Lessons in building for mental health from Tokyo and Hong Kong

The Shibuya crossing, Tokyo. Image: Getty.

Standing in the right place, deep within the density of tower blocks and the throng of crowds and the neon glow of kanji, is a snapshot of humanity’s future. We could be on the set of Blade Runner.

But sci-fi films are not the only way to envision our overcrowded, hyper-urban future. Asian megacities offer a present day glimpse of what the world’s soaring population and rising urbanisation could mean for how we will live. By doing so, these cities also hold clues about how to futureproof our sanity.

As more people flock to cities, we need solutions that balance urban density with liveability. Hong Kong and Tokyo are both super-ageing cities known for their tall buildings, long working hours, efficient underground trains, and tiny living spaces. In both cities, stress and loneliness are common complaints, suicide is not uncommon, and at least one in five people experience a serious mental illness in their lifetime. Like anywhere, many factors mediate these risks: genetics, upbringing, employment, certain physical illnesses.

But these one more factor whose impact is only now emerging as a key determinant of mental health: the built environment. Modifying the settings where we live, work and play is not just the next big public health opportunity; it is a key to the resilience that companies, cities and countries seek for their populations.

The built environment affects mental health in two important ways. First, by over-stimulation. Cities can provide social and cultural stimulation that surpasses that of rural settings. Everything we see in cities is designed to make us think, feel or act in certain ways. Many of us left our close relationships behind to move to the city, and instead of someone to confide in, every day we encounter tens of thousands of someones. All of this can result in overload: an urge to retreat from this assault on our senses.

Secondly, cities deplete the very factors that strengthen our mental health and build resilience, such as access to green, natural spaces, regular physical activity, and positive social interaction. As the population urbanises, these challenges risk escalating, to the detriment of society’s mental health and wellbeing.


This hyper-urban future is currently the present in many of Asia’s denser cities. Examining how these cities are adapting uncovers clues about our upcoming challenges and emerging solutions.

Growing density and demand for space drives up house prices unsustainably. In the quest for affordable housing solutions, some people in Hong Kong have had to live in ‘cage homes’, tiny ‘caged’ living spaces within subdivided apartments. And through the challenges of this very constrained living, it is becoming clear that affordability and quality of life can be improved through a return to social, communal facilities, from shared kitchens to shared study spaces.

Developments are encroaching on public open space, so in addition to incentivising developers to provide dedicated public spaces, Hong Kong’s population is improvising, appropriating spaces for different uses at different times. University plazas for older people to exercise at dawn before the students swarm in; the grounds of a major bank building, for migrant domestic workers to socialise at the weekends when office staff go home; and even corners of air-conditioned office lobbies have become informal day centres for older people.

Meanwhile in Tokyo, streets are being flexed as public spaces. Vehicle traffic is encouraged to stick to the bigger roads, and in many places, the smaller networks of roads inside these grids are given over largely to roadside plants (often provided and maintained by local residents), pedestrians, and mothers riding mamachari bicycles with several children strapped aboard, stopping to chat outside small and welcoming shops.

Looking at hyper-dense Asian cities also makes it clear that the future could be public transport – the key to which is seamless integration with safe and convenient pedestrian and bike links between stations and destinations. In Tokyo, hills are tackled with electric bicycles; in Hong Kong with free public outdoor escalators. In both cities, residents benefit from the regular physical activity that is naturally integrated into their daily routines.

Nature is good for our mental health, but dense development makes access to greenery challenging. Tokyo and Hong Kong both incentivise developers with tax credits to green their buildings, and invest in urban parks within new developments. But recognising the land use challenges, both cities also prioritise the provision of cheap, convenient public transport access to large swathes of greenery just outside the city. Whether they call it forest bathing (Tokyo) or simply hiking (Hong Kong), it is clear that to fully reap the mental health benefits of nature, we need both urban nature that people can access in the course of their daily routines, and immersive nature that delivers a bigger respite from the city.

What these solutions have in common is the design of settings that facilitate positive social interactions within dense neighbourhoods, enabling participation of people of all ages in shared spaces. These uses of space enable residents to physically see each other. In doing so, they build their social capital and a sense of community belonging. This is incredibly protective for mental health.

If we look to Hong Kong and Tokyo for clues to our future, it becomes clear that while some parts of our future cities might look like Blade Runner on the surface, underneath we may find a dense collection of overlapping villages.

Layla McCay is director of the Centre for Urban Design & Mental Health.

 
 
 
 

Barcelona’s car-free “superblocks” could extend lives. So will they catch on elsewhere?

Barcelona. Image: Getty.

The world’s biggest cities have larger populations and higher economic outputs than some countries. But as they grow in size and complexity, cities are also facing thorny challenges that threaten the health and happiness of residents. Congestion, pollution and a lack of community spaces have become major drags on people’s aspirations and experiences of urban living.

In response, cities must manage their resources and priorities to create sustainable places for visitors and residents, and foster innovation and growth. Enter Barcelona – the capital of Catalonia, in Spain – where a bold stroke of urban planning first introduced “superblocks” in 2016.

Image: ISGlobal/FAL.

Superblocks are neighbourhoods of nine blocks, where traffic is restricted to major roads around the outside, opening up entire groups of streets to pedestrians and cyclists. The aim is to reduce pollution from vehicles, and give residents much-needed relief from noise pollution. They are designed to create more open space for citizens to meet, talk and do activities.


Health and well-being boost

There are currently only six superblocks in operation, including the first, most prominent one in Eixample. Reports suggest that – despite some early push back – the change has been broadly welcomed by residents, and the long-term benefits could be considerable.

A recent study carried out by the Barcelona Institute for Global Health estimates that if, as planned, 503 potential superblocks are realised across the city, journeys by private vehicle would fall by 230,000 a week, as people switch to public transport, walking or cycling.

The research suggests this would significantly improve air quality and noise levels on the car-free streets: ambient levels of nitrogen dioxide (NO₂) would be reduced by a quarter, bringing levels in line with recommendations from the World Health Organisation (WHO).

The plan is also expected to generate significant health benefits for residents. The study estimates that as many as 667 premature deaths from air pollution, noise and heat could be prevented each year. More green spaces will encourage people to get outdoors and lead a more active lifestyle.

This, in turn, helps to reduce obesity and diabetes and ease pressure on health services. The researchers claim that residents of Barcelona could expect to live an extra 200 days thanks to the cumulative health benefits, if the idea is rolled out across the city.

Space to play. Imag: Mosa Moseneke/Unsplash.

There are expected to be benefits to mental health, as well as physical health. Having access to such spaces can stave off loneliness and isolation – especially among elderly residents – as communities form stronger bonds and become more resilient.

Stumbling blocks

It was Salvador Rueda, director of the Urban Ecology Agency of Barcelona, who first championed the introduction of superblocks – and he argues that the idea could be used in any city. Even so, authorities looking to expand the concept in Barcelona or beyond will need to be mindful of some concerns.

Changes like these require capital investment. Even as the car-free streets are transformed with urban furniture and greenery, the remaining major roads will likely have to accommodate heavier traffic.

Nothing comes for free. Image: Zvileve/Flickr/creative commons.

Further investments in local infrastructure – such as improving surrounding roads to deal with more traffic, or installing smart traffic management system – could be required to prevent serious congestion. Then the question remains, how to finance such investments – a higher tax rate is unlikely to be popular.


What’s more, whenever a location becomes more desirable, it leads to an increase in property demand. Higher prices and rent could create pockets of unaffordable neighbourhoods. This may lead to use of properties for investment purposes and possibly, displacement of local residents.

It’s also worth noting that Barcelona is an old and relatively well-planned European city. Different challenges exist in emerging global cities across Asia, Africa and Latin America – and in younger cities in the US and Australia. There is a great deal of variation in scale, population density, urban shape and form, development patterns and institutional frameworks across the cities. Several large cities in the developing world are heavily congested with uncontrolled, unregulated developments and weak regulatory frameworks.

Replicating what’s been done in Barcelona may prove difficult in such places, and will require much greater transformations. But it’s true that the basic principles of superblocks – that value pedestrians, cyclists and high quality public spaces over motor vehicles – can be applied in any city, with some adjustments.

Leading the way

Over the history of human civilisation, great cities have been at the forefront of innovation and social progress. But cities need a robust structure of governance, which is transparent and accountable, to ensure a fair and efficient use of resources. Imposing innovation from the top down, without consultations and buy-in, can go squarely against the idea of free market capitalism, which has been a predominant force for modern economies and can lead push-back from citizens and local businesses.

Citizens must also be willing to change their perspectives and behaviour, to make such initiatives work. This means that “solutions” to urban living like superblocks need to have buy-in from citizens, through continuous engagement with local government officials.

A man speaks at a public consultation on the Eixample superblock in Barcelona. Image: Ajuntament Barcelona/Flickr/creative commons.

Successful urban planning also needs strong leadership with a clear and consistent vision of the future, and a roadmap of how that vision can be delivered. The vision should be co-developed with the citizens and all other stakeholders such as local businesses, private and public organisations. This can ensure that everybody shares ownership and takes responsibility for the success of local initiatives.

There is little doubt that the principles and objectives of superblocks are sound. The idea has the potential to catch on around the world – though it will likely take a unique and specific form in every city.

The Conversation

Anupam Nanda, Professor of Urban Economics and Real Estate, University of Reading.

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