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Podcast interview on Green Urbanist

Green Urbanist podcast image showing Helen Pineo. Episode number 62.

In this podcast, Ross O’Ceallaigh of the Green Urbanist interviews Helen Pineo. This conversation covers personal reflections about urban living and the basics of healthy urbanism. We spend a lot of time talking about how healthy urbanism relates to planetary and ecosystem health. We also get into details on the ‘business case’, new models of development and a mutual love of community-led housing.

Listen to the podcast and read more on the Green Urbanist substack for Episode 62 using the link below.

Listen to the podcast
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Technology and supply chain issues aren’t our biggest barrier to decarbonizing homes

Outdoor section of a heat pump

If you had enough money to commission a global architectural practice to design your home, you would also expect them to use sustainable design principles so that your home did not contribute to the number one crisis of our times…right? Apparently not according to anecdotal evidence, but who is to blame for this lack of demand, the client or the industry? And what does this say about our readiness to change our homes for the climate more generally? Where the focus was previously on getting political commitment and funding for decarbonizing the built environment, we need to focus now on helping the public make changes to their homes, and this is a lot harder than we think.

Many companies in residential property development, big and small, aren’t selling sustainable design as core to their product. I came across a marketing piece by a high-end design firm. They were pitching ‘resilient design’ – not regenerative or even sustainable design – but resilient. It was about giving wealthy clients a sense of security and control in a rapidly changing world where overheating, wildfires and power outages are increasingly common. An example from the pitch was that a home would have mechanical cooling most of the time, but natural ventilation would be built in, for use if the power went down. There’s nothing stopping the firm from designing a resilient AND sustainable, even regenerative, home. If budget is not a barrier, these luxury homes could easily have a positive impact for people and planet, but judging by the marketing content, sustainability must not be important to these clients.

I started thinking, who are these clients and how can they disregard their environmental and social responsibilities when they have the financial means to live up to both? But what if they’re just acting on the information that they have, in the world they live in? Common thinking about sustainable homes is that they are a niche and expensive product for lefties. But they don’t have to be expensive. Before the government-led Code for Sustainable Homes was scrapped in the UK in 2015, developers had already found ways to deliver high sustainability at an affordable cost. They also don’t have to be niche. Many cities and countries require high sustainability standards in their building codes. But what about the political element, is sustainable design still seen as a liberal solution, not just a good solution for the problems we all face?

This brings me to the odd social media debates currently raging about heat pumps and stovetops in the USA decarbonization agenda. You don’t have to dig deep to find conspiracy theories and a lot of rage about what people feel they are being ‘forced’ to do in their own homes. So what if people are just acting on the information that they have, in the world that they live in? Relatively rapidly our homes and appliances have become the site of a new kind of fortress building and cultural conflict. In cities and communities that are not in themselves resilient to the impacts of climate change, people with means will buy technologies to keep themselves comfortable. The home fortress in the 2020s is not one with a bomb shelter, but one with a power generator, mechanical cooling and storm shutters. People might not know that their air conditioning unit is making it harder for their neighbours to stay cool. They might feel that the carbon emissions created from their cooling system are an unfortunate but necessary cost to stay safe (in extreme heat) and comfortable (in moderate heat). So lack of information and better solutions are driving current household coping mechanisms, rather than active disregard for the negative impacts of certain technical solutions.    

We need to take people along on the journey to homes that are safe for occupants, fit for instability and climate friendly. We have to meet people where they are at not only in terms of money, but also motivation and knowledge. Last summer in the UK heatwave, I took part in some media outreach. On BBC Radio 5 Live, as the academic built environment ‘expert’ I was asked some basic questions about how design could help us stay cool in a heatwave. Reflecting on this now, I overestimated the general level of understanding. I think it’s not just me who has failed to listen and communicate in the right way. A lot of the available information is professionals talking to professionals, not the general public. If we expect people to make changes in their homes to deal with a changing climate, we need to understand the challenges and solutions that they’re currently working with. For example, we need to find out how different people currently cope with heatwaves and how this varies across properties and by age, gender and other factors. Then we can offer help on a scale from free advice on when to close windows all the way up to subsidies for a new heat pump.  

If the goals in the US Inflation Reduction Act and similar policies globally are going to be achieved, we need to learn important lessons about getting people to make changes to their homes (not only homeowners but also those who rent or live in public housing). Part of the reason why the UK Green Deal failed to work was a mismatch between the public’s knowledge and willingness to change their home and the government’s support package – specifically a shortfall in dependable suppliers and a lacklustre financing package. There is a huge need to invest in tailored information campaigns and skills development to widen the pool of trusted suppliers. Those of us working on climate change and the built environment need to be more understanding of the reasons that individuals resist changes in their home. It’s not just about publishing infographics, it’s about responding to the cultural, emotional and economic factors that shape the everyday experiences of living through a changing climate.

This post is based on the topics discussed in Chapter 9 of Healthy Urbanism.

Image: Outdoor section of a heat pump. Credit Kristoferb, This file is licensed under the Creative Commons Attribution-Share Alike 3.0 license.

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Introducing ‘Healthy Urbanism’

Healthy Urbanism book launch

Pineo’s book Healthy Urbanism: Designing and Planning Equitable, Sustainable and Inclusive Places was published in May 2022.

Reviews

“Through the lenses of equity, inclusion and sustainability, Pineo’s ‘healthy urbanism,’ productively builds on existing theory and practice to consider and describe the processes, principles and goals that can support health through urban planning and development.”

—Professor Julian Agyeman, Tufts University, USA

“This treasure-trove book sightsees health and well-being on a journey. Beyond traditional boundaries of urbanism, it voyages by streets, cities, and planetary ecosystems, enhancing synergies between urban disciplines, evolving new approaches to preserve well-being, amplifying opportunities for a healthy and equitable life on a sustainable planet. Masterfully organized, combining social and built environments in a policy-based and historical context, the book anchors in carefully selected case studies, capturing lessons for a new generation of scholars illuminating the potential paths travelled in the pursuit of answers in this invigorating interdisciplinary science.”

—Professor Waleska Teixeira Caiaffa, Federal University of Minas Gerais, Brazil

“This book is an indispensable read for all those concerned about how urban development can support a growing world population, providing equitable opportunities for healthy living within planetary boundaries.”

—Professor Sir Andrew Haines, London School of Hygiene & Tropical Medicine, UK

“Pineo’s examination of healthy urbanism offers a deep dive and systems thinking framework to understanding the social and physical determinants of health. Virus transmission, extreme weather, social isolation and challenges to long standing inequities in how our communities are built and resources are distributed are challenging siloed, single issue approaches to sustainability, well-being and healthy community design.  The site-specific examples and case studies brings the research to life and makes this text very readable for people in and outside of public health and urban design disciplines.”

—Sharon Z. Roerty, Robert Wood Johnson Foundation, USA

Launch Event

A hybrid (online and in-person) launch event called ‘Urban Health Inside Out’ was held at University College London in July 2022. A panel of speakers discussed their experiences of working to support health through the fields of urban design and planning, public health and property development.

The event was chaired by Prof Yolande Barnes, Chair Bartlett Real Estate Institute, UCL with speakers: Prof Julian Agyeman, Professor of Urban and Environmental Policy and Planning, Tufts University; Kieron Boyle, Chief Executive, Guy’s and St Thomas’ Foundation; Dr Helen Pineo, Associate Professor in Healthy and Sustainable Cities, University College London; and Julia Thrift , Director, Healthier Place-making, TCPA (Town & Country Planning Association).

Recording

Healthy Urbanism book launch event, 7 July 2022, University College London.

Photo exhibition

The launch event included a photo exhibition of examples from our healthy urban development case study review and student contributions. A digital version of the photo exhibition is shared below.

About Healthy Urbanism

Structured around the THRIVES framework, the book offers a balance of theory and practice, illustrated with case studies. Each of the scales of health impact in THRIVES is examined through a chapter, first using evidence to demonstrate that the status quo of urban design and planning is insufficient to support health and then proposing frameworks and design solutions to overcome this challenge.

The book is a resource for existing professionals and students in built environment and public health professionals. Readers will find sections covering key topics in healthy urbanism, including:

  • An overview of health and wellbeing models with key definitions, global trends in urban health and drivers of urbanisation
  • Discussion of the shifting priorities for healthy places from ancient cities, social reform, high-rise housing and new urbanism through to 15-minute cities
  • Models for conceptualising the built environment’s impact on health and the need for THRIVES
  • Deep dives into each scale of health impact in THRIVES, including planetary health, ecosystem health and local health, with in-depth policy and design case studies
  • Ways of practising healthy urbanism, covering policy-making, community knowledge, funding healthy places, models of healthy development and monitoring
  • Priorities for the future of health urbanism, including disaster prevention and recovery, incremental to transformative urban change, smart cities and framing healthy urbanism.

Endorsements from Professor Julian Agyeman, Professor Waleska Teixeira Caiaffa, Professor Sir Andrew Haines and Sharon Z. Roerty are available on the Springer Nature website.

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Healthy housing policy review

Exposures in 'Policies, regulations & legislation promoting healthy housing: a review' (WHO, 2021)

The World Health Organization has long supported research and guidance on healthy housing. On behalf of the WHO, we conducted an international review of policies that would support healthy housing. The outputs include an interactive pdf and a policy repository. This work supports countries with implementation of the WHO Housing and health guidelines. 

The interactive report covers the following exposures: overcrowding, low and high indoor temperatures, home injuries, accessibility, water quality, air quality, damp and mould, noise, asbestos, lead and radon.

The image below from the report shows the range of policy approaches and instruments that were reviewed. Each section contains evidence reviews and global policy examples, alongside links to other WHO resources.

Reproduced from WHO 2021, Figure 3.1 ‘Overview of Policy Approaches and Instruments Identified in the Review’

Read: ‘Policies, regulations & legislation promoting healthy housing: a review‘

Published January 2021

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Obesity and the built environment

Turning the Tide

Obesity is a significant health challenge that relates to the built environment. The design of buildings, neighbourhoods and cities can create places where people can balance physical activity with a healthy diet. Being overweight may also be linked to sleep and stress, and the built environment can also help with these areas of our lives.

I was delighted to contribute to the new Obesity Health Alliance report ‘Turning the Tide: A 10-year Healthy Weight Strategy’ as an expert advisor with Julia Thrift and Michael Chang. We reviewed evidence and drafted content for Chapter 6 ‘The environment around us’.

This report provides many clear recommendations for policy-makers and I’m particularly pleased that our point about the purpose of planning being to support public health was included.

Read ‘Turning the Tide: A 10-Year Healthy Weight Strategy‘

Read the ‘Summary for Policy-Makers‘

Published September 2021

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Health and climate change mitigation

A healthy future – tackling climate change mitigation and human health together

The actions that we need to take to avoid severe climate change will help us in the short-term to improve health. This report from the Royal Society and Academy of Medical Sciences covers the latest evidence about health co-benefits from climate change mitigation and adaptation.

I contributed to the section on buildings, where we argued that increasing energy efficiency in homes can reduce cold-related deaths. We make the point that integrated design is needed to avoid risking overheating and poor ventilation.

Other sections in the report include Energy Use, Transport, Food, Natural Environment, Employment, Healthcare Systems and Global health implications of the UK’s transition to net-zero.

The report offers 4 recommendations, including:

  1. Incorporating health into the climate narrative
  2. Integrating climate adaptation and mitigation policies to benefit health
  3. Developing metrics to assess health impacts
  4. Promoting transdisciplinary systems approaches to address the complex interaction between climate change mitigation and health

Report: ‘A healthy future – tackling climate change mitigation and human health together’

Published in September 2021

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How are indicators used in urban planning?

Engineers drawing on whiteboard

Policy-making is complex and contested, and health is only one goal among many to be achieved through implementing urban planning policy. We researched the complexity of this process using a systems thinking approach, mapping out the value of urban health indicators in two case studies.

Key findings

  • Creating and using urban health indicator tools increased inter-sectoral relationships, which supported different stakeholders to better understand each other’s opportunities and constraints.
  • Relationships among stakeholders spurred new advocates for health in diverse organisations, supporting health-in-all-policies and whole-of-society approaches.
  • Constraints to health-promoting policy and implementation (e.g. legal, political and economic in nature), were overcome through community involvement in urban health indicator tools and advocacy effectiveness.
  • Some characteristics of indicator tools reduced their perceived relevance and authority, such as: a high number of available indicators, lack of neighbourhood scale data and poor-quality data.

In this research of activities in Melbourne (Australia) and San Francisco (USA), urban health indicator tools were a form of evidence that influenced local urban planning policy and decision-making when they were embedded in policy processes, networks and institutions.

Systems thinking approach

This research used systems thinking to map out participants’ mental models of how indicators were used in planning policy and decision-making. The image below is one of the causal loop diagrams produced in the research. It shows how inter-sectoral relationships led to increased urban planning policy that would be health-promoting.

Detailed view of the causes and effects of inter-sectoral relationships (arrow colours denote diverse participants’ perspectives: orange for producers, green for users, blue for both and grey for the researcher), from Pineo et al. (2020).
Read the research article

References

(1) Pineo, H., Zimmermann, N. and Davies, M. (2020) Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis. Palgrave Communications. 6  (1), pp. 1–14. https://doi.org/10.1057/s41599-020-0398-3

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Strengthening planning & health in England

In England, the planning and public health systems are nationally structured to create the policy opportunities for healthy place-making in local government. Yet, there is a frequent failure to create healthy communities that supported by infrastructure and housing that supports equity, sustainability and inclusion. There are many reasons for this, including a narrow focus on housing delivery above issues of quality.

With collaborators working across English local and national government organisations, we wrote an analysis in the British Medical Journal outlining the opportunities to increase healthy urban planning in England.

Key recommendations from the analysis include:

  • ‘Built environments are designed and developed using guidance from quality assured sources such as Public Health England and the Town and Country Planning Association
  • Person centred design is favoured over an infrastructure led plan to ensure places support healthy, active communities
  • The approach to person centred design is strengthened by ensuring that local health needs are linked to the planning policy process, led by integrated care systems
  • A stronger focus is placed on prevention and promoting the conditions for good health within all built environment plans, designs, and developments.’
Read the full analysis in BMJ

This collaboration and the resulting paper was developed following a Salzburg Global Seminar in partnership with Robert Wood Johnson Foundation. A number of other papers and blogs were written by global practitioners and academics working in healthy and equitable urban planning.

Read Building Healthy Communities

References

McKinnon, G., Pineo, H., Chang, M., Taylor-Green, L., Strategy, A.J., Toms, R., 2020. Strengthening the links between planning and health in England. BMJ 369. https://doi.org/10.1136/bmj.m795

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Cities, Health and Well-being

The Royal Institution of Chartered Surveyors commissioned an insight report on ‘Cities, Health and Well-being’. The report explains how urban environments can affect both health and wellbeing in different settings.

Readers will find the following topics:

  • An introduction to health in cities, including key urban health trends of increasing chronic diseases and physical inactivity
  • An overview of urban environment factors that affect health
  • International examples of urban planning policies and new development that have integrated health considerations
  • A comparison and overview of building standards that relate to health, particularly the WELL Building Standard and Fitwel
  • Discussion of the financial value and cost of achieving healthy places
  • A set of top tips for getting started (aimed at built environment professionals).
Cities, Health and Well-Being RICS Insight Report
Read RICS report

Pineo, H., Rydin, Y., 2018. Cities, health and well-being. Royal Institution of Chartered Surveyors, London.

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Healthy planning & regeneration

This report is a summary of best practice related to planning, regeneration, and community engagement about health and place.

The report includes:

  • a summary of (evidence-based) health impacts from urban environments (focused on healthy eating, physical activity, social interaction and access to health services);
  • a quick reference guide to built environment health impacts and related planning policy responses;
  • an overview of the health impacts of regeneration projects;
  • examples of innovative ways to involve communities in healthy planning; the role of urban health indicators in monitoring policy impact;
  • and further guidance.

This report was the output of a healthy planning project with Southwark and Lambeth Councils in London. The local authority planning and public health departments had several key focus areas that responded to local priorities:

  • social isolation
  • physical (in)activity
  • healthy eating
  • integrated health services

The table below shows the built environment topics that were explored in the project, and the strength of evidence for each of the councils’ priority areas.

Connection between built environment features and health themes (Pineo, 2017).
Healthy Planning and Regeneration: innovations in community engagement, policy and monitoring
Read the report

Pineo, H., 2017. Healthy Planning and Regeneration: innovations in community engagement, policy and monitoring. Building Research Establishment (BRE), Watford, UK. doi: 10.13140/RG.2.2.22459.11048

Funding for this report was provided by Guy’s and St Thomas’s Charity and the BRE Trust.