How Good Design Can Improve Public Health
Claudia Carol in Health & Wellness, Urban Planning

Willowbrook MLK Wellness Community Health Park. Image © Gensler

By the year 2050, a staggering 70 percent of the planet’s population will live in urban areas. That rate of change holds significant ramifications, not the least of which is that Non-Communicable Diseases (NCDs) are the leading cause of death globally and will be proportionately represented in growing cities. NCDs pose a significant risk to these burgeoning populations. To protect the health of the global population, we must mitigate the spread of NCDs in dense urban centers by applying scalable design strategies that prioritize our emotional and physical wellness.

Densification has already begun to transform our collective approach to well-being. No longer is “wellness” solely associated with exercise and fitness; everywhere, well-being is being re-framed as a holistic lifestyle defined by a heightened state of mental and physical wellness.

In recent times (as well as historically) a strong relationship exists between the design of the built urban environment and public well-being. Improved sanitation requirements, building regulations, and the development of hospitals and health care systems significantly reduced epidemics of cholera, tuberculosis, and other contagious health threats that plagued cities in 19th and early 20th centuries.

During the 21st century, however, these threats to public health have been replaced by a different epidemic: a significant rise in the percentage of adults living with chronic health conditions such as obesity and diabetes. Studies indicate these instances of NCDs are related to lifestyle choices such as inactivity and unhealthy eating habits, resulting in diseases that are both debilitating and expensive.

There are other obvious diseases associated with urban health. Problems associated with emotional well-being are associated with living in the city—people living in cities have a 21 percent increased risk of anxiety disorders and a 39 percent increased risk of mood disorders. Similarly, the impacts of poor health in urban workplaces are enormous. Employers bear the costs which stem from lost productivity and absenteeism. This alone provides a compelling argument for addressing the well-being of employees through scalable solutions aimed at reversing unhealthy lifestyles.

As planners, designers and architects, we can bring about a meaningful improvement in the general well-being of our society by designing physical environment that promote healthier lifestyles. We must approach well-being as an integrated lifestyle that affects all aspects of life in the city. Design professionals can address health and wellness for urban dwellers both at work, and outside of work. These two realms are converging to support the larger goal of total well-being.

Wellbeing in the Workplace. Image © Gensler

As a result, design is evolving to address well-being at multiple scales, ranging from city-wide transformations at a macro scale to integrating well-being design into the work environment at the micro scale. The idea that design can positively influence a person’s well-being is starting to transcend every project typology. A codified set of ideals and drivers embedded in design strategies and priorities are being incorporated into newly adopted health elements of general plans in cities throughout the United States. These health elements consider the emotional and physical well-being of urban dwellers as a function of the man-made environment. They incorporate various design responses, active design, social connectivity, and transit for instance, that make a significant difference on our holistic well-being.

At the urban scale, increasing activity by improving walkability and offering alternative modes of transportation are fundamental strategies for combating the growing global epidemic of obesity, heart disease, and diabetes. There is also a strong correlation between physical design and social capital. Dense urban cores increase access to cultural centers, transportation, amenities and retail services, which have shown to increase happiness overall. The evolution of transit oriented design to transit oriented healthy development, a concept initiated by Gensler Los Angeles Planning & Urban Design, formalizes a structure for implementing these concepts at a range of scales. Not surprisingly, the workplace has emerged as a testing ground for incorporating well-being design strategies at a smaller scale. Whether by encouraging movement and physical activity, providing healthy food options, or instilling a sense of engagement to increase produc¬tivity, developers and employers in growing numbers have started to embrace the notion that well-being design can positively shape the work environment. Nowhere is this better showcased than at major medical campuses. The Willowbrook MLK Wellness Community around the MLK Medical Center Campus in South Los Angeles is a great example of using wellness as the centerpiece for future development.

The direct correlation between workplace productiv¬ity, well-being, and the city will only evolve as more of the planet’s population moves to the urban cores. As more people move to cities, it is our responsibility, as employers, designers, architects and urban planners alike, to consider and prioritize wellness elements within the design of the workplace and the cities we inhabit to eliminate lifestyle diseases. Solving the health epidemic of chronic disease requires an integrated approach to health and wellness that looks not only at the resident or at the worker, but also at the entire person. Well-being is not a state; it’s a lifestyle. Our cities, buildings and workplaces, at all scales, must evolve to support healthy lifestyles.

Claudia Carol is the planning and urban design practice area leader of Gensler’s southwest region, with over 25 years of architectural and planning experience ranging from schools and universities to healthcare campuses to mixed-use developments and hospitality projects. Her delight in the urban environment encompasses both the built and experiential aspects of our cities. Contact Claudia at
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