How can we build healthier cities?

Cambridge, 1935: the city has always been cyclist friendly. Image: Hulton Archive/Getty.

“When a man is tired of London, he is tired of life; for there is in London all that life can afford,” said Samuel Johnson in the 18th century. For Johnson, the rich tapestry of London life and the myriad cultural assets clearly outweighed any downsides of city dwelling.

For others, though, city life is a grind. Public transport is overcrowded, house prices are soaring, traffic is at gridlock and diesel fumes hang almost perceptibly in the air. Little surprise, then, that people do become tired of London, even if not of life itself.

Even if issues such as air pollution are taken out of the equation, living in a city can be bad for your health – not good news considering that the World Health Organization estimates that, in 2017, the majority of people live in urban areas.

A study published in 2014 by Dr Manjinder Sandhu from the Cambridge Department of Medicine suggested that increasing urbanisation of rural areas in sub-Saharan Africa might lead to an explosion of the incidence of stroke, heart disease and diabetes. Yes, moving to towns and cities provides better access to education, electricity and hospitals; but town and city dwellers become less active, their work becomes less physical and their diets worsen.

“If this pattern is repeated across the globe – which we think it will – then we could face an epidemic of obesity, diabetes and other potentially preventable diseases,” says Sandhu. “Local and national governments need to take this into consideration when planning infrastructure to try and mitigate such negative effects.”

As far as healthy cities go, Cambridge has a lot going for it. Its population has higher than average levels of education and is physically active. Cambridge has been nicknamed “the cycling capital of Britain” – the sight of bicycles leaning against walls is as iconic as that of punts passing under the Bridge of Sighs. But as the city expands and house prices rocket, more and more people are living in neighbouring villages and towns, where cycling to work along winding, congested country lanes can be less appealing than driving.

In 2011, the world’s longest guided busway opened, connecting Cambridge with nearby Huntingdon and St Ives along a former railway line. An integral part of the busway was a cycle path along its route – and this appears to have helped nudge people in the right direction. A study led by Dr David Ogilvie from the Medical Research Council (MRC) Epidemiology Unit found that, among people who commuted into Cambridge from within a 30 km radius, those who lived closer to the busway were more likely to increase the amount of active” commuting they did, particularly cycling.

“Commuting is a part of everyday life where people could include a bit more physical activity without having to think about it very much or make time for it,” says Ogilvie. “When new infrastructure integrates opportunities for walking and cycling, we see people shifting their commuting behaviour.”

Ogilvie’s research is, he says, “contributing bricks of evidence to a wall that’s slowly being assembled from across the world of the health benefits of investing into this kind of infrastructure”/ While such benefits are often alluded to in business cases, until now the evidence to support them has been limited.

There are ways to integrate more pedestrian-friendly environments in existing infrastructure, he says, citing examples such as those in the Netherlands – now being introduced in some areas of London – where traffic is slowed to walking pace and the divisions between pavement and road are deliberately blurred, cuing drivers to share the space.

With more thoughtful urban planning, Ogilvie says, it should be possible to design towns and cities as environments that promote not just physical activity, but improved health and wellbeing – “in short, a place where people want to live”.

“Sprawling cities with retail parks on the fringes are not conducive to doing your shopping on foot,” he says. “People are more likely to walk and cycle around their neighbourhood if it is safe, well connected and has good local amenities. And getting people out on the streets not only gets them active, it also increases social interactions and a sense that it’s safe to be on the streets.”

Dr Jamie Anderson from the Department of Architecture is also interested in the relationship between the built environment and our broader wellbeing. As part of his PhD project with Professor Koen Steemers (architecture) and Professor Felicia Huppert (psychology), he did a study of another Cambridge initiative, the housing development known as Accordia.

Since the first residents moved into their homes in the mid-noughties, Accordia has won numerous prizes, including the Royal Institute of British Architects Stirling Prize, for its innovative mixing of private and public spaces. Yet surprisingly, says Anderson, no one had done a detailed study of the impact on its residents.

Accordia. Image: Jamie Anderson.

One of the interesting approaches taken by Accordia was to focus on communal spaces rather than private gardens: only one in five homes has its own garden. Given the stereotype of the British as a very private people, how did people respond? Did people spend time chatting outdoors with their neighbours, or did they shut themselves away and draw the curtains?

The results, explains Anderson, were mixed. While one middle-aged couple missed having their own garden and were now on a long waiting list for a local allotment, one mother described the communal gardens as “crucially important”: she had suffered from postnatal depression and, with her husband away at work all day, she told Anderson that she “wouldn’t have got through her depression” without the interactions that the adjacent communal areas provided.

“In terms of behaviours that we associate with physical health and positive mental health – so people interacting with each other, children out playing, for example – we found clear positive associations with Accordia’s outdoor neighbourhood spaces,” he adds, “but when we looked at people’s subjective wellbeing, it wasn’t as clear cut.”

With Accordia, Anderson was evaluating an already established development, but he now has a chance to influence a project at the planning stage. Part of the Northern Powerhouse project will see a £110m culture venue in Manchester named The Factory after the eponymous record company behind such iconic bands as Joy Division and Happy Mondays.

Under a fellowship from the Engineering and Physical Sciences Research Council, Anderson, in collaboration with engineering firm BuroHappold, is carrying out a Health Impact Assessment (HIA) of the proposed new site. He’s looking at factors that might influence health and wellbeing, from the lighting in office spaces, through to educational opportunities for young people from deprived communities and the restaurants within the venue.

HIAs are currently voluntary, but are set to become mandatory for significant developments across the UK in 2017, and can help architects and designers improve their submissions for planning application. How effective they’ll be is unclear, warns Anderson. “You might have some really strong evidence, but the final decision is a blend of opinion from various stakeholders, so you could end up with a watered-down version of what’s needed.”

He remains optimistic, however: “We’re moving in the right direction. By building consideration of health and wellbeing into the planning process, it should raise the bar and hopefully we will see many more cycle lanes, more inviting and better options for active transport, and maybe fewer fast-food shops.”

“I don’t know what makes me stay / The city life just ain’t the same,” sang New Order, one of Factory Record’s best known signings, in 2001. Perhaps the work of Cambridge researchers will help make cities attractive – and healthy – places to stay.

This article previously appeared on the University of Cambridge’s website, and appears here under a creative commons licence.

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Why doesn’t London build an RER network, like Paris did?

A commuter walking by a map of the RER B line at the Chatelet-Les Halles station in Paris. Image: Getty.

I’ve heard many people make many different complaints about the Parisian transport system. That it does a bad job of linking a rich, white city with its poorer, more diverse suburbs. That, even as subway systems go, it’s a hostile environment for women. That the whole thing smells distractingly of urine.

I’m familiar with all of these complaints – I’ve often smelt the urine. And I’m aware that, in many ways, London’s is the superior transport network.

And yet I can’t help be jealous of Paris – In large part, because of the RER.

Central Paris. The Metro lines are thinner, and in pastel shades; the RER lines are thicker, and in brighter colours. Image: RATP.

Paris, you see, has not one but two underground railway systems. The more famous one is the original Paris Metro, opened in 1900: that’s the one with those fancy green portals with the word “metropolitain” written above them in a vaguely kooky font.

The Metro, though, mostly serves Paris Intra-muros: the official city, inside the Boulevard Périphérique ring road, site of the city’s last set of walls. As a result, it’s of very little use in most of the city’s suburbs. Its stations are very close together, which places a limit on how fast its trains can cross town. It was also, by the mid 20th century, becoming annoyingly overcrowded.

So starting in the 1960s, the city transport authorities began planning a second underground railway network. The Réseau Express Régional – Regional Express Network – would link suburban lines on either side of Paris, through new heavy rail tunnels beneath the city. Its stations would be much further apart than those of the metro – roughly one every 3km, rather than every 600m – so its trains can run faster.

And fifty years and five lines later, it means that 224 stations in the suburbs of Paris are served by trains which, rather than terminating on the edge of the city, now continue directly through tunnels to its centre.

The RER network today. Image: RATP.

London is, belatedly, doing something similar. The Elizabeth Line, due to open in stages from later this year, will offer express-tube style services linking the suburban lines which run west from Paddington to those which run east from Liverpool Street. And Thameslink has offered cross-town services for 30 years now (albeit not at tube-level frequencies). That, too, is going to add more routes to its network over the next few years, meaning direct trains from the southern suburbs to north London and vice versa.

Yet the vast majority of suburban National Rail services in London still terminate at big mainline stations, most of which are on the edge of the centre. For many journeys, especially from the south of the city, you still need to change to the London Underground.

So, could London ape Paris – and make Thameslink and Crossrail the first element of its own RER network?

In a limited way, of course, it’s doing just that. The next big project after Crossrail is likely to be (original name, this) Crossrail 2. If that gets funding, it’ll be a new south-west to north-east route, connecting some of the suburban lines into Waterloo to those in the Lea Valley.

The proposed route of Crossrail 2. Click to expand.

But it’s not immediately obvious where you could go next – what Crossails 3, 4 or 5 should cover.

That’s because there’s an imbalance in the distribution of the remaining mainline rail services in London. Anyone who’s even remotely familiar with the geography of the city will know that there are far more tube lines to its north. But the corollary of that is that there are far more mainlines to the south.

To usefully absorb some of those, Crossrail 3 would probably need to run south to south in some way. There is actually an obvious way of doing this: build a new tunnel from roughly Battersea to roughly Bermondsey, and take over the Richmond lines in the west and North Kent lines in the east, as a sort of London equivalent of RER C:

Our suggestion for Crossrail 3. Image: Google Maps/CityMetric.

But that still leaves a whole load of lines in south and south east London with nowhere to send them beyond their current terminal stations.

In fact, there are reasons for thinking that the whole RER concept doesn’t really fit the British capital. It was designed, remember, for a city in which the Metro only served the centre (roughly equivalent of London’s zones 1 & 2).

But London Underground wasn’t like that. From very early in its history, it served outer London too: it was not just a way of getting people around the centre, but for getting them there from their suburban homes too.

This is turn is at least in part a function of the economic geography of the two cities. Rich Parisians have generally wanted to live in the centre, pushing poorer people out to the banlieues. In London, though, the suburbs were where the good life was to be found.

To that end, the original operators of some lines weren’t just railway companies, but housing developers, too. The Metropolitan Railway effectively built large chunks of north west London (“Metroland”), partly to guarantee the market for its trains, but partly too because, well, housing is profitable.

In other parts of town, existing main line railways were simply added to the new underground lines. The Central line swallowed routes originally built by the Great Western Railway and London & North Eastern Railway. The District line absorbed part of the London, Tilbury & Southend Railway.

At any rate: the Tube was playing the same role as the RER as early as the 1930s. London could still benefit from some RER-type services, so hopefully the Elizbaeth Line won’t be the last. But it doesn’t need an entire second metro network in the way 1960s Paris did.

There is another idea we could more profitably steal from Paris. Those suburban railways which aren’t connected to the RER are still run by the national rail operator, SNCF. But it uses the Transilien brand name, to mark them out as a part of the Parisian transport network, and – as with the RER – each route has its own letter and its own colour.

The Transilien & RER networks in Paris. Image: Maximilian Dörrbecker/Wikimedia Commons.

This would not have the transformative effect on London that building another half a dozen Crossrails would. But it would make the network much easier to navigate, and would be almost infinitely cheaper. Perhaps we should be starting there.

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites

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