Essential Futures (2): Public Health Places

Under lockdown, and with our movements restricted, the places within reach of our doorsteps have taken on renewed significance. A blocked-off street becomes a playground; a generous pavement or collection of well-placed balconies become places to socialise and connect with neighbours. We know that our health and wellbeing are linked to proximity to public green space, but what other types of public places can provide those particular qualities that help us to exercise, play, relax and socialise? Recognising that our everyday environments impact our physical wellbeing as much as they affect our physiological and mental health, we ask how the public realm can be planned to deliver primary preventative healthcare in-place.

Convalescing Everyday
Generations of city thinkers from Jane Jacobs to Jan Gehl have shown us that a city’s streets express its social intelligence. As cities consider models of pedestrianisation to accommodate physical distancing in the short term and remove cars (and air pollution) in the longer term, we ask what else pedestrianisation can do. How might we cultivate a freed-up streetscape towards actively improving our physical and mental health, as well as making space for diverse social lives? What if moving through the city, or even stepping outside our front door, could be as restorative as a walk in the park?

Models such as the Barcelona superblock demonstrate how pedestrianised islands in residential areas can be planned to retain citywide circulation. Park and ride schemes planned in tandem with mobility networks can restrict, rather than divert, numbers of cars on important circulation routes, enabling pavements to be widened and walkable corridors woven across neighbourhoods. While negotiating making use of newly available public space and mindful of prolonged social distancing measures, the city in conversation with collectives of businesses and residents could set objectives for ambient noise levels, lighting quality, climate, and biodiversity along these corridors. City-collected data combined with neighbourhood-scale citizen-sensing initiatives could be used to help set these goals; inclusive public design of both landscape and programme can help achieve them. Financing these alterations must however be balanced with measures to control ground-rent inflation over the long-term.


Ageing in (Public) Place
As populations age, improving our health-span is an urgent task that has bearing on both improving individual quality of life, as well as managing the increasing strain on our health services. How might we design the places and environments on our doorstep to meet specific needs across a lifetime, supporting living and ageing well in-place?

Public places designed to host multiple generations well together can help alleviate social isolation that leads to loneliness and mental decline. Streetscapes can be designed in conversation with public health researchers, local care homes and other care-giving institutions to ensure everyday places adequately accommodate a full-spectrum of physical and physiological needs. Underused pockets (brownfield sites, awkward plots, inaccessible patches) could be reclaimed for the public realm or managed according to the needs of our non-human cohabitants; our health depends on the diversity and health of the biosphere. By ensuring public places are socially and physically inclusive across generations, we can accommodate long and healthy lives in-place. 


Socialising Care
As we design public places to maintain and improve our physical and mental acuity, we could also plan in places that can help us get well again when we are sick. Could we design the public and semi-public realm to support and supplement the non-critical services demanded of centralised city hospitals and their staff?

We could design neighbourhood clinics and pharmacies in such a way that they incorporate public health libraries and medicinal gardens; places to learn about personal health on-demand in a cultural and social setting. Clinics for the management of chronic illness could be localised, bringing the benefits of chronic care-in place by reducing arduous commuting times. Looking to the design of Maggie’s Centres for guidance (providing holistic long-term cancer treatment, care and support in the UK), these clinics can be designed as beautiful and inclusive places to be enjoyed along with friends and family, both accommodated by and adding to the health bringing benefits of a well designed public realm. We could also find ways of bringing the outside in; designing waiting rooms inside hospitals as meditative gardens, or productive gardens, or gardens tasked with the attraction of local species of insect, animal and plant.

We can plan extensions and supplements to centralised health services by unfolding certain care-giving services within the public realm. In doing so, we could relieve pressure on centralised care services, increasing proximity to health services at the neighbourhood scale, whilst socialising health care. After all, as we chat with our neighbours 1.5 metres apart, we know now more than ever that our health is as much a public project as it is a collective responsibility.