How can city governments ensure better public health?

A Legible London sign, intended to encouraging walking. Image: Applied Wayfinding.

Crossing the street while texting could cost you your life. If you live in Honolulu, even if you survive, thanks to legislation passed earlier this year, it could also land you a hefty fine.

The Hawaiian capital is not the only city trying to get us to look up from our phone. Hayward, California, introduced snarky signs in 2015, reminding us to “Cross the road, then update Facebook.” Singapore installed LED lights on the pavement at crossings to prevent accidents involving people who don’t look up from their phones. Antwerp in Belgium and Chongqing in China have text-walking lanes, and Mumbai and San Francisco have no-selfie zones, while Rexburg in Idaho banned pedestrians from using phones when crossing the street in 2011.

The increase of urban populations around the world is putting pressure on local governments to tackle the preventable health problems caused by air pollution and lifestyle, and some cities are stepping up to the challenge. In London, for example, TfL’s Planning for the Future is investing billions of pounds to develop the city’s transport and lower emissions. And almost 100 cities have joined the World Health Organisation’s European Healthy Cities Network, which aims to improve public health.

But traditional methods of improving a populations’ health – offering free cooking classes and handing out leaflets on how to stop smoking – aren’t enough any more. In these innovative times, cities are starting to play a more involved role in changing our behaviour. Public health researchers in California, for example, installed signs in San Diego International Airport, to encourage people to take the stairs instead of the escalator, which led to twice as many people opting for the former.

But Theresa M. Marteau, director of the behaviour & health research unit at the University of Cambridge, says that far more radical change is needed. “While information-based approaches to changing behaviour can raise awareness of a need for change,” she says, “they are generally, at best, weak interventions for achieving such change.


“There is no doubt that the design of cities and towns is key to population and planetary health. Re-designing these to reduce or remove the use of fossil-fuelled vehicles and increase walking and cycling is just one such change.”

Susan Claris, a transport planner with the consultancy Arup, agrees that cities need to adjust their infrastructure. “Buildings should be designed so that the stairs are the first thing you see and they are inviting to use.” At the moment, she notes, the lifts or escalator are often the first thing you see, “with the stairs hidden away behind closed doors”.

Such re-designs are important, because cities have the potential to reshape human behaviour. The Massachusetts Institute of Technology recently published a paper titled, “Persuasive Cities: Health Behavior Change at Scale”. It argued that, “according to social cognitive theory, any well-designed environment can become a strong influences of what people think and do”, concluding: “As cities continue to grow… the design of future urban places will become more dominant in impacting human behaviour.”

The key to this level of change lies not in brand new infrastructure, but in the use of technology, according to Arup’s Claris. “Thanks to new technologies, the physical city is changing,” she says. “With sensors and cloud computing, streets are becoming smarter and more interactive. The city can now monitor and analyse activity levels, actively advocate walking and cycling routes, as well as create a layer of play, fun and games onto the streetscape.”

All this, she says, is enabling cities to play a growing role in public health and wellbeing, “away from the traditional posters, leaflets and other traditional campaigns”. By combining better design and better incentives, cities can make sure that “the healthy choice is the fun, easy, convenient and attractive choice”.

 
 
 
 

Could modular housing help Britain build the homes it needs?

Pre-fabricated housing being moved into position in Los Angeles in 2012. Image: Getty.

We’ve got ambitious government targets, an appetite to build and huge numbers of people who need housing. But we’ve known all this for some time, yet we are still in the same situation – a housing crisis.

So let me start with an obvious yet uncomfortable truth - relying solely on traditional construction methods will not halt the housing crisis. This isn’t a comment on the traditional product or its processes, more a reiteration of a well-known fact: skills capacity is also at crisis point. 

It’s a stalemate situation. In 2016, the Joseph Rowntree Foundation released a report on the relationship between housing and employment. The report found that neighbourhood investment creates a sound basis for employment, and that affordable rent provides a greater incentive for people to work.

One relies to some degree on the other. After all, a home is about so much more than bricks and mortar. So why aren’t we jumping at the chance of doing things differently to get out of this impasse?

The UK is something of an outlier when compared to many of our continental neighbours. Areas like manufacturing have seen steady productivity growth over the last twenty years, allowing more economic growth with the same or fewer number of workers. However, the UK construction sector has seen productivity flat line for the past two decades. This limits growth, and means a loss of more than £100bn a year of economic benefit.     

There are alternative products and processes we can take advantage of – but we seem to be simply dipping our toes in the water. Personally, I think we’re suffering from a lack of confidence. We need confidence in the quality of modular products (which, clearly, from our recent YouGov research, the public doesn’t have). We need confidence in the durability of MMC (modern methods of construction) products.

And we need confidence in the sector that the intention of modular suppliers is to add to capacity, not to replace traditional processes.

This is why my team are currently working with a range of modular and MMC suppliers to robustly compare and contrast a range of housing products. It’s a live research project in Gateshead that will monitor and evaluate the build process and lifestyles on offer through a range of different construction methods – including traditional. The homes will be for affordable rent and tenants will be involved in the ongoing evaluation.


So why are we doing it? If we make this research available to other developers perhaps as a sector we can make more confident and informed decisions about new construction methods.

Because while MMC is being used across the sector, we’re not using it at scale. And its scale that we need to affect change: 300,000 homes is no small number, after all. (What’s more, according to a survey by the Royal Institution of Chartered Surveyors, only 12 per cent of surveyors believe we can hit that target – another confidence boost needed).

 MMC isn’t as affected by the crisis in construction skills capacity. It’s an entirely different skillset. So it’s not about skilled tradespeople jumping ship.

You could almost envisage two different pathways into housebuilding. Studies have told us that millennials are purpose-driven, and therefore most likely to be attracted to organisations that are driven by purpose. So maybe that’s how we have to think about careers in construction.

There may be two distinct pathways being formed with two distinct skillsets – but ultimately, both are responding to the housing crisis. Perhaps that’s the draw. And having increased opportunities may well see an increase in people working in the sector overall. 

We’re not competing in a crowded marketplace. There is a desperate need for more homes. We need to embrace every construction method available to us and work collaboratively to meet the government’s targets.

Let’s keep the end goal in mind and not be restricted with the way we’ve always done things. It’s time to take a different approach.

Mark Henderson is chief executive of the housing association Home Group.

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