What have buildings got to do with health?

 There's a growing body of evidence that the environment around us very directly affects our health.  The recent Foresight  report on obesity talks about the way neighbourhood design affects how much exercise people take.  If shops and schools are nearby, many people will walk or cycle - if they have to travel miles, they may have little choice but to take motorised transport.  Hence human-scale neighbourhoods instead of vast suburbs with no amenities may help people to keep active.

We also need to look at ways of keeping people safe.  The design of our communities needs to balance the needs of people and traffic. Over 4,000 children and 8,000 adults are killed or seriously injured every year by cars or lorries while walking or cycling. The higher the traffic volume, the less time people spend outside.

If planning routinely included pedestrianised areas, traffic calming measures and wider pavements all pedestrians would feel more comfortable, and the very young and very old in particular would not find it risky to go out.

People also need somewhere within walking distance to go.  There has been a tendency for suburbs and dormer towns to be built with large areas all given over to the same use.  Identikit residential housing stretches for miles, interspersed with industrial areas with huge strobe-lit supermarkets, surrounded by vast car parks.   Community is naturally eroded by such anonymous developments, and with it the sense of inclusion and safety that comes from knowing your neighbours. 

Even when we are inside, the view from our windows may affect our health.  Dr Roger Ulrich has done groundbreaking work indicating that patients are like to recover more quickly from surgery if they have access to morning sunlight and a good view from their window.  Living in an unremitting concrete jungle may therefore increase our stress levels.  Very high-density housing has also been associated with increased crime. 

Alliances for better cities
 
There is some sign that the relationships needed to create better cities in the future are beginning to form.  The Department of Health has released draft guidance to help authorities judge the health impacts of their plans for using space.  The University of the West of England is beginning to include health in the curriculum for built environment students.  Some of the big architecture organisations including the Royal Institute of British Architects are spreading the word about the effect of buildings on health. 
 
As with visiting a GP, there is room here for collaboration between the expert and ordinary citizen.  The Prince’s Foundation for the Built Environment is an architecture trust that asks residents what kind of place they want to live in as a part of their planning process.  They report that the act of listening can often greatly change their plans, and that local people become enthusiastic about projects when their views have been taken into account.
 
It is cheering to see that, at best, there's a convergence of opinion between researchers, scientists, policy makers and architects.  But it is still an open question whether these promising beginnings will be enough to make a radical difference.  Without decisive action, we may end up with a few 'showhome' examples of excellent practice, and a majority of monotonous suburbs duplicating the mistakes of the past.