Healthy Urban Planning Research Articles

Whose Health in Whose City? A Systems Thinking Approach to Support and Evaluate Plans, Policies, and Strategies for Lasting Urban Health

An increasing interest has been present in scientific literature and policy making for the links between urban environments and health, as also learnt from the COVID-19 pandemic. Collaboration between urban planning and public health is therefore critical for enhancing the capabilities of a city to promote the well-being of its people. However, what leverage potential for urban health can be found in existing plans, policies, and strategies that address urban health? Starting from the relationship between urban systems and health issues, the purpose of this contribution is to broaden the systemic knowledge of urban systems and health so as to try to figure out the impact potential of local urban governance on public health. Considering the systemic nature of health issues, as defined by the World Health Organisation, this is done through a systems thinking epistemological approach. Urban health proposals are studied and assessed in four European cities (Copenhagen, London, Berlin, and Vienna). Current criticalities are found, starting from the guiding goal of such proposals, yet a systemic approach is suggested aimed at supporting and evaluating lasting and healthy urban planning and management strategies.

Spatial disparities of self-reported COVID-19 cases and influencing factors in Wuhan, China.

The lack of detailed COVID-19 cases at a fine spatial resolution restricts the investigation of spatial disparities of its attack rate. Here, we collected nearly one thousand self-reported cases from a social media platform during the early stage of COVID-19 epidemic in Wuhan, China. We used kernel density estimation (KDE) to explore spatial disparities of epidemic intensity and adopted geographically weighted regression (GWR) model to quantify influences of population dynamics, transportation, and social interactions on COVID-19 epidemic. Results show that self-reported COVID-19 cases concentrated in commercial centers and populous residential areas. Blocks with higher population density, higher aging rate, more metro stations, more main roads, and more commercial point-of-interests (POIs) have a higher density of COVID-19 cases. These five explanatory variables explain 76% variance of self-reported cases using an OLS model. Commercial POIs have the strongest influence, which increase COVID-19 cases by 28% with one standard deviation increase. The GWR model performs better than OLS model with the adjusted R2 of 0.96. Spatial heterogeneities of coefficients in the GWR model show that influencing factors play different roles in diverse communities. We further discussed potential implications for the healthy city and urban planning for the sustainable development of cities.

Healthy Design and Urban Planning Strategies framing the SDG 11 Sustainable Cities and Communities

Abstract According to the “Urban Health Rome Declaration” at European meeting “G7 Health” that defines the strategic aspects and actions to improve Public Health into the cities, and referring to the Agenda 2030 in which the 11th SDG argue about “Sustainable Cities and Communities. Make cities and human settlements inclusive, safe, resilient and sustainable”, one of the most expressive syntheses of the challenging relationship between urban planning and Public Health is stated by WHO (2016): “Health is the precondition of urban sustainable development and the first priority for urban planners”. Referring to the Healthy Cities & Urban Health definitions, we can consider Public Health not merely an aspect of health protection and promotion, but an individual and collective condition, strongly influenced by the environmental context and by the strategies implemented by local Governments. The “Health in All Policies” strategy, clearly underlines how health doesn't depend only on the supply of the healthcare services, but also, on the quality of outdoor and indoor living environments. Aim of the Presentation 3 is the share the findings of a literature review about the link between the urban contexts' morphological and functional features; the results are divided into: 14 Health Outcomes, representing the main Non-Communicable Diseases (NCDs) whose come from the urban environment's quality and by the adoption of healthy lifestyles; 8 types of Environmental Risk Factors (Urban Heat Island Effect; soil/air/acoustic/light pollution; vehicular traffic; Safety & Security; weak attractiveness of places); and 14 Healthy Urban Planning Strategies (green/blue/grey infrastructures; biodiversity protection; adverse meteoric events management; public transport systems; vehicular traffic reduction; pedestrian and cycling paths; social and functional mix; urban solid waste's management; renewable energy and efficiency; outdoor spaces lighting; Design for All).

10.E. Workshop: SDGs as a roadmap for Citizens, Environment and Public Health

Abstract Sustainability, especially in an era of growth health inequality, is one of the most important challenges facing health systems around the world. Environmental sustainability is responsibly interacting with the planet to maintain natural resources and not jeopardize the ability for future generations to meet their needs. The SDGs put environmental sustainability at the center of sustainable development. Environmental health is the branch of public health concerning all aspects of the natural and built environment affecting human health. It is targeted towards preventing disease and creating health-supportive environments. It encompasses the assessment and control of those environmental factors that can potentially affect health, as pollution, poverty and inadequate energy solution. Urban health is an intersectoral arena that links both the public health and the urban planning sectors, mainly captured by SDG3 and SDG11. Cities as human settlements, recognizes the transformative power of urbanization and represents a pivotal step to empower cities., and making a city “smarter”. Cities as human settlements, recognizes the transformative power of urbanization and represents a pivotal step to empower cities., and making a city “smarter”. There is a tight relationship between the concepts of environmental health and urban health. Urban health could be considered as a complex system since it deals with 15 out of 17 SDGs. Huge global changes are occurring on our planet in natural and urban environments. The ongoing pandemic of COVID-19 is a strong reminder that urbanization has changed the way that people and communities live, work, and interact, and it is necessary to boost actions and policies aimed to transform our cities into healthier and “salutogenic” living environments.We shoudn't exclude energy issues -SDG 7, and presence of increasing poverty SDG1 in urban areas. It is essential to redesign the concept of public health in relation to the built environment and the contemporary cities adopting healthy urban planning and design strategies. The environment interacts with technology by providing the resources needed for technological development and is affected by the environmental impact of technology. Artificial intelligence (AI) might impact all aspects of sustainable development goals influencing the ability to meet all SDGs. Benefits from AI could be derived by the possibility of analyzing large-scale interconnected databases to develop joint actions focused on preserving the environment. The AI-based algorithms are now going beyond the provision of urban services and the maintenance of urban infrastructure, entering the realms of urban governance, planning, health, and safety. Thus, it is essential to leverage on the potential of AI and digital technologies in addressing the complex challenges of urban health. Smart Cities and AI brings a multidisciplinary, integrated approach, examining how the digital and physical worlds are converging. Key messages In pledging to achieve the SDGs, countries need to organize Urban Health initiatives to improve the built, social, economic, and physical environments promoting health and sustainability globally. Governments, private sector, civil societies and citizens alike to allow cities to become inclusive, safer, resilient and sustainable, which are driving forces to implement the development equation.

Assessing the association between lifetime exposure to greenspace and early childhood development and the mediation effects of air pollution and noise in Canada: a population-based birth cohort study

Exposure to greenspace is associated with improved childhood development, but the pathways behind this relationship are insufficiently understood. Therefore, we aimed to investigate the association between lifetime residential exposure to greenspace and early childhood development and evaluate the extent to which this association is mediated by reductions in traffic-related air pollution and noise. This population-based birth cohort study comprised singleton births in Metro Vancouver, BC, Canada, between April 1, 2000, and Dec 31, 2005. Children and mothers had to be registered with the mandatory provincial health insurance programme, Medical Services Plan, and have lived within the study area from the child's birth to the time of outcome assessment. Early childhood development was assessed via teacher ratings on the Early Development Instrument (EDI), and we used the total EDI score as the primary outcome variable. We estimated greenspace using percentage vegetation derived from spectral unmixing of annual Landsat satellite image composites. Lifetime residential exposure to greenspace was estimated as the mean of annual percentage vegetation values within 250 m of participants' residential postal codes. Multilevel modelling, adjusted for eight covariates, was used to investigate associations between greenspace exposure and EDI scores. We estimated the mediation effects of nitrogen dioxide (NO2), fine particulate matter (PM2·5), and noise levels using causal mediation analyses. Of the 37 745 children born in Metro Vancouver between April 1, 2000, and Dec 31, 2005, 27 372 were included in our final study sample. In the adjusted model, 1 IQR increase in percentage vegetation was associated with a 0·16 (95% CI 0·04-0·28; p=0·0073) increase in total EDI score, indicating small improvements in early childhood development. We estimated that 97·1% (95% CI 43·0-396·0), 29·5% (12·0-117·0), and 35·2% (17·9-139·0) of the association was mediated through reductions in NO2, PM2·5, and noise, respectively. Increased exposure to residential greenspace might improve childhood development by reducing the adverse developmental effects of traffic-related exposures, especially NO2 air pollution. Our study supports the implementation of healthy urban planning and green infrastructure interventions. Canadian Institutes of Health Research.

A health political science for health promotion.

If health promotion as a field of change for human and ecological health is to maintain its urgency, it needs to continue building its policy credentials. This paper charts the development of policy as a concern for IUHE/IUHPE (International Union for Health Education/International Union for Health Promotion and Education) from the mid-1970s when 'health education policies' were prominent issues, to the launch of Healthy Public Policy (in the 1980s) and Health in All Policy (in the 2000s). We argue that solid conceptual and theoretical foundations exist to frame and develop the relevance and connectedness of health promotion more prominently. We start off with a brief introduction into (health) political science, and then illustrate the urgency of the argument with three case studies. The first takes a critical realist perspective on 'closing the gap' in Australian Indigenous populations. With recent evidence it demonstrates that the core of the policymaking process needs to re-align itself with an Indigenous narrative. The second case study reviews the politics of healthy urban planning and health equity in cities. Taking a critical theory institutionalist view, the case describes how the political and narrative parallels between urban theory and health equity have gone underexplored. With an explicit gaze to connect the two, the field could become a large and influential driver of enhanced health promotion and public health policy. The third case describes the languages, policy frames, and distinctions, in four urban/health paradigms. It shows that unconscious policy and practice bias exists in policy priorities and processes. We conclude with observations and recommendations on the role of health promotion as a conceptual realm and field of activity. We show that all health promoters should be aware of the political nature of their enterprise. Tools and analyses exist to help further action.

Bibliometric Analysis and Research Trend Forecast of Healthy Urban Planning for 40 Years (1981-2020).

The history of healthy city planning can be traced back to the beginning of the 19th century. Since the industrialization period, the harsh living conditions of cities and the outbreak of infectious diseases have promoted the coordinated development of urban planning and public health, and people have gradually realized the importance of urban design and planning to the health of residents. After searching keywords related to health city and urban planning, and excluding repeated, non-English, and unrelated papers, this work retrieved 2582 documents as the basic data (timespan is 1 January 1981–31 December 2020, retrieval time is 28 January 2021). Additionally, CiteSpace was used to analyze document co-citation, cooperation network, and topic co-occurrence. Subsequently, random forest algorithm was used to predict the probability of citation. Overall, this work found that the hot spots of healthy urban planning are physical activity, green space, urban green space, and mental health. It also shows the diversification of themes and the development trend of cross-fields in the field of healthy urban planning. In addition, the article found that two factors, namely, the average number of citations of the first author and whether the article belongs to the field of environmental research, have a great impact on the number of citations of the article. This work is of practical significance to relevant practitioners and researchers, because it provides guidance for hot topics and future research directions in the field of healthy urban planning.

The Association Between Cumulative Lifetime Exposure to Greenspace and Early Childhood Development – Is the Relation Mediated by Reduction in Air Pollution and Noise?

Background: Greenspace exposure is associated with improved childhood development, yet the pathways behind this relation are insufficiently understood. Here, we investigated the association between lifetime residential exposure to greenspace and early childhood development and evaluated the extent to which this association was mediated by reductions in traffic-related air pollution and noise. Methods: In a large population-based birth cohort in Metro Vancouver, Canada (n=27,593), early childhood development was assessed via teacher-ratings on the Early Development Instrument (EDI) (mean age = 5·6 years). Greenspace was estimated using vegetation percentage derived from spectral unmixing of annual Landsat satellite-image composites. Lifetime residential exposure to greenspace (from birth to time of EDI assessment) was estimated as the mean of annual vegetation percentage values within 250 m of participants’ residential postal code. Multilevel modeling was used to investigate associations between greenspace exposure and EDI scores. The mediation effects of NO2, PM2.5, and noise levels were estimated using causal mediation analyses. Findings: In adjusted models, one interquartile range increase in vegetation percentage was associated with a 0·16 increase in EDI score (95% CI: 0·03, 0·29), indicating small improvements in early childhood development. 86·6%, 20·6%, and 37·3% of the association was mediated through reductions of NO2, PM2.5, and noise exposure levels, respectively. Interpretation: Increased residential greenspace exposure may improve childhood development by reducing the adverse developmental effects of traffic-related exposures, especially NO2 air pollution. This study contributes to knowledge of pathways between greenspace exposure and childhood development and supports healthy urban planning. Funding Information: This work was supported by the Canadian Institute of Health Research (grant reference number: 156152). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: Ethics approval for this study was granted by the University of British Columbia Behavioral Research Ethics Board (certificate H18-00908).

Development of Synthetic Health Records to Support Urban Planning for Healthy Aging

Urban planning for healthy ageing is about planning for ageing population, which considers the needs of older adults and communities during the planning process and the implications of decisions for human health and well-being. However, access to real electronic health record (EHR) data is hindered by legal, privacy, security, and intellectual property restrictions. The lack of freely distributable health records become one important issue for healthy ageing urban planning. This research develops a source of synthetic health records based on reviewed and meta-analysed evidence on the association between built environmental characteristics related to lifestyle chronic diseases for urban planning. Type 2 Diabetes Mellitus (T2DM) is used as a case study for proof of concept. This research methodology includes three steps: 1) Review and meta-analyse of the individual and built environmental variables related to the prevalence of T2DM. 2) Develop agent-based modelling and simulation for synthetic health records. 3) Evaluate the simulation result with standard healthcare file format in Geographic Information System (GIS) application. The pilot validation compares the annual prevalence of T2DM by age group and ethnicity with the public available health data. The simulation results roughly approximate age, gender and racial group at diagnosis curves (R2 = 0.876), it correctly generated more than 90% of patients for the all age group in Singapore. As a summary, these pilot validated synthetic records could be used as a risk-free (no privacy & security issues) data for supporting urban planning for healthy ageing.

Walkability as the key element of urban planning within the Healthy Cities concept (systematic review)

The purpose of the study. The purpose of this work is the exploration and generalization of scientific researches on walkability to determine its advantages as an element of public policy in human-centered cities. Over the past fifty years, the world community has actively discussed the issue of healthy and sustainable urban development planning, which has gained particular relevance with the recent World Health Organization publication of the “Healthy Cities: An Effective Approach to a Rapidly Changing World” concept (2020). One of the Healthy Cities approach goals is to promote healthy urban planning and design centered on human well-being (unlike prevalent in the past vehicle orientation), and the main component of such planning is pedestrianization or walkability. The systematic reviews and meta-analyses reporting method (PRISMA) were used in the review. The search was carried out in the bibliographic databases Elibrary, PubMed, MEDLINE, Scopus, Google Scholar. The study of the structure, types, and relationship between pedestrianization and the type of urban planning revealed the global advantages of creating walkable areas, such as maintaining the physical, mental and social health of citizens, increasing social capital, and improving the city’s ecological and economic atmosphere. Conclusion. Thus the promoting walkability was concluded to be a public policy as a relatively simple and highly effective way to benefit in the short, medium, and long term. This fact ultimately makes pedestrianization one of the most important tools for healthy urban planning and design.

The three paradigms on urban health

Abstract Background While public health and urban planning share a historical connection in the mid-19th century, when public health and sanitation became a key guiding principle for urban planning, the two disciplines evolved in separate ways after major technological and social developments such as the development of germ theory and the ascent of biomedicine. Recently, urban planners and public health experts globally are calling for a reconnection between the health and urban planning spheres. However, there are different schools of thought around how to address health in the urban context that originates from different worldviews and epistemological traditions of the disciplines. Methods This study is a narrative review that explores the core beliefs and assumptions of the different research traditions that are observed around health in the urban context. Results The study identifies three main traditions. The 'urban health science' tradition is characterized by the pathogenic and epidemiological analysis of urban problems, suggesting predominantly technological solutions to these issues. Scholars of this tradition emphasize that urban health requires straight Cartesian causal thinking to inform interventions to promote the health of urban populations. The 'healthy cities movement' tradition is based on the principles of the Ottawa Charter for Health Promotion with strong roots in social movements, and takes a value-based approach to solutions that embraces the principles of solidarity, equity, sustainability and empowerment. While these two traditions originate from the discipline of public health, the third 'healthy urban planning' tradition emerged from the urban planning discipline and proposes to include health as objectives in the spatial development of cities. Conclusions This study identifies the core beliefs and assumptions of the paradigms of urban health and highlights areas where beliefs and assumptions epistemologically or practically overlap and interface. Key messages Scholars from different epistemological traditions possess different worldview on the problem definition and solution to urban health. The three paradigms on urban health are not mutually exclusive, rather each could learn from each other to promote the health of urban citizens.

Urbanization and greenness in HBSC survey: association with life satisfaction and health complaints

Abstract Background Several studies have shown that neighborhood greenness is associated with lower problematic behaviors in children and better perceived well being. While urbanization showed opposite results. The aim of the study was to assess the relationship between urbanization and greenness levels with perceived health, life satisfaction and health complaints on adolescents. Methods The study is based on data from 2018 Health Behavior in School-aged Children in the region of Piedmont(Italy), which involved 3022 11-,13-,15-year olds, sampled in 122 schools across the region. Every school was georeferenced. Greenneess was measured by Normalised Difference Vegetation Index (NDVI-satellite images) and urbanization by population density, traffic intensity (satellite measurements) and air pollution concentration (sampling stations). Health complaints were evaluated with a set of 8 psychosomatic symptoms(reported more than once a week). Life Satisfaction (LS) was measured by using the Cantril scale (low LS < 5, high LS > =6). Self-Rated Health was measured by means of a four points scale (fair or poor, good or excellent). Results More than 66% of adolescents reported frequent health complaints; 11% declared low life-satisfaction and 9% of adolescents scored poor or fair self-rated health. The proportion of the three variables increased with age in both genders, and was higher among girls. Gender differences increased from 11- to 15-years of age. Preliminary results showed a positive association between greenness and life satisfaction, urbanization and health complaints. Conclusions In times of increasing urbanization and reduced availability of green areas, characterizing the association between urbanization, greenness and perceived health is revealed to be the challenge for Public Health. Redefine the urban spaces accordingly requires collaboration between different disciplines. Coherently with the recent studies, communities can be actively involved through qualitative approaches. Key messages The topic of urban nature is becoming central for healthy and sustainable urban planning, not the least for population groups like adolescents and children. The relation between urbanization, with decreasing access to green spaces, and the impact on physical as well as mental health presents an important issue and a big challenge for Public Health.

Incorporating practitioner knowledge to test and improve a new conceptual framework for healthy urban design and planning

ABSTRACT There are increasing arguments for bridging diverse knowledges and co-producing new knowledge between researchers, professional communities and citizens to create health-promoting built environments. The new THRIVES Framework (Towards Healthy uRbanism: InclusiVe, Equitable, Sustainable) echoes the call that healthy urbanism processes should be participatory and this principle informed the development of the Framework itself, which involved several stages of informal and formal testing with stakeholders, through a process of action research and ‘extended peer review’. Formal feedback about the design of the preliminary Framework and its implementation in built environment practice was gathered through a participatory workshop with 26 built environment and public health professionals in January 2020. Participants were encouraged to share their knowledge, ask questions, critique and provide recommendations. Overall, participants were supportive of the conceptual messages of the THRIVES Framework and more critical of the visual design of the preliminary version. They also questioned whether further resources would be required to implement the Framework. This research created a forum for stakeholders, who may typically be outside the research process, to shape the development of a conceptual framework for healthy urbanism. Further research and collaboration will create resources to bridge the gap between this new conceptualisation and practice.

Green space indicators in a social-ecological system: A case study of Varanasi, India

From an ecological perspective, quantification indicators of urban green space distribution and accessibility have been the focus of only a few studies. To determine the thresholds of various urban drivers influencing the extent of green spaces was the major objective of this study. We selected Varanasi, a typical city having transition-features of a rapidly growing million-plus city, as a model using a multivariate approach. The ward level differences with literates, workers, population density, household density, per-capita green space, open spaces, built area and green spaces were found to be non-linearly distributed. Indicators for green spaces were identified using the Generalized Additive Model (GAM). Varanasi showed a variation of per capita green-spaces from 0 to 59.95 m2 at the ward level. Green-spaces showed a large negative correlation with population density (τ = −0.5), household density (τ = −0.5) and built area (τ = −0.7). Sustainability thresholds for built land use and open spaces were identified as 49–76 % and 5.6 %, respectively. Provision of greenspaces even in very small amounts and education based on a local environmental perspective is essential in creating a sustainable urban landscape. The threshold values of identified indicators can help in devising a “safe operating space” for sustainable and healthy urban landscape planning, worldwide.

Developing a participatory approach to building a coalition of transdisciplinary actors for healthy urban planning in African cities - a case study of Douala, Cameroon

ABSTRACT Africa is undergoing rapid urbanisation with migration into informal settlements. Exposure to these environments is associated with a rise in infectious and non-communicable diseases. Addressing these urban health challenges will require collaboration across sectors that influence health. However, the siloed nature of policymaking means that little is known about the barriers and facilitators of integrated intersectoral policy approaches for improving health through urban planning and development. Furthermore, the transdisciplinary research methodological approaches to establishing intersectoral collaboration are not well documented in Africa. We utilised participatory methods to engage a variety of stakeholders in the co-design and conduct of a transdisciplinary workshop. Through co-development processes, this workshop was designed to explore stakeholder perspectives on urban health priorities in Douala municipalities and experiences of intersectoral collaboration. We describe the process and experience of co-creation of the workshop agenda between academic, policy, private and civil society partners. We further present stakeholder experiences of intersectoral collaboration prior to the workshop, convey their understanding of the urban drivers of ill health, and discuss perspectives on strategies to mitigate these health risks through human settlement intervention. This study documents the development of a participatory transdisciplinary approach to urban health in rapidly urbanising Africa.

Healthy urban planning: an institutional policy analysis of strategic planning in Sydney, Australia.

Healthy urban planning: an institutional policy analysis of strategic planning in Sydney, Australia.

Healthy urban planning: an institutional policy analysis of strategic planning in Sydney, Australia.

Rapid urbanization requires health promotion practitioners to understand and engage with strategic city planning. This policy analysis research investigated how and why health was taken up into strategic land use planning in Sydney, Australia, between 2013 and 2018. This qualitative study develops two case studies of consecutive instances of strategic planning in Sydney. Data collection was done via in-depth stakeholder interviews (n = 11) and documentary analysis. Data collection and analysis revolved around core categories underpinning policy institutions (actors, structures, ideas, governance and power) to develop an explanatory narrative of the progress of 'health' in policy discourse over the study period. The two strategic planning efforts shifted in policy discourse. In the earlier plan, 'healthy built environments' was positioned as a strategic direction, but without a mandate for action the emphasis was lost in an economic growth agenda. The second effort shifted that agenda to ecological sustainability, a core aspect of which was 'Liveability', having greater potential for health promotion. However, 'health' remained underdeveloped as a core driver for city planning remaining without an institutional mandate. Instead, infrastructure coordination was the defining strategic city problem and this paradigm defaulted to emphasizing 'health precincts' rather than positioning health as core for the city. This research demonstrates the utility in institutional analysis to understanding positioning health promotion in city planning. Despite potential shifts in policy discourse and a more sophisticated approach to planning holistically, the challenge remains of embedding health within the institutional mandates driving city planning.

The role of urban design in childhood obesity: A case study in Lisbon, Portugal.

We hypothesize that physical features of the urban environment might enhance or prevent childhood obesity. Thus, this study's main goal was to verify if there is an association between the neighborhood urban design and childhood obesity-independent of well-known childhood obesity determinants, such as, father's level of schooling (as a proxy for socioeconomic status), and parent's weight status. This study classifies neighborhoods according to land use and building features using hierarchical clusters analysis and examines their association with childhood obesity through logistic regression models. Four clusters resulted from the analysis: Cluster 1 represents areas with older buildings and mixed land use, cluster 2 is an area with small rented buildings and urban areas, cluster 3 comprises newer buildings with parking and urban green space, and cluster 4 is a forest area. Living in cluster 3 protects from childhood obesity, even when adjusting for father's level of schooling or parent's weight status. There are distinct urban configurations in Lisbon's municipality and children who live in Cluster 3 (more recent and greener neighborhoods) seem to be protected from obesity. Therefore, public policy should focus on healthy urban planning at the neighborhood level, to promote positive impacts on peoples' health.

Healthy Design and Urban Planning Strategies, Actions, and Policy to Achieve Salutogenic Cities.

Starting from a previous experience carried out by the working group “Building and Environmental Hygiene” of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a “Healthy and Salutogenic City”, which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

The relationship between buildings and health: a systematic review.

BackgroundThe built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed.MethodThis study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies.ResultsIn total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links.ConclusionThis review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn.