When medicine meets architecture: why urban planning is key to promoting health and wellbeing

As the world economy grows and cities continue to expand, it becomes increasingly important to address health issues in the context of the urban environment. Not surprisingly, the World Health Organisation has highlighted health as a precondition of sustainable urban development and the first priority for planners. The characteristics of the urban context can be linked to risk factors such as sedentarity and Non-Communicable Diseases (NCDs), which pose major threats to people’s health. It is therefore essential to develop urban planning strategies that exert a positive impact on people’s wellbeing and contribute to the promotion of a healthy lifestyle. The latest scientific literature and recent research conducted at the Design & Health Lab, Department ABC of Politecnico di Milano, show that three factors, in particular, significantly improve the urban environment and, in turn, people’s health: green spaces, digitalisation and inclusive design

Workshop: Urban Green Spaces, Built Environment and Urban - Mental - Environmental Health outcomes

Environmental sustainability, especially in an era of growth health inequality, is one of the most important challenges facing Public 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, such as pollution, poverty and inadequate energy solutions. Urban Health is an intersectoral arena that links both the public health and the urban planning sectors, mainly captured by SDG3 (including Mental health) and SDG11. Both during the first waves of the Covid-19 pandemic period and in contemporary cities, urban environments were stressed; the resilience of our cities were tested, highlighting the strengths and weaknesses of the urban contexts, not always capable to pro-mote and protect the population health status. Urban Green Spaces (UGS) have proved essential role as ‘‘tools’’ to improve Urban Public and Mental Health. Unfortunately, the heterogeneous distribution of UGS inside the contemporary cities, together with the disparity in quality of such spaces, led to some exclusion phenomena. Evidence/experience-based research strongly demonstrated the positive effects on Public Health of the UGS, and for this reason, they are now becoming the strategic and challenging issue of many urban regeneration programs. The importance of UGS as a key infrastructure has generated the necessity of developing new health-centered design criteria able to conform to their new role in urban environments. The augmentation of UGS surface alone, does not necessarily make cities more livable. An increase in area and surfaces does not translate in ease of accessibility from all social groups or from all the cities’ neighborhoods, or not does it give data on the qualities of such areas, like potential for social engagement or Physical Activity. Aim of the Workshop - organized by the three EUPHA Section URB+MEN+ENV - it would like to be to build the capacity and knowledge between participants about the main topics and urban features capable to have relevant Urban Public, Mental and Environmental Health outcomes. Additional scope is to collected case studies and research experiences considered virtuous at the international level, analyzed in detail to highlight the main urban and architectural features of those healthy experiences and the related health outcomes, such as sedentary lifestyle reduction, increase of the attractiveness of places, reduction of air and noise pollution

Workshop: The city of proximity: Accessible, Inclusive, Sustainable, Healthy and Salutogenic

According to the ‘‘Urban Health Rome Declaration’’ at European meeting ‘‘G7 Health’’ that defines the strategic aspects and actions to improve Urban, Environmental and Public Mental 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 individual health protection and promotion, but a 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 depend by the quality of outdoor and indoor living environments. In this scenario, healthy living and the requirements for healthy places, infrastructure for the public good and Public Health, cycling, walking, disintegrating the role of polluting traffic from the urban environments, social vulnerability and equality are just a few aspects in complex puzzle when designing the urban spaces for healthy, active, walkable cities. The lockdown due to the pandemic has prevented travels, forcing many people to work at home and reducing the possibility of accessing services in the territory. This condition has further highlighted the importance of urban living areas capable of satisfying basic needs within a reasonably easy range of accessibility. The concept of the ‘‘15 minutes city’’ is a useful vision to represent the city of proximity, where it is possible to meet the needs for sustainable, fair, quality, and healthy living. This dimension of proximity can be central to formulating strategies to improve the quality of urban life. A place of proximity, therefore not only defined based on the physical characteristics and people’s uses, but also based on the data collected from a public health perspective in which it is also possible to try to test different types of information and build the conditions to suggest suitable policies and projects. Aim of the Workshop - organized by the two EUPHA Section URB+ENV - it would like to be to build the capacity and knowledge between participants about the main topics and urban features capable to have relevant Urban Public and Environmental Health outcomes. Additional scope is to collected case studies and research experiences considered virtuous at the international level, analyzed in detail to highlight the main urban and architectural features of those healthy experiences and the related health outcomes, such as sedentary lifestyle reduction, increase of the attractiveness of places, reduction of air and noise pollution

(Re)thinking the city of proximity for Salutogenic purposes.

As centres of population and human activities, nowadays urban environments are simultaneously the main cause of and solution to a growing number of health-related challenges. In this setting, COVID-19 pandemic has helped reiterate this and serves as a wake-up call and an opportunity to rethink the way we approach cities. Aim of this paper is to research what today seems the most promising urban model for long-term individual and global resilience: the ‘‘city of proximity’’, namely about inclusive walkable and cycling environments where people can access all basic destinations within reason- able times and distances from home. Therefore, urban proximity dimension, methodological approach and urban features and functions become the main subject of a quanti- qualitative matrix of comparison of five international case studies centred on the topic, by which it is possible to set out general criteria for such model, along with a methodology to measure all cities in its respect. As a result, residential density, functional mix, pedestrian surface, cycle routes, public transport stops, green areas, schools, cultural facilities, sport facilities, retail services and urban gardens make up the fix components of a comprehensive set of 11+n urban features, whose occurrence is investigated through GIS-based analysis within designated distance ranges, creating a comprehensive assessment framework that is adjustable to all urban contexts worldwide. In the end, the application of such framework to the city of Milan finally helps to validate its effectiveness in providing a picture of city-wide accessibility to proximity services, and in highlighting the value of integrated analysis in view of shaping public policies and informed planning choices which put health and sustainability at the centre

Explorative Study on Urban Public Space Renovation during COVID-19: Test of a Visual Web-Based Survey about the City of Saint German en Laye, France

Background: The complex socio-epidemiological situation caused by the COVID-19 pandemic forced cities to rapidly adapt to new prevention distancing measures. Several interventions have been made but specific tools are needed to rapidly verify the suitability of such design proposals. This study aims to describe the process of development and testing of a visual web-based survey to assess potential user feedback on Urban Public Space renovation for the city of Saint Germain-En-Laye (SGL), France during the pandemic. The renovation included pedestrianization strategies for the city center and the design and installation of new street furniture. Method: After an exploration of the literature and stakeholder interaction, an online survey composed of three sections and seven questions evaluating the project was developed to rapidly validate the design solution before its actual installation and compare the pre- and post-situation trough visual insights on a 5-point Likert scale. Data was collected through a Google Form and analyzed with descriptive statistics. Results: We received 371 full replies from Italian and French respondents. The survey results showed that the Urban Public Space proposal improved the baseline situation for different reasons, such as safety, sustainability, and accessibility. In fact, Solution A (the existing situation) obtained an average score of 2.08 while Solution B (the design solution) obtained 4.13. Conclusions: The features identified allowed for timely comparisons and possible insights, and the approach can be implemented in other medium-sized European cities dealing with Urban Public Space transformation during COVID-19

Can Homes Affect Well-Being? A Scoping Review among Housing Conditions, Indoor Environmental Quality, and Mental Health Outcomes

The purpose of the scoping review is to explore the relationship between housing conditions, indoor environmental quality (IEQ), and mental health implications on human well-being. In fact, time spent at home increased due to the recent COVID-19 lockdown period, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. This scoping review, conducted on the electronic database Scopus, led to the identification of 366 articles. This, after the screening processes based on the inclusion criteria, led to the final inclusion of 31 papers related specifically to the OECD area. The review allowed the identification of five housing conditions [house type, age, and floor level; housing qualities; household composition; neighborhood; green spaces] that, by influencing the IEQ parameters, had impacts on the mental health outcomes addressed. By synthesizing the contributions of the review, a list of design recommendations has been provided. These will serve as a basis for future researchers, from which to develop measures to reduce inequalities in housing by making them healthier, more resilient, and salutogenic

Measuring the expected increase in cycling in the city of Milan and evaluating the positive effects on the population’s health status: a Community-Based Urban Planning experience

BACKGROUND: It's scientifically known that inactivity is one of the major risk factors for Non-Communicable Diseases. One of the elements affecting the choice of transport mode, regarding circulation in the city, is the cities' urban morphology, i.e. the infrastructural facilities for the slow mobility service. Cyclability, in fact, can help to increase daily physical activity level, therefore becoming a protective factor for individual health. METHODS: After a literature review about the state of the art regarding the correlation between built environment, active transport and quantification of the physical activity level, we have developed a specific questionnaire to collect information about current and forecast use of bicycle, in case of improvement and implementation of the cycling network. The questionnaire also investigated social and health aspects concerning the anamnesis of the interviewees (age, gender, health status, sport activity performed, etc) and users' opinions about existing infrastructure and planned interventions, designed to promote cycling mobility. Aim of the research was to quantify the increase of physical activity people would have realized in front of an improvement of the specific infrastructures, and the expected positive effects in terms of health. RESULTS: The collected data (343 interviewed in a district of Milan, named "Zona 7") demonstrate that through the implementation of the cycle network, there would be more cyclists to practice the 150 minutes weekly of physical activity recommended by WHO: time spent in cycling, indeed, would increases by 34.4% compared to the current level of cyclability, as detected by our survey. CONCLUSIONS: The investigation confirmed that urban interventions, especially those in small-scale, could play a key role in the promotion of healthy lifestyles, inducing therefore important positive effects on the population health. It was also carried out an application of the WHO "Health Economic Assessment Tool" to evaluate the benefits in terms of Non-Communicable Diseases' reduction, specifically a provisional quantification of deaths saved

Challenges in IAQ for Indoor Spaces: A Comparison of the Reference Guideline Values of Indoor Air Pollutants from the Governments and International Institutions

Since people spend most of their time inside buildings, indoor air quality (IAQ) remains a highlighted topic to ensure in the built environment to improve public health, especially for vulnerable users. To achieve a better indoor environment quality (IEQ), some countries’ governments or regional institutions have developed and published reference guideline values of various air pollutants to prevent the IAQ from becoming adverse to occupants. Beyond guidelines by World Health Organization (WHO), in some countries, there are specific institutional requirements on the IAQ, and others integrated it into the building regulation for the built environment. This paper is based on the literature research, summarized from previously conducted works by the authors, on the chemical reference values of IAQ-related regulations and guidelines published by several Governments or related institutions from various regions around the World. Despite these efforts at standardization and legislation, many indoor air quality monitoring activities conducted in several countries still fall short of the main indications produced. By comparing the reference values of 35 pollutants, both physical and chemical ones, which are proposed in documents from 23 regions included so far, the IAQ research and prevention actions on progress in different regions should be included in monitoring plans with guidelines/reference values in their current state. The outcome of the paper is to define the current trends and suggest some perspectives on the field of interest for improving the indoor air quality of generic spaces at an international level. It becomes evident that, at the global level, IAQ represents a complex political, social, and health challenge, which still suffers from the absence of a systematic and harmonized approach. This is not a new situation; the issue was raised more than 40 years ago, and despite efforts and a pandemic, the situation has not changed

Feasibility and Affordability of Low-Cost Air Sensors with Internet of Things for Indoor Air Quality Monitoring in Residential Buildings: Systematic Review on Sensor Information and Residential Applications, with Experience-Based Discussions

In residential buildings that are private, autonomous, and occupied spaces for most of the time, it is necessary to maintain good indoor air quality (IAQ), especially when there are children, elderly, or other vulnerable users. Within the development of sensors, their low-cost features with adequate accuracy and reliability, as well as Internet of Things applications, make them affordable, flexible, and feasible even for ordinary occupants to guarantee IAQ monitoring in their homes. This systematic review searched papers based on Scopus and Web of Science databases about the Low-Cost Sensors (LCS) and IoT applications in residential IAQ research, and 23 studies were included with targeted research contents. The review highlights several aspects of the active monitoring strategies in residential buildings, including the following: (1) Applying existing appropriate sensors and their target pollutants; (2) Applying micro-controller unit selection; (3) Sensors and devices’ costs and their monitoring applications; (4) Data collection and storage methods; (5) LCS calibration methods in applications. In addition, the review also discussed some possible solutions and limitations of LCS applications in residential buildings based on the applications from the included works and past device development experiences