Designing Cities for Health and Wellbeing: Transforming Place into Common Wisdom

1. ‘Health, Wellbeing & Design of Cities’ Graham Marshall Urban Environment Expert @ Prosocial Place Director @ The Centre for Urban Design and Mental Health Honorary Senior Fellow @ University of Liverpool Cardiff Convention 2016

2. Key Messages “Sustainable Communities are the Foundation of Attractive & Resilient Cities” ■ Understand the bond between place and mental wellbeing. ■ Embed successful place-making and stewardship in the growth agenda for Cardiff. ■ Generate a ‘common sense of place’. ■ Consider how a ‘well-design’ approach can transform this into ‘common wisdom’. ■ Champion a call to arms for the future of Cardiff.

3. “A Common Sense of Place” A film by Martin Cassini https://www.youtube.com/watch?v=RtxKhmLDUuo

4. Thoughts?

5. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

6. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

7. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

8. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

9. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

10. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

11. Exercise 1 • How nice is this place? • How much would you like to live in this place? • How wealthy are the people who live in this place? (100=richest of rich) • How much antisocial behaviour do you think there may be in this place? • How much would you say that people who live in this place mix with each other on friendly terms? • Rate each question from 0-100 (0 lowest -100 highest)

12. What do you Like About Where you Live? Exercise 2 Amy Casey

13. Where do you go to Feel Better? Exercise 2 Ed Fairburn

14. Design of Cities for the Common Good Talk Neil Cocker An interactive 'happiness map' of Cardiff

15. The Planning Context • ■ The NPPF sets the Context: “…the process of managing the development of land and buildings….to save what is best of our heritage and improve the infrastructure upon which we depend for a civilised existence.” • ■ Planning Practice Guidance: “…intended to assist practitioners.” It contains procedural, technical, design and health guidance to be implemented mutually. • ■ Local Plans: “Local planning authorities must prepare a local plan which sets planning policies in a local authority area.” • ■ Place-based Development & Regeneration Tools: • Design Guides • Planning/ Development Briefs; Masterplans; Design Codes; ‘Designs’. • Regeneration Frameworks; Action Plans.

16. Visions for ‘Any-place’ The Golden Aims For (insert your town here) We will create a distinctive 21st century place by: • Enabling a wide range of functions and activities in the day and in the evening and creating a thriving evening economy. • Revitalising the markets to accommodate a more varied range of shops, including national and specialised retailers (with a greater focus on new ideas, new businesses, quality fashion and food). • Establishing a more family-based environment, with a wide range of education, leisure and cultural opportunities including youth facilities. • Increasing job opportunities especially in creative and digital industries, information technology and financial services. • Encouraging a greater mix of uses including a range of housing to support a varied economy, which makes the best use of the available land and is affordable to local people. • Providing a more interesting and attractive environment by securing important landmark and ground-breaking buildings and good quality public spaces. • Maximising development opportunities at gateway locations and securing public art in appropriate locations. • Ensuring that new development maintains and enhances the character and appearance of the town centre including heritage assets and cultural resources through high quality design. • Encouraging the use of sustainable design principles including renewable energy. • Protecting existing open spaces and biodiversity and securing new and improved open space in the form of green space and civic space as part of new developments and improving the streetscape and public realm. • Developing and improving pedestrian and cycle links, encouraging alternative modes of transport other than the car, and creating an improved pedestrian environment.

17. Design Wisdom

18. Cullen/ Halprin/ Lynch / Alexander “The Timeless Way of Building …towns and buildings will not…come alive, unless they are made by all the people in society, and unless these people share a common pattern language…and unless this common pattern language is alive itself.” Christopher Alexander Serial Vision Ecology of Form Image of the City

19. Design Myths • Currently describing somewhere as “well designed” is meaningless - there is little or no evidence to support current urban design assumptions. • “Science, pseudo-science & urban design: • Abstract: Urban design theory has been criticised for being incoherent and insubstantial. • Generally uncritical affirmation as if factually established. • ...urban design rests on...a foundation of untested hypotheses...” • Dr Stephen Marshall, Bartlett School of Planning • URBAN DESIGN International (2012)

20. The Urban Context ECONOMY • ■ A human habitat; an urban ecology. • Its important to understand the bond between people and place. • Perceived ‘harsh’ environments promote habitual ‘survival’ behaviours. • Perceived ‘benign’ environments promote ‘thrival ‘ behaviours. PEOPLE + PLACE

21. Evolutionary Psychology Co-operation is an evolutionary stable strategy. Strong relationships between individuals, communities and the built environment promotes a resilient economy.

22. The Public Realm ‘Built’ or ‘Living’ environment’? The ancient Greeks “spoke of communities rather than cities made of buildings” - of Corinthians, Athenians and Spartans rather than Corinth, Athens or Sparta. (Scott, 2016).

23. Life History Theory When Your Place Makes you Discount Your Future ■ Where resources are perceived to be stable, reliable and predictable, people plan their futures, develop the capacity to adapt to inevitable life stresses, cooperate with other future -oriented people, to determine their positive futures. ■ Where resources are perceived to be unstable, unreliable and unpredictable, thrill-seeking and non-cooperative impulsive, self-centered choices are primed and become the norm.

24. People - Place Dynamic Uplift ■ Place (context)… …determines Thinking… …determines Behaviour… …determines Place… ■ Cues to threat or safety ■ Cues to high or low resource Decline

25. What is Wellbeing? • ■ Feeling good and functioning well: • Depends on having access to the • things that make life worthwhile. • ■ Hedonic approach: • Well-being from the pursuit of • maximum pleasure and minimum pain. • ■ Eudaimonic approach: (ancient Greek good ‘eu’ & spirit ‘daimon’) • Well-being from the pursuit of meaningful goals; ‘transcending oneself’ for the sake of the greater good.

26. Subjective Wellbeing ■ National data on subjective wellbeing: ONS * * * *

27. ‘People’

28. Subjective Wellbeing ■ National data on subjective wellbeing: Welsh Government

29. Subjective Wellbeing ■ National data on subjective wellbeing: Welsh Government

30. The Urbanicity Effect • A History of Research • Faris & Dunham (1939) “Mental disorders in urban areas”: Schizophrenia prevalence in inner city deprivation • Wirth ( 1938): depression prevalence in urban compared to rural settings • Pedersen & Mortensen (2001): a dose-response relationship between time spent in urban environments in childhood and risk. • Sundquist et al. (2004): Sweden - 4.4 million adults. Those living in the most densely populated areas had 68–77% more risk of developing psychosis and 12 –20% higher risk of developing depression than the reference group. • Peen et al.(2010) meta-analysis of urbanicity - mood and anxiety disorder. • Vassos et al. (2012): meta-analysis of urbanicity -schizophrenia • ‘Urban penalty’ extends to the wellbeing of all individuals

31. The Urban Penalty • Mental Wellbeing • North West Mental Wellbeing Survey 2009: • compared to the other North West areas surveyed, people in Liverpool had lower general levels of MH&W across the lifespan. In particular Liverpool residents felt: • Reduced sense of belonging to their community • Less participation in organizations • Feeling unable to ask others for help • Feeling unsafe outside their home • Relative isolation Lynn Deacon, Helen Carlin, Joy Spalding, Susan Giles, Jude Stansfield, Sara Hughes, Clare Perkins, Mark A Bellis

32. Urban Penalty Over Time • North West Mental Wellbeing Surveys 2009 + 12 • The number of people who talk to their neighbours ‘on most days’ has fallen from 51.9% to 33.6% • The number of people who ‘never’ talk to their neighbours has risen from 2.6% to 4.7% • The number of people who meet with friends and family (not living with) ‘on most days’ has fallen from 53.9% to 41.2% • There was a 12.7% fall in the number of people who felt ‘very strongly’ that they belonged to their immediate neighbourhood

33. Explaining the Effects • According to Wirth (1938) the effects are due to: • Decline in community relationships. • Poor social integration. • Isolation. • According to Wang (2004); Trivedi et al. (2008); Turan & Besirli (2008); Ellaway et al.( 2009) the effects are due to: • The perceived quality of the environment. • “Those living in relatively harsh urban areas are at an increased risk of depression, anxiety and paranoia.” • (Weich et al. 2002; Galea et al. 2005; Trivedi et al. 2008; Kirkbride et al. 2012McKenzie et al. 2013)

34. Thoughts Daily Mail: “Shops in Fairwater, Cardiff: The area has been plagued by groups of youths in recent months, leading to the 'acne light' suggestion.” (Daily Mail)A readers comment: “Another method of stopping this might be to Police it properly. Just a thought.” (‘Disillusioned’, Local Governmentshire) Is both design and stewardship the problem and the solution?

35. 5 Ways to Wellbeing ■ Be Active: prioritise active movement in the public realm and generally facilitate the pursuit of physical activity. ■ Keep Learning: endorse engaged design to enable individuals to learn about their place; encourage conscious foraging where dealing with uncertainty engages the brain. ■ Take Notice: elicit conscious awareness of place; avoid risk-averse approaches which strip agency; foster flexible dynamic design to surprise and re-orient attention. ■ Give:‘place’ back to people through co-production; advocate volunteering in the pursuit of good places to live; prioritise flexible spaces to accommodate prosocial community activity. ■ Get Connected: facilitate movement between gathering places and interaction between people.

36. What makes a Good Place? Discussion Walt Disney - Celebration

37. Moving Forward Recommendation Focus on the ‘built’ environment facilitates silo thinking. Focus on the ‘living environment’ promotes co-operative working.

38. Our Estate Place-Making for the Common Good ■ Fore-sighting that tells us that 80% of the buildings that we will inhabit in 2050 have already been built. ■ Much new development will be within existing fabrics, infrastructures and stewardship regimes, and so will be quickly assimilated to become ‘existing’. ■ We therefore need to make existing environments liveable as a matter of urgency, building on our evidence bases. ■ Lessons learned should direct the development of new places, not untested design theory or developers business plans.

39. ‘Living’ Environment ■ Without the skeleton, you can’t build the body. Effective connections and flow are the foundation of successful places.

40. FUTURE FOCUS: CHANGE VS. MORE OF THE SAME STUPID RESOURCE: THE ECONOMY PEOPLE: DON'T FORGET HEALTH CARE James Carville – 1992 messages for Clinton campaign.

41. Change Place; Change Behaviour ■ Well intentioned provision does not lead to sustained behaviour change. ■ Considered design solutions change behaviour by changing response to place.