From playful elements in street architecture in Cork, Ireland, to teaching children how to grow vegetables in Lisbon, Portugal, cities across Europe are using urban design and health interventions to promote the well-being of their populations.

Europe has a unique opportunity to make city life healthier since it has relatively few mega cities; more than 70% of Europeans live in cities with less than half a million inhabitants. 

These are some of the World Health Organization’s findings in a new report, “Urban design for health: inspiration for the use of urban design to promote physical activity and healthy diets in the WHO European Region,” published Wednesday and launched at the 11th Conference of HEPA Europe on health-enhancing physical activity in Nice, France. 

The report, prepared by the WHO European Office for the Prevention and Control of Noncommunicable Diseases, looks at ways to promote physical activity and healthy diets in urban settings.

Rather than simply telling people about the ‘right’ food choices and benefits of physical activity, cities can use better strategies to help people choose more wisely, the report suggests. Research has shown that design also plays a role in the health of communities around the world.

“If we want to make cities a better environment that helps people to live healthier lives, first we need to understand the people’s needs,” said Dr Kremlin Wickramasinghe, head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases.

“This will give us insights to integrate healthier habits into everyday lives effectively.”

Urban environment influences health 

The report says urban design and planning influence public health and human behaviour “by limiting or providing access to healthy foods and active lifestyles, which have profound effects on people’s physical and mental health.”

For instance, in the WHO European Region, environmental risk factors are estimated to cause at least 1.4 million deaths per year, approximately half of which are linked to air pollution, a major contributor to the rise in noncommunicable diseases (NCDs). One in four cases of ischaemic heart disease and strokes, and one in five cancers are estimated to result from environmental exposure.

These risk factors can be the result of inequalities in environment and health from different aspects of home and work life, including housing conditions and access to basic services and transport. 

Traffic tends to be greater in cities’ less affluent neighbourhoods, posing a greater risk of road-related injuries and exposure to air and noise pollution, which has implications for poor health and a higher incidence of NCDs.

That is why it is crucial, the report emphasizes, to find the best approaches to address these risk factors in urban settings: “Cities are places where it all comes together.”

Building connections with communities to facilitate healthy urban planning 

Wickramasinghe emphasizes that gathering data and building connections with local communities is “essential for healthier urban planning.”

WHO’s report presents several tools to facilitate this:

• collecting data on how people move around in a city
• identifying local food infrastructures that can improve food security
• estimating the economic benefits of healthier policies
• engaging various types of stakeholders, including citizens
• analyzing data for healthier urban planning

One such tool, called the healthy streets approach, uses an index for large-scale, long-term strategic planning to make improvements across ten indicators. 

The index has indicators for things such as how much clean air there is, whether the streets are easy to cross, and the degree to which everyone feels welcome.

The intent, the report says, is to make it easier for citizens to promote a healthy, safe neighborhood through “simple language that everyone can understand and relate to.”

Real-life examples from cities

Many cities are trying to improve urban transport and mobility, as well as access to urban nature and green spaces. The new report highlights some of the positive examples.

Cork, Ireland

As Cork is dominated by cars but lacking in green spaces, air quality was found to be a problem, in addition to limited outdoor spaces for physical activity. 

This city decided to introduce more playful elements into its street architecture by developing ten new “parklets” with entertainment equipment and seating. It also included a “playful culture trail” in July 2021 to encourage active, playful movement between and within the locations. 

Tbilisi, Georgia

Tblisi has a transport system that is not pedestrian-friendly and lacks buses and cycling infrastructure. Its car-dependent nature results in traffic congestion and air pollution. 

Additionally, pedestrian areas are considered possible only in tourist areas and are, therefore, not found in resident neighborhoods

To solve this problem, the city is transforming its streets to make them pedestrian-oriented. The new street design is meant to address the main challenges of Tbilisi: air quality, physical inactivity, and mental health.

Adam Mitskevichi Street, a pilot area, was closed down for a few days, to familiarize citizens with a different perception of how the street could be used. From the first hours of the street’s dedication to the public, children arrived with music and started dancing, and some people enjoyed cycling and skateboarding.

Lisbon, Portugal

Tapada da Ajuda, a green space in Lisbon, is located on hilly terrain, and its steep topography makes it difficult to ensure easy access for children. Additionally, the surrounding streets are not safe for children because cars are parked on some sidewalks.

In order to build more connections between local citizens, especially children, in the area, the city promotes healthy eating by putting local produce at the heart of its public space project, while teaching children how to grow vegetables and the importance of a healthy diet.

The tools and examples in the report highlight the types of actions that policy makers and urban planners can use for inspiration to rethink and improve their cities.

Cities in other parts of the world have also come up with other ways to promote health through urban planning and policy, including Buenos Aires, Argentina and Baku, Azerbijian, showing how urban design is crucial to long-term social and health benefits. 

“Urban design is a key determinant of physical activity and healthy diets,” the report concludes, “contributing to the prevention and control of NCDs and improving global health.”

Image Credits: WHO , WHO.