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The unexpected challenges of urban density on health

Mid-rise developments, like the new Wilanow district in Poland, have shown outstanding health statistics.

Both design and health professions are increasingly aware of how our environment impacts our wellbeing.

Concerns have evolved from sanitary conditions and communicable disease transmission in past centuries to an unprecedented increase in NCDs (non communicable diseases or “lifestyle diseases”) over the last few decades. Recent urban development patterns often fall into two extremes: horizontal sprawl and hyper density, with both producing new challenges to the health of inhabitants. The way we shape our environment, and consequently our lifestyles, has a significant impact on our wellbeing and longevity.

Low density urban sprawl is considered a precursor to health challenges associated with the increasingly sedentary lifestyles. Suburban environments built during recent decades on the edges of cities in many parts of the world make it increasingly difficult to walk, not to mention being active and fit. Low density single use districts too often collectively form a kind of “suburban cellulite” of disjointed development zones devoid of human scale at the neighbourhood or city level. Mixed-use programming, environmental and climatic sensitivity, along with human metrics, can largely offset the wellbeing challenge as was the case of the suburban Brisa-Damha Sergipe project in Brazil.

The Brisa-Damha Sergipe project in Brazil.

The Brisa-Damha Sergipe project in Brazil.

Life patterns in places like Dubai and Tokyo are extremely different – so are the health outcomes. Dubai, to an extreme, promotes a “modern” but sedentary life, so much so that diet can have almost no effect on peoples’ wellbeing rates. Mega block high-rise towers or suburban gated compounds create a place where cars are essential. Civic realms are limited to highways and shopping malls. Diabetes rates are among the highest in the world and approximately a third of the population is obese.

In contrast, Tokyo promotes a “modern” but active lifestyle. Though the world’s largest metropolitan area, it remains a series of interconnected villages that maintain a finer more human-scaled urban grain for living than Dubai. Most streets in Tokyo are “shared”: given over to pedestrians, bicycles and motorised vehicles in equal measure. People naturally walk on the street and regularly up and downstairs within their 2-3 level homes. It is no wonder that obesity rates are well below 10 per cent.

Asia has embarked on an unprecedented “verticalisation” of human habitat and workplaces. However, extreme high density environments, such as Hong Kong’s high-rise estates, create their own set of challenges to our wellbeing. While Hong Kong has avoided many of the problems created by low density urban sprawl, like the over-reliance on the automobile and the sedentary time that entails, it has created a city which “lives above the 15th floor”. The high and compact apartment units of Hong Kong have also engendered a more sedentary lifestyle for all ages because of the detachment from the ground plane to walk, play or even interact with neighbours. Not surprisingly, in addition to the isolation felt by many Hong Kong residents in such environments, studies in China have determined an increased likelihood of childhood obesity and diabetes amongst high-rise dwellers.

With the imperative to build high density environments during a period of unprecedented global urbanisation, a central question to our human wellbeing will be how we appropriately build high-rise buildings and neighbourhood clusters. During the sustainability studies of the Anderson Road Quarry site overlooking Hong Kong, AECOM reconsidered the human metric and lifestyle patterns of residents calculating their typical MET (metabolic equivalent of task) of residents of five different age groups to establish a basis for enhancing the new high-rise districts. Minimum interventions recommended the balance of services throughout the area and the replacements of lakes by lawns and the covering (though not enclosure) of hard sports surfaces to maximise their usefulness. The objective was to create active lifestyle patterns, to offset increased sedentary activities, like screen time, especially amongst youth.

Anderson Road Quarry MET overlays.

Anderson Road Quarry MET overlays.

Skip stop lift

Skip stop lift

More bold recommendations included incorporating activities and green space into the higher floors of structures to make them more accessible to the young and elderly as well as the incorporation of skipped landing for elevators that would require most residents to climb a flight of stairs several times a day, and encourage interaction with their neighbours. Such a stair strategy within units in high rises can also promote more active living patterns, mimicking what Tokyo does with individual homes.

Many urban settings still exist that provide a sustainable balance between density and wellbeing, but most of those cases comprise often overlooked compact mid-rise urban morphologies. Mid-rise developments, like the new Wilanow district in Poland, have shown outstanding health statistics after 10 years of inhabitation. Even though the area achieves a residential density of 10,000 people per square kilometre – three times the Warsaw city average – life expectancies are over 10 years higher than the national average and the highest in the city. Birthrates are the highest in the country while childhood obesity is very low.

People can live healthier lives within different urban settings, but each environment must be shaped with a focus on human metrics at both the building and district level.

Guy Perry is AECOM’s Asia Pacific executive director, Buildings & Places. He will be speaking at the Urban Development Institute of Australia NSW’s “Cities for the Future” Annual State Conference on Thursday 29 October.

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