DrPH, Gelman Professor of Epidemiology and Chair of the Department of Epidemiology at Columbia’s Mailman School of Public Health, in reference to urban planning.

“When you look at the political context—politicians, communities, societies—often health is a very important value, but it is not the only value. People also care about issues like economic development, the environment, equity issues,” said Karen Lee, MD, senior adviser on the built environment and healthy housing at the New York City Department of Health and Mental Hygiene. “Finding synergies and co-benefits has been a critical part in terms of advancement of these issues in communities.”

Karen Lee

She pointed to the multiple benefits of New York City’s “pedestrianization” of Times Square, Herald Square, and Union Square where the city converted automobile lanes to pedestrian plazas with more walking space and seating. In addition to reducing traffic injuries and encouraging more physical activity, the urban makeovers have conferred economic benefits. In Union Square there has been a 49 percent drop in vacant storefronts, and for the first time, Times Square became one of the top ten retail areas in the world. In a similar vein, the city’s FRESH (Food Retail Expansion to Support Health) program has incentivized the building of grocery stores in parts of the city that were formerly food deserts, creating both new jobs and proximity to healthy food for residents.

In China, alarm over the economic effects of heavy air pollution has fueled concern from a government that historically has been lax on environmental regulation. “Businesses are paying a premium to send people to China because of air pollution concerns,” said Carlos Dora, MD, coordinator of the Interventions for Healthy Environments unit, part of the Department of Public Health and Environment at the World Health Organization. “We’re going to use air pollution as an entry point” to address issues like chronic disease and climate change, he added. A recent WHO study reported that one in eight people die because of air pollution globally.

By reducing use of cars, dense urban living better promotes sustainability. Even more so than green suburban living, said Vishaan Chakrabarti, AIA, the Marc Holliday Associate Professor of Real Estate Development at Columbia Graduate School of Architecture, Planning, and Preservation, and a partner at SHoP Architects.

Cities also promote a factor that he calls “public joy.” This can be seen in the many urban centers across the U.S. that are “creating extraordinary pieces of public landscape, public architecture, culture, waterfronts.”

People are seeking a walkable urban lifestyle free of long office commutes, which affords them “something that’s critical for health and joy, which is more time,” he said. “Most young people today are looking at that 20th century technology of that suburban house and that office park and trying to find a different way.”

Natalie Jeremijenko and Vishaan Chakrabarti

Illustrating Chakrabarti’s point that cities are home to all kinds of creative endeavors, Natalie Jeremijenko, PhD, an associate professor of art at New York University’s Steinhardt School of Culture, Education, and Human Development, spoke about her work as an artist and scientist who creates sustainable projects for urban environments. At her Environmental Health Clinic at NYU, she sees clients who tell her their environmental health concerns, and then works with them on projects to address them. Projects of hers include a Butterfly Bridge in Washington that gives the insects a bridge above traffic so that they do not meet untimely fates on car windshields.

She has also created various air collection devices like “solar chimneys” to collect air pollutants and filter the air. She has tried to work with the MTA to put a device on one of the system’s air vents but “for security reasons, I’ve been told that I can’t have access to it, which is a great way to say what the MTA is doing provides no filtration whatsoever.” She also runs an urban farm and says that this kind of agriculture is “the only non-technology we have for improving urban air quality.”

Such projects buttress the idea that the marriage of urban design and health can address a variety of concerns and provide a variety of benefits.

As Gina Lovasi, PhD, an assistant professor of epidemiology at the Columbia Mailman School of Public Health, said: “Cities that support health are going to be supporting our other social and economic goals and the kinds of lives we want to live.”