How can cities ensure healthy architecture in an era of rapid population growth?

A new building emerges on Place de la Concorde, Paris. Image: Getty.

Worldwide population growth and mass migrations are putting the infrastructure of many cities under strain. With city governments under pressure to provide more housing and work spaces, people can end up living and working in poorly designed or low quality buildings.

Since the beginning of human civilisation, people have been striving to create a beneficial built environment. Take Neolithic buildings, for instance: they were purposefully orientated to catch the sun and allow for ventilation. Later, over 3,000 years ago in Crete, the Minoans built underground sewage systems to avoid plagues. So too did the Romans, who also used underfloor heating systems and aqueducts, and provided baths throughout the empire to keep the population in good health.

Slums in Wentworth Street, Whitechapel. Image: Wellcome Images/Wikimedia Commons.

Despite these early successes, maintaining healthy conditions became much more difficult in times of rapid population growth. During the industrial revolution, for instance, many cities quickly became overpopulated. With growing industries, employers were under pressure to accommodate more workers, and decayed or unfit buildings were used to host increasing numbers of tenants.

In the UK, living conditions reached such poor standards that the government passed a number of laws to improve public health. A similar sanitation project took place in Germany, at around the same time. These strategies provided many cities with outstanding green infrastructure such as parks and boulevards, which still bring many health benefits to those who can access them today.

Sick building syndrome

But in recent years, “sick building syndrome” has become a worry worldwide. Research has shown that headaches and respiratory problems among office workers were directly related to the use of air conditioning, poor ventilation and other widely-adopted technologies. Today, health professionals and designers have plenty of evidence to show that some buildings can harm people, both physically and psychologically. Yet ensuring buildings are “healthy” is a difficult task.

In the UK, some features such as ventilation and heating have to meet certain standards. But other design features, which are known to have a big impact on human welfare, are still not regulated. For example, there’s evidence that exposure to natural light and direct contact with nature have a positive effect on school exam results – yet there’s no legislation which says they must be a feature of learning environments.

And while scientists are constantly experimenting to grow our knowledge of the impacts that buildings have on human health, laws and regulations tend to develop more slowly. This means that even new buildings can be inadequately ventilated, or suffer from a lack of natural light – even though we now know that both cause symptoms of ill health.

A lack of natural ventilation means viruses are retained in the air, while a lack of natural light can affect brain functions. In Britain alone, these design pitfalls are adding to the stress on the NHS, and costing the economy an estimated £24.6m due to lost working days each year.

What’s more, as the Grenfell Tower disaster made awfully clear, technical difficulties and budget constraints can mean refurbishments are made using incompatible or inappropriate building materials, resulting in homes which simply aren’t safe to live in.

Tech fails

Architects aim to deliver sustainability by reducing energy consumption. There is a huge range of technologies which can help achieve this. But relying too heavily on such solutions can backfire: in 2016, researchers found that many homes had been built to be airtight, in a bid to meet energy efficiency targets. This can cause CO₂ and other pollutants to build up indoors, which in turn has adverse effects on residents’ health.

Human factors – including how we navigate and socialise within the built environment, and how our body responds to it – also have a big impact on the overall efficiency of buildings, and the sustainable technologies which go into them. Research has shown that people don’t always operate equipment as instructed – rather, they naturally look for comfort through more instinctive behaviours.

For example, when we feel a room is overheated, we tend to open windows to gain instant refreshment, rather than turning the thermostat down. This reduces the effectiveness of low-carbon technologies. So even buildings that have plenty of features to enhance energy efficiency can still be unsustainable, if people don’t use them properly.


The power of good design

Design is still the most powerful tool an architect can use: simple design measures, such as opening buildings towards sunnier aspects or adding ventilation in strategic locations to make the most of prevalent winds, are tried and tested techniques which can help to deliver healthier, more sustainable buildings.

Yet this approach comes with its own issues. Inner-city locations are often difficult to build in, because of their small size and crowded surroundings. Sometimes, architects will prioritise creating a “landmark” exterior, at the cost of a healthy interior. Other times, architects misinterpret planning guidance and recommendations, which can be vague and unspecific. Likewise, planning restrictions can actually be enforced to the detriment of the overall building quality.

The ConversationAt the moment, planning laws aren’t strong enough to provide truly sustainable environments that take human factors into account. Reform is long overdue, and designers, builders, planners and health professionals need to make a greater effort to find a more collective and coordinated way of working. But as a society, we must take joint responsibility: we can all make a start by learning how to change our our behaviour, to make the human aspects of sustainability a central part of our lives.

Laura B Alvarez, Architectural Technologist and Urban Designer, Nottingham Trent University.

This article was originally published on The Conversation. Read the original article.

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.