Healthy People need Healthy Places

The ongoing Coronavirus pandemic has thrown a spotlight on public health and highlighted how this fundamental aspect of urban planning has been neglected for too long. We need to focus on how the design of places impacts the health of the citizen and for that, the ultimate objective is not healthy places per se but healthy people.

I am therefore suggesting a framework or dimensions of citizen health and wellbeing against which we can gauge interventions in the planning and design of the lived environment.

In the UK where I work, but also in many other developed countries, too many developments are being built which literally make people sick.

  • Housing developments designed at lower densities but reliant on centralised amenities reduce the number of short journeys traditionally made on foot and increase reliance on private cars.
  • Social isolation of young, elderly and carers, leading to the poorer health outcomes associated with increased loneliness.
  • Isolation of elderly in ‘grey ghettoes’, away from established support networks of family and friends.
  • Poor housing quality lacking good air, light and space especially external space. Cost to U.K. of poor housing is estimated at £1.4b/year.
  • Poor air quality – especially alongside distributor roads. Estimated 40,000 deaths per year from air pollution in U.K.
  • Inadequate access to green spaces, contact with nature, sport and active recreation.
  • Poor diet with insufficient access to fresh food and over-reliance on fast and heavily processed food.
  • Centralised healthcare accessed via longer journeys, reducing contact with families.
  • Isolation from learning and employment opportunities resulting in poorer economic outcomes correlating with poorer health outcomes.

Sources; ‘Health Inequality in England: the Marmot Review 10 years on’ 2020; ‘Transport for New Homes’ 2018

Healthy places mean healthy citizens   Citizen-centric solutions

The objective of Healthier Places is to have Healthier People. This means not only helping those with recognised health conditions but helping currently healthy people stay that way longer and later into life. The relationship between the healthy citizen, their urban environment and the supporting care and health services they receive can be distilled into three dimensions of healthy places that are:

Active – in mind, body and spirit, encouraging physical and mental exercise as part of our everyday routines. This includes active travel – walking and cycling but also sport and recreational activity such as gardening. Mental stimulus is also important – from learning and skills to jobs (paid and voluntary); and Sustained – through the air, food, water and light healthy bodies demand. Healthy people also need to be economically sustained through rewarding employment.

Independent – to ‘age in place’ and remain connected to our friends and family; and Supported – through health and social care, education and training, multi-cultural spiritual support and financial services.

Sociable – To support mankind’s natural desires for company. Places that offer opportunities for safe social interaction, reduce feelings of loneliness and alienation. to create a spectrum of sociability supporting different scales of interaction from strangers to family members; and Empowered – To make decisions in the care we receive and the choices facing our communities. So that our contribution to society can make a difference and influence what happens. Motivating volunteering and mutual support. Participation in decisions affecting the community, Empowered to participate economically. Combating social exclusion, prejudice and fear.

Decision makers; public sector; private sector; and local communities can all benefit from putting healthy living at the heart of Placemaking. These insights are applicable across a wide range of projects at varying scales and for varied client groups. They are certainly not limited to projects for the healthcare sector alone – they should inform placemaking in housing and mixed-use developments at a fundamental level.


Marcus is an award-winning, international architect and town planner, specialising in creating liveable neighbourhoods and with over 30 years’ experience in a range of building and planning projects. As a leading figure in the UK’s urban design movement, Marcus has been at the forefront of changing the way we plan and build towns and cities. His work with local communities has resulted in places that work for the people that live there, making them more popular, safer and well cared for.

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