Scales of health impact

There are three interconnected scales of health impact: planetary health, ecosystem health and local health. Impacts across these scales are not all immediate and may occur over months, years or decades, within and beyond the boundaries of changes to the physical environment.

Built environment decisions often result in changes that last decades or longer, and it is therefore essential to consider how they will impact health at multiple scales. THRIVES positions core principles and planetary health at its core, shifting the focus from individuals to our environment.

The scales of health impact are pathways through which urban environments affect human health and they are aligned to a set of example evidence-based design and planning goals. In turn, these link to scales of urban decision-making related to the built environment.

Planetary health

The concept of planetary health refers to ‘the health of human civilisation and the state of the natural systems on which it depends’.(1) The built environment causes environmental degradation at a global scale through resource-intensive design, construction and operation and through habitat destruction that reduces biodiversity.

The THRIVES Framework sets out three example pathways through which the built environment can support planetary health: enhancing biodiversity and promoting resource efficiency and zero carbon systems.

Ecosystem health

Ecosystem health in the THRIVES framework references an ecosystem services perspective whereby ecosystems provide food, clean water, climate regulation and recreational opportunities, and in turn these services support human health and wellbeing. Ecosystems are ‘webs of connections between living and non-living system components’ and they are foundational to human health (2).

THRIVES lists five example goals for ecosystem health: sustaining air, water and soil quality, and greenspace, and improving sanitation, waste, and mobility infrastructure.

Local health

The final scale of health impact is local, and it contains two rings in the THRIVES Framework representing design and planning decisions for buildings and neighbourhoods.

At the neighbourhood scale, example design and planning goals are to connect people with services (covering employment, education, retail, leisure, healthcare and other facilities), perceived and actual safety, culture, public space and food. At the building scale, example goals are to shelter people with acoustic and thermal comfort, affordability, tenure security, lighting and space.


References

(1) Whitmee, S., et al. (2015) Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. The Lancet. 386  (10007), pp. 1973–2028.

(2) Buse, C.G., et al.. (2018) Public health guide to field developments linking ecosystems, environments and health in the Anthropocene. Journal of Epidemiology and Community Health. 72  (5), pp. 420–425.