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2023 | Buch

Design for Health

Proceedings of the UIA World Congress of Architects Copenhagen 2023

herausgegeben von: Arif Hasan, Christian Benimana, Mette Ramsgaard Thomsen, Martin Tamke

Verlag: Springer International Publishing

Buchreihe : Sustainable Development Goals Series


Über dieses Buch

The book provides new perspectives from leading researchers accentuating and examining the central role of the built environment in conceiving and implementing multifaceted solutions to the complex challenges of physical and mental health, revealing critical potentials for architecture and design to contribute in more informed and long-term ways to the urgent transition of our society. The volume book offers a compilation of peer-reviewed papers that uniquely connects knowledge and criticality broadly across practice and academia; from new technologies, theories, and methods to community -engaged practice on many scales, and more.

The book is part of a series of six volumes that explore the agency of the built environment in relation to the SDGs through new research conducted by leading researchers. The series is led by editors Mette Ramsgaard Thomsen and Martin Tamke in collaboration with the theme editors:

- Design for Climate Adaptation: Billie Faircloth and Maibritt Pedersen Zari

- Design for Rethinking Resources: Carlo Ratti and Mette Ramsgaard Thomsen (Eds.)

- Design for Resilient Communities: Anna Rubbo and Juan Du (Eds.)

- Design for Health: Arif Hasan and Christian Benimana (Eds.)

- Design for Inclusivity: Magda Mostafa and Ruth Baumeister (Eds.)

- Design for Partnerships for Change: Sandi Hilal and Merve Bedir (Eds.)



Land, Water, Economy and Health

Chapter 1. Urban Regeneration and Green Spaces System: São Paulo Metropolitan Area

This paper aims to reflect about urban green spaces role as an important regeneration element to restore urban landscapes in a decline process. The urban landscape is understood here as an interactive system between natural processes and human impacts. The study object is an area located in Guarulhos city, belonging to São Paulo metropolitan area and surrounded by important infrastructures, as Guarulhos international airport and Dutra regional highway. The area also contains established precarious settlements on protected floodplains; unqualified green spaces and riverbanks in process of illegal settlements; and a lack of basic sanitation services and silted streams that contribute to the floods occurrence in a local and metropolitan dimension. The study attempts to mitigate the conflict between infrastructure, environment and social dimension, which are so precariously articulated in this urban landscape, through a system of strategically planned green spaces, in order to achieve urban and metropolitan sustainability goals. Based on theoretical support, cartography and empirical observations, it aims to understand the logic of this territorial occupation and also recognize, recover and integrate urban green areas in order to set an urban plan proposal. Finally, the paper tries to achieve population better quality of life, reduction a local and regional environmental impacts and political awareness to set public policies able to regenerate this territory in a process of urban and environmental decline.

Daniela Maria Eigenheer
Chapter 2. Water Efficiency Strategies for Improving Sustainability in Social Housing: Comparative Analysis Between Cairo and São-Paulo

Water shortage is a major problem in many megacities, especially those in developing countries; its impact is largely felt in the residential sector, particularly social housing. This study introduces a framework for assessing water efficiency in social housing projects to measure the effectiveness of using water conservation strategies. This study also addresses the relation between the water efficiency in such projects and the urban water situation in their countries. The research methodology involves a comparative study of two megacities, Cairo and São Paulo, which are facing increasing water challenges. The comparison focuses on one social housing project in each city to study the opportunities for improving water efficiency and the challenges affecting water efficiency in each project. Water use reduction calculators are used to provide indications about water consumption. The assessments show that the average water consumption/person in the case study of Cairo is 67% higher than the average water consumption/person in the case study of São Paulo due to the differences in the adopted water strategies and the water use behaviors. Results also show that reducing costs while developing social housing projects isn’t the optimal solution, as water conservation could be of greater value in the long-term. Thus, water conservation must be considered from the early stages of planning and design of social housing projects.

Esraa Elazab, Ahmed Eltawil
Chapter 3. Sustainable Infrastructure and Water Strategies for a Resilient Addis Ababa (Ethiopia)

The capital of Ethiopia, Addis Ababa, is one of the fastest-growing cities today, experiencing rapid urbanization over the past few decades. The city’s population has almost doubled from 2.7 million in 2007 to around 4 million today. With such unprecedented growth, sustainable development in the city has been compromised as existing infrastructures struggle to keep up, leaving much of the urban population with a lack of access to basic public services. With that, the network of rivers that run through Addis Ababa has deteriorated as modernization has increased pollution and the overall degradation of river ecologies. Coupled with the rising threat of climate change, inhabitants who live along those rivers increasingly suffer from flooding and other issues related to worsening weather patterns. This paper details the outcomes of the “Addis Ababa River City” research project, which seeks to resolve some of the most urgent urban issues that the city currently faces due to rapid growth. Within it, urban issues are analyzed, and holistic solutions are proposed to create a more resilient city and to improve the relationship that Addis Ababa has with its rivers. The interventions introduced in this paper serve as examples of what can be done to improve infrastructures throughout the city, applying ecological engineering with hybrid infrastructures that work in tandem to enhance sociocultural programs and reinforce the natural dynamics of the city’s rivers.

Ruben Garcia Rubio, Alec Paulson, Sonsoles Vela Navarro
Chapter 4. New Water Village Planning Model: Preserving Ocean Biodiversity for Community’s Health and Well-Being

Malaysia is one of the eleven countries in Southeast Asia. Long-term sewerage pollution is a source damaging 90% of coral reeves by 2050. Decades of untreated sewage pollution also exposes children living at water settlements to water-borne diseases. This paper proposes a new water village planning model for Malaysia which could empower the local community to pay for sanitation management through architectural provisions, hence could generate ecotourism revenue. This study combines results from three earlier studies on Lok Urai, a water village located in East Malaysia. From these studies, incorporation of ISTP wastewater treatment tanks must come with viable economic activities; the architectural solution must include related microarchitecture to support homestay activities; and the local community desires to develop a homestay program to improve their livelihood. The architectural aim is creating opportunities for water villagers to self-finance Lok Urai’s sanitation provision and maintenance. This study posits that microarchitecture for small enterprises and combined with a well-planned homestay program are suitable amenities to attract tourists to stay with local families at Lok Urai. The proposed model consists of 98 housing units planned with twelve clusters of homestay units that will support the community to pay for their sanitation management and stop sewage pollution from spreading water-borne diseases. A viable water village model is replicable to 25,000 islands in Southeast Asia.

Muhammad Adham Nor Efenday, Rahinah Ibrahim, Harhamsah Hairal, Anna Kamelia Kamarudin
Chapter 5. Age Distribution and Accessibility to Green Areas in the City of Copenhagen

This paper presents an analysis of the distribution of urban spaces, parks, and other green areas in the City of Copenhagen in relation to demographic indicators, notably concerning population density and the spatial concentration of different age groups. The broad health benefits provided by urban greenery to urban dwellers are well documented in urban studies. The aim of this paper is to further contribute to this scholarship through the analysis of accessibility to green spaces by different age groups and in this way to shed light on their opportunities for health enhancing physical activity in the urban environment. The analysis is part of an ongoing study of urban density mapping based on a collaboration with the City of Copenhagen. The analysis of distribution of green spaces is based on several datasets, including location of major green spaces and parks, location, and radius of individual trees and NDVI index. The Copenhagen Municipal Plan 2019 proposes to increase social equity through physical and mental health-promoting urban planning and through provision of good quality green public spaces. The analysis shows that vulnerable groups such as the older population (≥ 65-year-olds) are not particularly challenged in terms of accessibility to green spaces. Based on this analysis, the authors formulate urban policy recommendations for meeting the targets for healthy living set by the City of Copenhagen.

Gustavo Ribeiro, Aleksander Nowak
Chapter 6. Study on the Complexity of Urban Waterfront Interface from the Perspective of Restorative Experience

Against the backdrop of rapid urbanization and pandemic, how to alleviate the increasing mental health problems of people in high-density cities has become an important challenge for urban sustainable development. This paper proposes new perspective and method to re-examine urban public space in order to explore the ability of built environment to support residents’ restorative experience. Waterfront public space, a typical restorative environment in high-density cities, is selected as the research object to explore the impact of urban waterfront interface on peoples’ restorative experience. It is pointed out that the restorative experience preference related to waterfront interface is likely to depend on the mixture of formal characteristics and content of waterfront interface, and this complexity can be defined from three dimensions, skyline silhouette complexity, and variance in building facades and interface color. On this basis, the quantitative analysis methods of each dimension are proposed, and the support capacity of different complexity dimensions to people's restorative experience is analyzed with the help of regression model. Based on the analysis results, the study finds that compared with the internal environment elements, urban waterfront urban interface is a more restorative element; ΔH and ΔH /ΔL of main landmark, first layer building facades visual proportion, diversity of building façades, and color diversity are the key factors affecting the level of waterfront restorative experience. The suggestions to develop a healthy urban waterfront environment are provided.

Chengzhe Lyu, Chunxia Yang
Chapter 7. Health, the Circular Economy, and Our Built Environment

Covid-19 rapidly highlighted the significance of good public health, similarly, showing that our built environment is crucial in responding to global challenges. Through the lens of Building Back Better, and with a continued focus on health, this paper presents a literature and rapid scoping review examining the extent to which the relationship between our Health, the circular economy, and our Built Environment has recently been investigated. Building Back Better is a future risk mitigation strategy focused on establishing resilient communities. Circular economy has been explored as one such vehicle towards developing economic, social, and environmental resiliency. Circular economy is a systems’ solution framework, aimed at breaking the linear ‘extract, use, dispose’ model. Circular economic advantages are largely emphasised from the perspective of effective and sustainable production and consumption: with the ramifications for health receiving comparatively little attention. Despite this, a circular transition may offer potentially considerable health benefits, while simultaneously contributing societal resiliency, and numerous UN Sustainable Development Goals. The study finds that the implications of the circular economy on health are largely under-explored and highlights significant gaps in the literature regarding the health outcomes of a transition to a circular economy in the built environment. It concludes that while the circular economy presents a viable option for building resilience, it also calls for more systematic investigation to fully understand the potential health and social impacts of circular transition in the built environment. The paper also notes that the uptake of the circular economy remains relatively slow and further research is required to understand its social and health impacts.

Tiago Da Costa Vasconcelos

Health as Consequence of Design

Chapter 8. Analysis of Spatial Elements Affecting Human Thermal Perception and Thermal Landscape Design

The energy consumption and carbon emissions for indoor heating and cooling in the building field are getting higher and higher. At the same time, the steady thermal environment regulated by equipment for a long time is not only harmful to the health of users but also reduces the energy utilization rate. Therefore, from the perspective of space combination and detail design, the paper analyzes the six spatial elements of human body heat perception, including space material, color, scale, shape, natural proportion, and human flow density. Breaks through the traditional design method of thermal environment, but from the perspective of space thermal perception analysis puts forward landscape design method, respectively, attraction, for the space diversity, energy saving and guides the architect in the thermal environment design and energy-saving building design, coordination of thermal environment, space combination, the relationship between the thermal perception, make buildings more energy efficient, make people healthier.

Zhuoyu Yu, Dexuan Song
Chapter 9. Design as Loom: Interweaving Health with Nurturing Care. A Visual Essay on Two Early Childhood Development Centres in Eastern Zambia as Architectures of Health

Through a visual essay, the authors argue that health needs to be understood not simply as a medical result, but should instead be the evidence of a holistic attention to care for all, where the physical and conceptual framework of any infrastructure plays a pivotal role in creating the conditions for a planetary well-being. This is evidenced in the narrative of their experience in enabling a collective and participatory design and build process for two pilot early childhood development (ECD) hubs in remote villages in Eastern Zambia. Initiated by a programme launched by UNICEF Zambia in support of the country’s Government Seventh National Development Plan, the architectural response proposes the construction of social landscapes of care, benefitting existing cultural practices, bringing new spatial perspectives, and augmenting educational and agricultural capacities. Conceived of as a ribbon of meandering structures, interweaving health with nurturing care, each centre becomes the anchoring point for societal change. Here services are delivered, promoting resilience and social transformation, using a language of scarce material resources, planting the seeds for an evolving, living ecosystem. One marker of the success of the scheme presented has been its replication in eight other sites since 2020, as a lead up to developing national guidelines for ECD centres in the country.

Tomà Berlanda, Sunniva Berlanda Viking
Chapter 10. The Effect of the Front Porch and Loft on Natural Ventilation of the Main House in Beijing Courtyard

Since urban development began, Beijing courtyard homes have struggled with issues like population growth, renewal and renovation, and a lack of available housing. While the population is growing, the size of the original house remains intact for the occupants. In light of this incremental growth, the primary methods of remodeling the main house involve advancing the exterior wall, making use of the front porch to expand the living space, and adding a loft at height of approximately 6–7 m on the hard roof of the room, with stairs or climbing ladders connecting the upper and lower levels. However, despite the fact that ventilation is crucial to the home's indoor environmental condition, the designers did not give it enough consideration before the restoration. The goal of this essay is to investigate the effects—both good and bad—of two variations on the quadrangle's front porch and loft designs on the patterns of indoor ventilation. The comparative analysis approach is employed as the primary method in the study, with the front porch and loft serving as two variables to examine the internal ventilation of four distinct building models using computational fluid dynamics (CFD) techniques. The sectional airflow study and the 1.5 m height cloud in plane results show that the loft isolates the indoor airflow organization to some extent and makes the high interior windows less effective. Although the effect of occupying the front porch on ventilation is not significant, other effects on aspects other than ventilation need further study.

Zhongzhong Zeng, Zichen Liang
Chapter 11. Cities Designed in Human Scale Make Healthier and Happier Societies: A Visual Essay

Cities are built for humans. Yet most modern cities fail to keep it human centric. With challenges of constant population growth, limited land availability, most cities are now adopting the high-rise model. Vertical cities may resolve the above challenges to some extent; however, they do not represent human scale. Most often these forms of development have led to social exclusion, fewer interaction opportunities with neighbors which increased feelings of loneliness among residents. Research states that loneliness can affect mental health and overall well-being of humans. Along with other social factors, architecture and urban design play a huge role in achieving the much needed social sustainability, which is one of the main pillars of ‘sustainable cities & communities’ (the 11th SDG of the UN Agenda 2030). On the one hand, researchers are talking about place making for humans, the importance of public spaces and happier cities. On the other hand, modern urban design is creating concrete giants with a total disregard for human connections. In India, most cities present a combination of urban environments with low to mid-rise residential developments in older neighborhoods and high-rise high-density developments in newer planned parts. This visual essay attempts to compare the human scale attained through the built environment between ‘high-rise’ and ‘low to mid-rise’ neighborhoods in Kolkata and analyze their impact on social sustainability.

Shreya Das
Chapter 12. Designing a Rehabilitation Center for People with Physical Disabilities: Social Sustainability-Climatic Approach Interaction in Tehran

Human society is a combination of diverse strata and people with physical disabilities are also an integral part of society. In the past, this group and their needs and challenges they are faced with have been neglected due to lack of knowledge, lack of facilities as well as technology that has led to their low presence in society. One of the most important components of social sustainability is improving life quality, removing discrimination and ensuring individual independence and social identity. Therefore, the society should provide equal opportunities to everyone in the first step, and in the next step, there should be the right of individual choice for everyone independently. Health, efficiency and satisfaction in work and the feeling of human comfort are largely dependent on environmental physical criteria. The stable physical environment, which is the result of complex factors such as ventilation, temperature, lighting, acoustics and installation systems, directly affects people's work ability. Despite the many researches that have been done in the field of providing indoor thermal comfort for the general public, still few researches have focused on special people such as the elderly, the sick and people with physical disabilities. Accordingly, the aim of this study is to achieve a model of design using the definition of architecture and social sustainability and its application to meet the needs of these people, such a center that can be designed in one of the crowded areas of Tehran city to address the challenges these marginal groups are faced with.

Mona Sadeghian, Seyedeh Negar Seyedmahmoudbaraghani, Mehrnoosh Sherafat
Chapter 13. Using Co-benefits of Sustainable Building to Drive Net Zero Emissions in Southeast Asia: Findings of Two Evidence-Informed Stakeholder Dialogues

Co-benefits of sustainable building are rarely used to promote policy reform. Two stakeholder dialogues were convened by Monash University, Australia in collaboration with the Global Building Performance Network (GBPN) to deliberate upon strategies to support the progression towards net zero emissions in the building sector in Southeast Asia. The dialogues were informed by a rapid literature review which reported sufficient evidence of health benefits of sustainable building. The first dialogue (July 2021) between Monash University academics identified that narratives are a powerful tool for communicating value propositions of sustainable building—for example through demonstration projects, first-person accounts, creative arts and media strategies. The importance of tailoring strategies to the differing roles of multiple actors across government, civil society, and the building sector, and across countries and settings was emphasised. Consideration of ‘top-down’ and ‘bottom-up’ influences on sustainable building was also discussed. Formation of a community of practice and careful consideration of a long-term strategy were also highlighted. The second dialogue (December 2021), with participants from New Zealand and Indonesia, moved beyond the broad idea of health benefits of sustainable building to more specific priority areas for potential collaboration. These included the relationship between thermal comfort and health; air pollution and other risks associated with overcrowding; placing importance on indigenous knowledge; setting emissions reporting requirements for government-backed projects; and exploring the nexus between public facilities & housing, transport, urban planning, and health. The dialogues provide a platform for more formal projects or initiatives in this critical area.

Nita Lauren, Paul Kellner, Alyse Lennox, Peter Graham, Peter Bragge
Chapter 14. The Thermal Indoor Environment of Danish Detached Houses—Past, Present and Future

Danish detached houses have shown a new tendency in terms of the thermal indoor environment. On 13.4% of houses built after 2000, problems regarding overheating have been reported by the owners. In addition to this, we stand before climate changes resulting in rising temperatures, which will increase the problem of overheating in the indoor environment even further. Since 1979, the energy requirements of the Danish Building Regulations (BR) have been tightened regularly, causing increased focus on re-insulation and sealed constructions. But as we are now experiencing the consequences of the tightened requirements regarding problems of overheating in new and energy-retrofitted houses, it is urgent to assess the Danish Building Regulations’ influence on the thermal environments of Danish houses. This paper investigates the consequences of rising outdoor temperatures on the indoor temperatures of Danish detached houses providing state-of-the-art on the subject. Through studies of the Danish Building Regulations, the paper examines how we ended up with overheated houses in the first place. Furthermore, it discusses the influence of the Danish ‘Design Reference Year’ (DRY 2013) on indoor temperatures in the future. Finally, the paper points towards different solutions, which could decrease the risk of indoor overheating and improve the thermal indoor environment.

Mette Lyhne


Chapter 15. Place Attachment and Community Impacts of 24-H Convenience Stores: A Case Study in the Central City of Nanjing, China

During the lockdown of COVID-19, there was a lack of community support for residents. The 24-h convenience stores thus played an essential role as the commercial facility in ensuring the smooth running of community life. This study investigated the impact of the 24-h convenience stores on communities with reference to theories of place attachment. It also discussed the factors determining the effectiveness of the support given by convenience stores during the lockdown period, especially the spatial design factors, and how these factors facilitate the design of a resilience community. A comparative study was carried out based on empirical evidence of the convenience stores in the central city of Nanjing, China. Data were collected and analyzed through a longitudinal survey of the community residents affected by the epidemic (2019 before the outbreak and 2022 after the normalization of the epidemic). The findings highlighted the significance of the community support system represented by the 24-h convenience stores during the lockdown and showed the variability and possibilities of the convenience stores in different communities. Suggestions are provided in the end to improve community resilience and community attachment by redesigning convenience stores.

Jin Xu, Yuzi Da
Chapter 16. Sustainable Housing Provision in Post COVID-19 Era in the Developing World: Challenges for the Architects

The surge of urbanization in the developing economies of the world has resultant effect on housing condition. However, housing is pivotal to the overall well-being and total quality of life of individuals and is believed to be both the cause and cure of Coronavirus pandemic, a respiratory problem plaguing the world today. This is due to the fact that people spend more time in houses during lockdown. This paper therefore examined the impact of housing conditions on the Coronavirus pandemic in the developing economies of the world in order to suggest strategies that will make architects create a sustainable environment for human habitation in the post-pandemic era. A historical survey method was employed and data was collected from secondary sources. The paper finds that there are various dimensions to housing condition which aid the spread of the pandemic and have impacts on residents’ health. The paper therefore suggests that architects need to provide functional and flexible spaces, connect houses to the outdoors and adopt the principle of universal design among others in order to allow air into the building.

Oluronke Odunjo, Sharon Odunjo
Chapter 17. Impact of Environmental Design Changes on Primary Healthcare Services in Mohalla Clinics During COVID-19: Findings from a Rapid Ethnographic Study

The Mohalla Clinic (MC) scheme was launched in Delhi, India, to provide primary healthcare services accessible to underserved populations at their doorstep. Starting with one clinic in 2015, the scheme has expanded to 518 clinics today and more are planned. While studies have documented the success of the scheme and its popularity among beneficiaries such as the elderly, children, women, and migrant populations, there is limited research on how the environmental design of MCs impacts the quality of healthcare delivery. This is especially relevant as many MCs have been converted into COVID-19 testing centers. Therefore, this qualitative research investigated how environmental design changes necessitated by COVID-19 impacted healthcare delivery in MCs. Field studies were conducted in two phases. First, a rapid ethnography of 24 MCs was conducted followed by semi-structured interviews with thirty-five medical staffs in nine MCs. Findings suggest that environmental design changes negatively impacted healthcare delivery. Space accessible to the patients was reduced by 66%–75%, exterior openings were reconfigured to offer healthcare services, covered waiting spaces were inaccessible, restrooms and drinking water facilities were unavailable, crowding of patients increased, and guidelines for ventilation were unmet. While these design changes may be reversible, workarounds devised by users during this time offer actionable insights on how to create pandemic-resilient community clinics. Findings from the study can inform the development of guidelines for the design of flexible and resilient MCs which can effectively respond to contemporary and future public health emergencies.

Amarjeet Mohanty, Gourab Kar
Chapter 18. Research on Resilience Regeneration of Old Community in the Post COVID-19 Era—A Case Study of Factory Community in Harbin

The epidemic era has affected and changed the residents’ lifestyles, especially in China, where strict epidemic control policies have confined the majority of activities in the community. As a result, there is a growing demand for community space, and the existing spatial environment needs to be revised, especially in older communities. In the face of the impact of severe global public health events, the ability of community resilience becomes particularly important. This paper selects a typical old community named factory community in Harbin, which not only faces infrastructural problems due to its construction age but also has a more urgent need for resilient adaptation due to the aging population living there. This paper first constructs a research framework for community resilience and then explores the problematic aspects of spatial vulnerability from the residents’ perspective. Besides, we draw on the Eisenhower matrix model to determine the highest priority resilience issues: activity space, parking facilities, and living facilities. We also propose some resilience enhancement strategies to deal with these critical issues by doing traffic diversion, public space creation, aging design, and barrier-free vertical transportation, which could provide a reference for other older communities of a similar type.

Jiayu Xie, Zhiqing Zhao, JiXian Wang
Chapter 19. 24 H of Happiness: A Child-Initiated COVID-19 Response to Reopen Schools, Mitigate Prolonged School Closures and Rebuild Resilient School Communities

About 1.5 million schools were shut after March 2020 across India which impacted 247 million children enrolled at elementary and secondary schools. Children from poorest households were five times more likely to be out of primary schools than those from the richest (UNICEF 2020). The online mode of learning was largely been inaccessible for children from marginalized communities, economically weaker backgrounds and physical or mental disability. When COVID-19 struck, India witnessed mass migration, inequities surfaced and schools were closed for 600 days for the youngest students. This became the second largest school closure globally. Young students sent WhatsApp texts willing to be seen, heard and be part of the support ecosystem. One message from one child (age 11 year old) reimagined a holistic school reopening solution that was backed by evidence-based data collected by community, codesigned solution and actionable representation through a core team where children had an equal seat at the table. Through human-centered methodology, over 2000 + families are participated in the process between July 21 and March 22 translating into a child-initiated adult-supported effort—the highest form of participation (Hart, R. A. (1992). Children’s participation: From tokenism to citizenship. Florence, Italy: United Nations Children’s Fund International Child Development Centre.). The intervention not only embraced Sustainable Development Goals principles to leave no one behind, in particular such as SDG 3, SDG 4, SDG 11, SDG 16 and SDG 17, but gave birth to a systematic community-driven approach that activates SOPs, decentralizes power from state to school, prepares for resilience among new waves, school closures, shocks and stresses. Empowered young voices become change makers and active participants that push for change and long-term sustainability.

Ruchi Varma, Tarusha Mishra

Planning for Healthy Environments

Chapter 20. VARCITIES EU Project: Visionary Nature-Based Actions for Health, Well-Being and Resilience in Cities

In an increased urbanized world, cities face several challenges and threats, and struggle to propose credible urban futures and new opportunities for their citizens. Social services and health facilities are significantly affected in negative ways owed to the increase in urban populations (70% by 2050). Air pollution and urban heat islands are exacerbating. Nature will struggle to compensate in the future city, as rural land is predicted to shrink by 30% affecting liveability. VARCITIES is an ambitious EU research project that puts the citizens and the “human communities” at the centre of future cities’ vision, in the belief that future cities should become fully human-centred cities. The project started in September 2020. Seven Pilot Cities are testing and implementing a series of innovative nature-based actions. The vision of VARCITIES is to implement real, visionary ideas and add value by establishing sustainable models for increasing health and well-being of citizens who are exposed to diverse climatic conditions and challenges around Europe through shared public spaces that make cities liveable and welcoming. VARCITIES sets the ambitious target to advance innovation across different urban scales by fully exploiting nature-based solutions from a digital, social and cultural perspective. Public spaces are envisioned as people-centred areas that support creativity, inclusivity, health and happiness for the citizens.

Sara Van Rompaey, Eleni Goni, Denia Kolokotsa
Chapter 21. Tools to Promote Physical, Mental and Social Well-Being in the Built Environment-Takeaways from the Development Project ‘the Urban Health Culture of the Future’

In 2019, Juul Frost Architects launched the interdisciplinary development project ‘The Urban Health Culture of the Future’, supported by Realdania with the aim to secure the link between health and planning. The project has resulted in the publication ‘The Urban Health Culture of the Future’ that features an analytical tool, four cases, contributions from the think tank, urban theories, and a toolbox, that we hope will inspire new strategic and multidisciplinary partnerships between local health and planning factors. The following paper presents excerpt or takeaways from the project, more specifically, from the tools developed. The aim of the tool is to ensure that considerations of health and well-being are explicitly reflected in planning. Thus, the tools can be used to promote the United Nations’ Sustainable Development Goals, more specific Goal 3. Ensure healthy lives and promote well-being for all at all ages, and Goal 11. Make cities and human settlements inclusive, safe, resilient, and sustainable.

Helle Juul
Chapter 22. Healthy Cities Make Healthy People and Healthy Planet

We acknowledge that it is time to put the health and general well-being of people at the center of our development, and the way to achieve it is to act under the beliefs of good social and territorial health, as the foundations of truly SDGs localization. Therefore, we propose that healthier lifestyles be at the very core of architectural creation, policymaking, territorial planning, and sustainable development, meaning a renewed architectural practice.

Karin De Poortere, Jose Alejandro Gómez
Chapter 23. Restorative Perceptions of Different Urban Residential Environments in Different Seasons in the Severe Cold Area: A Case Study in Harbin, China

Nowadays, China is urbanizing rapidly, however, the rapid urban expansion and social development have brought enormous psychological pressure on people. People's mental health has been challenged. In such times of distress, there is increasing importance on the restoration of the residential environment. However, the existing residential environment can not meet people’s desire for a healthy environment. The purpose of this research is to explore how to create a healthier residential environment within established planning regulations and land-use constraints. Based on the residential planning policy of Harbin, this research compared the restorative effects of residential space in different kinds of environments. The residential environments were shown by photos taken every other month from summer to winter (July to January) with the same location and perspective. The restorative effects were evaluated by the PRS scale. Our results clearly showed that environmental elements such as buildings, hard paving, trees, leaves, and snow have a significant impact on restorative perceptions. Restorative perception varies seasonally in residential areas with different designed environments, and although this trend is not the same, none of the restorative perceptions are the best in summer. Our results highlight the important role of seasonal design strategies for the residential environment with restorative effects based on planning policy. This paper present provides a reference for the seasonal factors of residential construction and provides a healthier environment for the residents.

Lei Zhu, Yue Wu, Cunyan Jiang, Boxu Chen, Hongyu Wei
Chapter 24. Planning Response of Urban Community Governance in China from the Perspective of Prevention and Control of Children’s Mental Health Risks

In the past 20 years, China’s urban living environment may have undergone significant changes, bringing about many adverse effects. Many studies show that the urban community environment is related to the mental health of residents. At the same time, due to children’s social and health vulnerability, their mental health is more vulnerable to environmental factors. Therefore, based on the literature research on children’s mental health risk factors and urban community environmental health impact factors, this paper proposes the planning response method of China’s urban community governance from the perspective of children’s mental health risk prevention and control, clarifies the main body and implementation path of community governance, and proposes the planning strategy of community governance, which provides theoretical support and guidance for promoting China’s healthy community governance.

Hong Leng, Dongyu Zhang, Qing Yuan
Chapter 25. A Study of How Residents’ Subjective Well-Being Affects the Design of Healthy Sports Parks in Cold Areas

In addition to providing physical and social interaction spaces, Healthy Community Sports Park improves residents’ health and well-being under the influence of COVID-19. Healthy Community Sports Park is the “cell engineering” of a healthy city and the basic unit of a healthy city. Using qualitative observation and questionnaire methods, this paper analyzed two community sports parks with different characteristics in cold areas––one is a newly developed community sports park with perfect facilities, and the other is a park with inadequate facilities for a long time. The relationship between subjective well-being and community sports parks was analyzed by multiple regression with sports space perception and subjective happiness as the dependent variables, diversity, accessibility, park area, and interest in space types in community parks as the independent variables. The results show that: (1) The interest and spatial privacy of the activity facilities in the community sports park are positively correlated with the subjective happiness of residents, and the correlation between accessibility and subjective happiness is insignificant; (2) the spatial richness of water bodies and squares in the park is positively correlated with the subjective happiness of residents; (3) the design elements of the community sports park are related to the activity space and the age group of the user; (4) intelligent facilities show significant differences according to age segments, which are negatively correlated with the subjective satisfaction of people over 50 years old. For this reason, community sports parks should consider the functional needs of all ages, as well as diversity, accessibility, and spatial interest.

Boxu Chen, Lingling Li, Youpeng Yan, Lei Zhu, Yuanrui Zheng, Chenxi Liu, Hongyu Wei
Chapter 26. The Necessity of Natural Darkness for Humans and Biodiversity

Our daily rhythm consists of night and day—darkness and light. This cycle is fundamental to our circadian rhythm, and all life on the earth has evolved under these conditions for millions of years. But because humans are primarily active during the day, we tend to forget half of our reality: the night and the necessity of darkness. This inherent bias in our collective thinking lets us ignore the most basic relationship that natural darkness is as essential for our circadian rhythm and the functioning of ecosystems as natural light. Many do not consider how artificial light at night (ALAN) alters the natural cycle of light and darkness and how this disturbs nature's and human's biological rhythms. Instead, the emission of ALAN is increasing by up to 10% globally, turning relatively dark cities into bright lightscapes (Falchi and Bará Salvador 2023). This rapid and significant increase in ALAN has drastically disrupted the natural light and dark cycles, severely affecting nature and humans. ALAN also plays a positive role in our society. ALAN binds us together culturally, economically, and socially. It allows us to navigate streets, supports experiences of safety, and forms inviting urban spaces after sunset. This review explores the severe impacts of ALAN and demonstrates that to bridge the seemingly opposing needs, we must understand our connectedness with nature and how we, as well as nature, need natural darkness to sustain health and circadian rhythm.

Lisbeth Dam Kørner

Healing through Design and Academic Research

Chapter 27. A Narrative Essay on the Relationship Between the Biopsychosocial Model of Health and the Built Environment

A correspondence between a Designer and a Neurologist, presented as a narrative essay on the relationship between the biopsychosocial model of health and the built environment. The discussion addresses how architecture, specifically that of the hospital, can apply scientific principles to understand how designed environments shape health behaviours and outcomes, bridging the gap between medical treatment and the architectural framework that supports it. It examines the benefits of utilising design as the ‘third carer’—enabling it to actively support a patient’s medical team (first carers) and family and friends (second carers) facilitating nurturing interactions and anticipating the needs of its occupants—exploring its potential to create inclusive clinical spaces that are adaptable, sensorially engaging, domestic in scale, colour and tactility, well-lit, acoustically controlled, and permeable to the natural world. The scientific understanding of illness has moved beyond strictly molecular and surgical models to a realisation that health is a combination of biological, psychological, and social factors. Therefore, the essay investigates the notion of the hospital as a tool for urban regeneration and the connections between the socio-economic and environmental factors that are vital to the success of medical treatment and the larger goal of health creation, exploring how our understanding of these connections can help re-imagine a built environment with the power to give users greater agency, better care and more control, enhancing health, welfare and quality of life.

Ab Rogers, Ashish Ranpura
Chapter 28. Rethinking the Design of Architectural Space Thermal Environment—Thermal Landscape

In the context of global warming, building-related energy usage and pollutant emissions remain high. Therefore, it has become a consensus to provide a comfortable and healthy thermal environment with the least energy. At present, the existing architectural design language does not pay enough attention to the health and energy saving of space thermal environment. Based on this background, the concept of space thermal landscape was proposed according to the relevant theories of human thermal perception, dynamic thermal environment, and thermal synesthesia, and the concept, prospect, and characteristics of thermal landscape are analyzed. Rethinking the design of space thermal environment, put forward the design method of space thermal environment from four parts: water landscape building thermal landscape, maintenance of traditional thermal landscape, natural ecological thermal landscape, and local installation thermal landscape, liberated the space design language of architects from universalism, and explored thermal environment design from a new angle. It is expected to provide designers with new ideas and new directions in the early stage of thermal environment design and energy-saving design.

Zhuoyu Yu, Dexuan Song
Chapter 29. Walkability Assessment Using Agent-Based Model: Why It Becomes An Advantageous Way

Highly walkable urban design has a significant impact on the health of residents. However, accurately evaluating the walkability of an urban design can be challenging for designers, urban planners, and policymakers. In the past, researchers have used both qualitative methods like auditing and questionnaires and quantitative methods to support a more accurate assessment of walkability. In this study, we conducted a two-phase review of walkability assessment studies in the Web of Science and ultimately selected three common quantification methods: space syntax (SS), geographic information system (GIS), and agent-based model (ABM). Our review found that ABM has several advantages, such as the incorporation of subjective factors, the integration of multiple factors, the ability to differentiate different populations, and numerous applications in public health. We compared these three methods in detail and discussed their strengths and weaknesses. We also identified current limitations of ABM and proposed potential solutions based on existing research. Overall, we concluded that ABM is a superior method for quantitatively assessing walkability, and we call for more architects and urban planners to use this method to design more walkable urban spaces and improve the health of residents.

Yi Liu, Dexuan Song, Zhengyang Wang, Xiangyu Yu, Ruimin Wang
Chapter 30. Changing Health Needs: Victoria Nurses’ Home, 1927–1933

The reconstruction of the Victoria Nurses’ Home (1927–1933) was to perpetuate the glory of Queen Victoria and provide more accommodation for nurses in Shanghai’s international settlement. Designed by German architect Rudolf Hamburger, this building is located in Shanghai’s western district, which was considered a country with fresh air and light to overcome health problems caused by the urbanization of Shanghai. For functional reasons, it exhibits a modern style that differs from the surrounding hospitals. The architect created a healthy environment by regulating the body’s relationship to Shanghai’s semi-tropical climate through the organization of nurses’ units, windows, terraces, and a verandah. The building’s design process reflects how different people’s ideas about health, from hospitals’ supervisors, nurses, and health officials, are influenced by existing technologies, the local climate, body experiences, and popular fashions.

Di Lu
Chapter 31. Implementation of Biophilic Design at Workplaces

Experiences of nature have various benefits on human health and well-being. In workplace environments, the integration of biophilic design strategies to incorporate elements and features of nature can enhance employee productivity, emotional state, and psychological well-being, mainly addressing the third goal of United Nations Sustainable Development Goals (UN SDGs). The literature abounds with studies providing empirical evidence on the positive effect of nature exposure in the workplace on employees. However, there is a lack of understanding of the status of such studies. To this end, the authors conducted descriptive analysis and a review on the applications, capabilities, and limitations of studies implementing biophilic design principles at workplaces. A total of 59 peer-reviewed articles that met the inclusion criteria were selected and reviewed based on the defined factors and sub-factors. The results show that the introduction of biophilic design elements into indoor, semi-outdoor, and outdoor workplace environments can promote employee health, well-being, and productivity. However, the literature gives limited attention to some of the identified categories/factors including “natural analogues”, “emotion and mood”, “physiological data”, “non-visual sensory input”, and “virtual reality”. Based on the review findings, we have identified several knowledge gaps and opportunities for further research.

Muhammed Yildirim, Anastasia Globa, Arianna Brambilla, Ozgur Gocer
Chapter 32. Analysis of Key Points in the Design of Hybrid Operating Room for the Future

Based on the trend of the development of hospital wisdom and the time-varying needs of future patient groups for personalized experiences, this paper combines domestic and international case studies of hybrid operating rooms and equipment manufacturers' data and uses a case study approach to summarize and refine the design elements of the intelligent application of hybrid operating rooms from the perspectives of function, environment, space, facilities and transmission, in order to provide ideas for the sustainable development of hybrid operating rooms. In turn, it will provide reference for the renovation and upgrading of existing general clean operating rooms in hospitals and the future construction of intelligent operating departments with hybrid operating rooms as the mainstay.

Yaonan Ai, Yue Wu, Shanshan Zhang
Chapter 33. Facing up to the UK’s Food Crisis—A Design Exploration of the Self-Sufficient City for Resilience and Food Security

The increasing population and the aggregation of people in dense urban pockets add to the pressures on already complex and volatile global systems (WFP in Global food crisis, 2022). Food supply systems need to adapt and be resilient to not only natural phenomena such as climate change or the post COVID-19 crisis, but also in resistance to socioeconomic and geopolitical disturbances. The dependency of urban populations on external food systems makes these populations vulnerable to systemic breakdowns. This research looks at the looming food shortage in the UK (Bancroft in UK is ‘sleepwalking’ towards food shortages, farmers warn | The Independent in 2022), authors investigate design strategies for creating a more sustainable agrarian urbanism, which includes three classic urban utopias: Frank Llyod Wright’s Broadacre City, Kisho Kurokawa’s Agricultural City and MVRDV’s Pig City. Three case studies provide ideas and notions of creating a self-sufficient city in the post-colonial era of the UK. The design hypothesis responds to the increasing pressure from population and consumption growth, and the decreasing farming land and food suppliers. The final resolved urban farming system is based on existing conditions such as waste flows and underused spaces, it adopts novel design strategies and interacts with different elements of self-sufficiency to generate a network of farms with highly dense, multi-level structures.

Jiayi Jin, Mingyu Zhu
Chapter 34. Healthcare 2030. A Design Studio on the Future of a Distributed System in Singapore

Taking Singapore as a laboratory for thinking and designing future healthcare spaces, services, and deliveries, architecture, and industrial design students worked together to develop innovative and scalable solutions for a distributed healthcare system in the year 2030. The projects are collaborative, multi-scalar, and multi-stakeholder in approach. They considered near-to-far-future scenarios for a distributed system across different sites, touchpoints, and experiences by harnessing digital technologies, deploying connected care platforms, and being supported by grassroots organisations, social agencies, and communities. The paper will share the critical reflections and outcomes from the studio led by an architect, experience, and industrial designers working in academia and the industry. The paper argues that designing a system-based healthcare future demands a re-tooling of current architecture education to one that is multidisciplinary, collaborative, and empathetic.

Thomas Kong
Design for Health
herausgegeben von
Arif Hasan
Christian Benimana
Mette Ramsgaard Thomsen
Martin Tamke
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