SUPPORTING CITY KNOW-HOW
Human health and planetary health are influenced by city lifestyles, city leadership, and city development. For both, worrying trends have lead to increasing concern, and it is imperative that these become core foci for urban policy. This will require concerted action; the journal Cities & Health is dedicated to supporting the flow of knowledge, in all directions, to help make this happen. We wish to foster communication between researchers, practitioners, policy-makers, communities, and decision-makers in cities. This is the purpose of the City Know-how section of the journal. We, and our knowledge partners, the International Society for Urban Health and Salus.Global invite you to join these conversations with the authors and communities directly, and also, we hope, by publishing in Cities & Health.
This thematic issue of Cities & Health comprises a collection of papers that help shed light on urban health research within the spatial governance, planning and design remit of the journal. In all it contains leading editorial ‘Challenges and opportunities for urban health research in our complex and unequal Cities’, a reflective think-piece and 13 research papers. Together these provide an insight into the wide variety of urban health research across many countries. We invite you to dip into this wealth of content.
Each research papers has its findings distilled in this article – as an accessible ‘City Know-how’ briefing – to support urban place-based research, policy and action.
As a journal, we welcome conjecture, commentary and debate arising from these papers. Let’s make human settlements healthier and more equitable for communities; and healthier for the planet.
What does mega-sport volunteering contribute to a city and the wellbeing of volunteers?
People and place – an analytic framework.
It’s not just the sport – new research shows the impact of Glasgow Commonwealth Games volunteers on wellbeing in the city.
For the attention of: City planners – culture, leisure and sport; Volunteer-involving organisations – public, private and voluntary sector; Public health professionals
The problem: Volunteer engagement is crucial to the effective delivery of mega-sporting events and getting people involved may bring additional benefits to cities and regions. Most evidence focuses on event volunteering, while less is known on how participation fits with the wider social context. The city of Glasgow hosted the 2014 Commonwealth Games, which provided an opportunity to explore volunteer views on the longer-term health and wellbeing benefits.
What we did and why: This was a qualitative study using interviews and focus groups to explore volunteer perspectives one year post Games. This complemented a quantitative study based on a longitudinal survey of volunteers. We used a social determinants lens to explore the potential health and wellbeing impacts of participation. Our sample included volunteers living in Glasgow and further afield and also a small number of unsuccessful applicants, as there is little known about people unable to participate.
What our study adds: This study helps unpack the range of impacts from mega-event volunteering based on the perspectives of volunteers. Volunteers identified individual wellbeing benefits and wider social and economic outcomes, such as increased pride in the city. Our ‘people and place’ framework highlights the strong links between event volunteering, other forms of pro-social action and the wider context. The study also builds understanding of the experience of people who aren’t selected to volunteer in a mega-event.
Implications for city policy and practice: Promoting and sustaining pro-social action following one-off mega-events is an important issue for host cities. City policy makers should think widely about the different ways citizens can participate and how rewards and motivations are enhanced through recognising the value of place. This may help with evaluating impact and legacy. Ensuring event volunteering is inclusive involves communicating how people contribute to a welcoming atmosphere in the city – even when they are not selected as an event volunteer.
For further information:
Report from Leeds Beckett University: Exploring the experiences and impacts of Glasgow 2014 volunteer applicants
Evaluation from Scottish Government: Glasgow 2014 Commonwealth Games legacy: final evaluation report April 2018
Full research article: Volunteerism, social context and health impacts: a qualitative study of Glasgow Commonwealth Games event volunteers by Jane South, James Woodall (@woodalldr), Kris Southby (@krissouthby), Russell Jones, Gregor Yates, Karina Kinsella & Ellie May (@ellieloumay21).
Making the invisible visible: tuberculosis in Detroit
Mean values of the economic disadvantage index by race/ethnicity, nativity, and health department.
The face of tuberculosis looks different across metropolitan Detroit. U.S.A born Blacks in Detroit City with tuberculosis experience greater economic disadvantage and instability than those with tuberculosis outside of the City.
For the attention of: City public health departments, mayors of major cities, urban planners constructing neighbourhood environments, housing authorities.
The problem: Inequities in socioeconomic resources across metropolitan areas give rise to inequities in tuberculosis at large. Neighbourhoods that are already disadvantaged are more likely to see epidemics of tuberculosis. However, we know very little about the neighbourhood and social context of individuals with tuberculosis in the modern-day USA.
What we did and why: We did an in-depth survey of the social experience of individuals with TB across three areas in metropolitan Detroit. Using the survey data we were able to describe the social profile of individuals with tuberculosis and how they differed across geographic space with metropolitan Detroit.
What our study adds: This is the first in-depth survey of individuals with tuberculosis in current day USA. We explored differences in patterns within metro Detroit. We found that:
tuberculosis in Detroit City is concentrated among non-Hispanic Blacks and U.S.-born individuals,
non-Hispanic Blacks/USA born individuals, had higher levels of economic disadvantage and instability than those outside of Detroit City, or their White/foreign-born counter parts.
Implications for city policy and practice: More resources are needed to address neighbourhood level factors that promote the spread of tuberculosis such as crowded housing, degraded housing, little access to green space. To tackle the disease, cities also need comprehensive promotion of programs that improve housing conditions and give access to healthy foods.
Full research article: Making the invisible visible: the current face of tuberculosis in Detroit, Michigan, U.S.A by Grace A. Noppert & Philippa Clarke.
What is the anticipated economic return of urban greenways?
Dixon Hollow, Connswater Community Greenway, Belfast, Northern Ireland.
Every £1.00 invested in an urban greenway can expect to return an investment of £2.00-£6.00 presenting a strong business case for investment in urban green infrastructure.
For the attention of: Local government (those responsible for infrastructure and public health); transport planners; city planners; public health advocates
The problem: Urban greenways are open spaces in cities used for recreation or to protect the environment.
Previously published research points to the health benefits of urban greenways. They also have social, environmental and economic benefits. However, to date, a full economic business case for new urban greenways has not been developed.
To the best of our knowledge, this is one of the first studies to conduct a social return on investment analysis of a new urban greenway estimating the potential benefits.
What we did and why: We assessed the economic business case for urban greenways, and demonstrated their value. Our approach was to undertake a ‘Return on Investment’ study of the Connswater Community Greenway in Belfast. We identified seven key areas to look at: property values; flood alleviation; climate change; health; labour employment and productivity; tourism; and quality of place.
For each area, we summarised the evidence base to predict an ‘effect estimate’ (how large the impact was likely to be). We added together all the monetary values of the impacts to obtain the total monetary benefit, and then divided that by the total cost of the intervention works. This provided us with a ratio describing the amount in pounds sterling (£) generated in benefits for every £1 invested.
What our study adds: Assuming the greenway will be managed and maintained for at least 40 years, we found that the economic case to be that for every £1.00 invested in the greenway, there would be a £2 – £6 economic return (this is between 2.88 and 5.81 as a Benefit Cost Ratio).
Implications for city policy and practice: Our work highlights, and quantifies, many of the positive benefits – including environmental, health and economic – which urban greenways can bring to an area.
Other monetised and non-monetised benefits, such as the attraction of economic investment and social value through planned concurrent community engagement activities (such as walking programmes, litter pick-ups, arts and crafts, local markets), are also likely. However, they can be difficult to measure and value. To date, few studies have attempted to aggregate and value the total economic business case for urban greenways.
Further information:
Website for Connswater Community Greenway, and Twitter @ConnsGreenway
Website for QUB Centre for Public Health, and Twitter @CPH_QUB
Read the full paper: Social return on investment analysis of an urban greenway by Ruth F. Hunter (@Ruth_HunterQUB), Mary A.T. Dallat, Mark A. Tully (@MarkATully), Leonie Heron (@leonieheron92), Ciaran O’Neill & Frank Kee
Who are we designing transport systems for (and who is missing out)? A study from Auckland, New Zealand
Naama to research assistant: ‘I can feel the heaviness on my legs and that is a sign of enough. Can we continue another time?’ Her closest bus stop is yet another 240 metres down this road.
We have transport systems that are designed to privilege the needs of people who are most valued in society. Who is missing out, and what does this mean for their health and wellbeing?
For the attention of: Transport authorities, City councils, Organisations serving older citizens and/or the disability community
The problem: Transport systems have huge implications for health, influencing mobility and access to places, resources, and relationships important for wellbeing. But transport systems are often built to prioritise the needs of socially-advantaged commuters. How does this impact the mobility, health and wellbeing of people who don’t fit this ideal?
What we did and why: We worked with communities in four sites in Auckland, New Zealand. We used community-based participatory research methods, including ‘go-along’ interviews, focus groups and interactive workshops, to engage communities who are least often heard at policy or strategic levels. We particularly sought the experiences older- and disabled- or bodily-diverse people from varied ethnic groups living across a range of socio-economic circumstances.
What our study adds: This study adds to understandings of the multi-layered nature of transport disadvantage, particularly active forms of travel. The participants’ narratives showed us how urban transport systems limit opportunities for mobility, health and wellbeing among older citizens and people living with disabilities. These disadvantages are amplified by transport infrastructure that further marginalises those already marginalised, such as poorer communities and people identifying with Indigenous (Māori) and non-Western disadvantaged ethnic groups.
Implications for city policy and practice:
City planners need to consider how multiple forms of marginalisation intersect as part of transport consultation and design.
Forms of marginalisation (age, socio-economic status, ethnic minority status, illness and disability) are not discrete and independent, but tend to coalesce and intensify.
People who are impacted in multiple dimensions may be among the least enabled to be heard.
Consultation processes must therefore meaningfully engage people who are impacted in multiple dimensions.
Full research article: Inequitable mobilities: intersections of diversity with urban infrastructure influence mobility, health and wellbeing by Julie Spray, Karen Witten, Janine Wiles, Anneka Anderson, Dolly Paul, Julie Wade and Shanthi Ameratunga.
Using health data to target non-communicable disease prevention for vulnerable urban populations
Geographic Heat Mapping of Proximal NCD Risk Factors.
How can health officials reach urban populations most at risk for NCDs? A new study from the USAID-funded ‘Building Healthy Cities’ project argues that equity-focused data analysis is the key.
For the attention of: Donors funding urban health and NCD projects, smart city leaders in India, and researchers collecting NCD data
The problem: Health data are often collected in a way that suits national and international needs, not in a way that informs municipal decision-making on health programs in a practical way.
What we did and why: The Building Healthy Cities project collected representative city data and disaggregated it by sub-population. Cross referencing this with spatial geographic data we are better able to understand not only who is really most at risk in the city of Indore, but also where in the city they live.
What our study adds: This analysis adds nuance to the urban health equity discussion, adds to best practices for urban data collection, and is a starting point for discussion of intra-city risk groups in the Indian context.
Implications for city policy and practice: We already know that urbanization can increase health inequities, but important data can be hidden within average prevalence rates. This approach can be used in cities to identify sub-groups at risk of ill health.
In doing this we found that disease risk factors can be compounded, especially on those residents with multiple disadvantages. Our analysis can inform city planners, both locally and internationally, about how to target scarce health resources to decrease disparities.
Links to other resources and support:
USAID-funded Building Healthy Cities project: Testing healthy urban planning approaches in Indore, India; Makassar, Indonesia; Kathmandu, Nepal; and Da Nang, Vietnam.
Indore Smart City: website
Twitter handles to follow: @JSIHealth, @USAIDAsiaHQ, @IndoreSmartCity
Full research article: Exploring urban health inequities: the example of non-communicable disease prevention in Indore by Amanda Pomeroy-Stevens (@apomeroystevens), Damodar Bachani, Meera Sreedhara, John Boos, Ritvik Amarchand & Anand Krishnan
Menstruation in focus: where does the waste go? A case study of Blantyre, Malawi
Informal settlement in Blantyre, the study area in Malawi. Photo: Heather Roxburgh.
New study shows how culturally sensitive menstrual waste is burned and compromises urban sanitation infrastructure in Malawi and discusses consequences for public/environmental health.
For the attention of: Solid waste management practitioners, Faecal sludge management practitioners, Menstrual health specialists
The problem: Throwing menstrual waste into urban pit latrines inhibits the development of pit emptying markets and faecal sludge composting ventures because it makes removing and treating the faecal sludge more difficult and expensive. As menstruation is often stigmatised, pit latrines are anecdotally known to be a popular disposal route due to their discretion. However, there is an absence of data to show the scale at which menstrual waste interacts with household toilet and waste facilities.
What we did and why: We surveyed 258 women in the southern African city of Blantyre, Malawi, on their menstrual absorbent use and disposal practices, along with their demographic characteristics and toilet and solid waste services. For those who were menstruating 10 years prior to the survey, they were asked what menstrual absorbents they used at that time.
What our study adds: The results show that disposable pads and menstrual cloth are the most commonly used menstrual absorbents, and almost all of these are either burned or thrown into pit latrines. Little menstrual waste goes into bins or rubbish pits due to privacy-related concerns about visibility of the waste. The results also suggest that the volume of waste is likely to grow in the future due to increased preference for disposable absorbents among younger generations.
Implications for city policy and practice: It is critical for public health that pit latrines in dense settlements are emptied when full. However, this remains difficult and expensive to do until either menstrual waste is diverted from pit latrines to culturally acceptable alternative destinations or pit-emptying and sludge treatment practices are designed to cope with the presence of menstrual waste in sludge. Supporting markets for high-quality reusable pads may reduce menstrual waste volumes, which are otherwise expected to grow.
For further information :
The Menstrual Health Hub: A digital networking and knowledge platform to support the global menstrual community. It provides online space to connect to those working on menstrual and female health. It hosts free access to relevant data and resources for research, education, policy and innovation.
The Shit Flow Diagram initiative: A step towards providing adequate sanitation services in urban areas is to monitor the whole sanitation service chain, to identify its strengths and weaknesses. Shit Flow Diagrams can help achieve this by offering a new and innovative way to engage sanitation experts, political leaders and civil society in coordinated discussions about excreta management in their city.
Full research article: Blood flows: mapping journeys of menstrual waste in Blantyre, Malawi by Heather Roxburgh, Caron Magombo, Tamandani Kaliwo, Elizabeth A. Tilley, Kate Hampshire, David M. Oliver & Richard S. Quilliam.
The potential of zoning policy to improve tobacco control in urban neighborhoods
Map of the distribution of tobacco retailers; current smokers; and medium- and high-density residential zones. Wilmington, Delaware.
Smoking continues to be the number one cause of premature mortality in the US. The tobacco industry deliberately targets marginalized communities. Better urban zoning policy may reduce these harms.
For the attention of: City councils, local health departments, tobacco control organizations
The problem: Existing tobacco laws and policies have been less effective for reducing smoking rates in lower-income and predominant racial/ethnic minority communities. This may be in large part because stores that sell cigarettes concentrate in these same communities, which are supported by the tobacco industry. More stores selling cigarettes in these communities means more marketing and advertising, lower prices, easier access, and social norms more tolerant of smoking,
What we did and why: We assessed the potential of using a novel, residentially focused zoning approach to produce a more targeted and equitable reduction of tobacco retailers in high-risk urban settings. We focused on Wilmington, Delaware, a city with high poverty rates, a majority Black population, a disparate number of tobacco retailers, and an elevated smoking prevalence.
What our study adds: The results of the study suggest that new regulations of tobacco stores in residential areas of lower-income, predominant minority cities have the potential to help reduce the chances of youth starting smoking and increase the chances of current smokers quitting.
Implications for city policy and practice: By engaging the community and local store owners, city governments can advance social justice and health equity by putting in place new restrictions on selling tobacco products in residential areas.
Full research article: Reducing exposure to tobacco retailers with residential zoning policy: insights from a geospatial analysis of Wilmington, Delaware by Scott D. Siegel, Madeline Brooks, Jason Bourke & Frank C. Curriero.
Perceptions of healthy neighbourhood design among new homebuyers and land developers
Conceptual model of the relationships between neighbourhood qualities: walkability, bikeability, vibrancy, livability, and health supportive.
What makes a neighbourhood walkable, bikeable, livable, vibrant and healthy? Canadian homebuyers and land developers shared their perspectives on health supportive neighbourhood design.
For the attention of: Homebuyers, Urban planning professionals, Real estate professionals.
The problem: The importance of creating healthy built environments is recognized by public health authorities and the urban planning professions. There are different perspectives regarding neighbourhood qualities (walkability, bikeability, livability, vibrancy and healthy), which to date are not universally defined. The perspectives of recent homebuyers and land developers are often missing from the neighbourhood quality narrative. Homebuyer and land developer perspectives on neighbourhood qualities may not align with the perspectives presented in the academic literature.
What we did and why: We undertook a qualitative study to explore recent homebuyers’ and residential land developers’ perceptions of walkability, healthy, bikeability, vibrancy, and livability in relation to neighbourhood design. The study was undertaken in Alberta (Canada) and included one-on-one semi-structured interviews with 12 homebuyers and 12 land developers. The interviews included questions related to the neighbourhood terms of interest to gain in-depth insight into the perceptions of the built and social environment features associated with neighbourhood design.
What our study adds: The perspectives shared by land developers and homebuyers provided insight into their perceptions of walkability, healthy, bikeability, vibrancy, and livability in relation to neighbourhood design. Land developers described how these concepts related to their field of work, while homebuyers described these concepts and their influence on their recent home purchases. Participants described:
walkability as: ease of movement, contextual differences, and connections;
healthy as: opportunities for activity, and diversity;
bikeability as: supportive infrastructure, and differing preferences;
vibrancy as: matches peoples’ values, and supportive built features; and
livability as: all encompassing, and safe and friendly.
Walkable and bikeable neighbourhoods are not necessarily livable or vibrant, but all these qualities contribute to a healthy neighbourhood.
Implications for city policy and practice: Homebuyers and land developers have similar perspectives on walkability, bikeability, livability, vibrancy and health although the built and social features described were not exclusive to any one-neighbourhood label. Walkability and bikeability appear necessary for vibrancy, vibrancy is required for livability, and livability is an essential quality for a health supportive neighbourhood. Our findings suggest that neighbourhoods should be described as ‘health supportive’ rather than ‘healthy’ due to the many perceptions of ‘health’ among individuals.
For further information:
Built Environment and Healthy Living Lab: A research lab committed to improving the health and wellbeing of populations through neighbourhood built design.
Full research article: Cul-de-sacs make you fat: homebuyer and land developer perceptions of neighbourhood walkability, bikeability, livability, vibrancy, and health by Gavin R. McCormack, Autumn Nesdoly, Dalia Ghoneim & Tara-Leigh McHugh.
City standards and compliance for telecommunication mast setup, a study from Ghana
Installed masts close to a clinic at Oforikrom.
There is growth and expansion of the telecommunication sector in cities, which however pose numerous health and safety concerns; hence, the need to regulate their siting.
For the attention of: City planning officials, telecommunication companies and communities, Public Health researchers and practitioners.
The problem: There is increasing number of telecommunication masts in urban areas across Africa, which pose several health and safety risks to residents. In response to the risks, countries have adopted precautionary standards and regulations to streamline their deployment and installation across its cityscape.
The increasing demand for telecommunication services in Ghanaian cities has contributed to the expansion of the telecommunication. To regulate the siting of masts towards orderliness, there are several locational planning standards. There is however little research on the extent of regulatory compliance by operators in the siting of masts.
What we did and why: We examined the distribution and the level of compliance of installed masts by telecommunication operators to the locational planning standards adopted by Ghana. This was necessary considering the numerous health and safety risks they pose.
What our study adds: Similar to other countries across the globe, Ghana has adopted precautionary guidelines and regulations to manage the deployment of telecommunication masts and towers. In spite of these guidelines, we found cases of the siting of telecommunication masts in neighbourhoods not in line with the set locational standards and regulations. We found that 90% of masts installed in the study communities do not comply with the minimum setback to the nearest building. Our research also indicated that only 11% of residents were consulted before the masts in their neighbourhood were installed. The reasons for non-compliance are not well explored in the research literature to date. Our study indicates that further research, in other cities and countries, would be useful to explore issues of operator compliance to the regulations for siting telecommunication masts.
Implications for city policy and practice: There is the urgent need for city authorities to integrate telecommunication infrastructure into future land use plans. The study therefore calls for well-planned land use planning regime where the siting of telecommunication mast is done before physical development catches up with peri-urban neighbourhoods.
In addition there are four main areas where city authorities and regulators need to focus:
Regulatory agencies urgently need to address high level of non-compliance of the regulations that guide siting of telecommunication masts by ensuring strict enforcement of the standards and guidelines.
Improvements are needed to the monitoring systems of the regulatory agencies through periodic inspections and monitoring of sites before and after installation of masts.
Better education of residents and companies on the details of locational planning standards.
Better location of masts is required to promote safety and aesthetics. This could be achieved through the collaborative effort between the government, regulatory agencies and all relevant stakeholders.
Full research article: Assessing the level of compliance of telecommunication masts to locational planning standards towards harmonious and orderly city growth by Emmanuel Amponsah, Stephen Appiah Takyi, Michael Osei Asibey & Owusu Amponsah.
Exploring asthma incidence correlates of social and environmental factors in the Cook County, Illinois
Chicago among the country’s most polluted cities © Aynaz Lotfata.
Impacts of social and environmental factors on asthma incidence from study in Cook county in Chicago Metropolitan Area.
For the attention of: Chicago Metropolitan Development Authority and Transport Department, and other similar metropolitan areas in and US and elsewhere. US Environmental Protection Agency, and US Department of Agriculture-Forest Services.
The problem: Cook County is witnessing a public health crisis where the prevalence of asthma is rising steadily. Studies have shown that socioeconomic status, tree cover, and access to medical care might affect asthma incidence and prevalence.
What we did and why: We illustrated the usefulness of a statistical technique (geospatial regression) in the analysis and presentation of spatially distributed asthma prevalence among the population with disabilities. This included minorities with the language barrier, non white population, age 17 and younger, and age 65 and older in the census tracts of Cook County, where Chicago Metropolitan Area located.
What our study adds:
• We found that aged 65 and older was associated with increased asthma incidence.
• With increasing access to healthcare services rise in asthma incidence.
• Tree canopy was associated with lower Asthma incidence.
Implications for city policy and practice: The need to:
Balance vegetation coverage and residential density.
Protect and balance distribution of vegetation cover, to remove the air pollution especially for improving air quality in the residential areas in the proximity of the industrial corridors.
Find solutions for old multi-use, and crowded buildings in high-density urban areas with poor air quality.
Full research article: Spatial association of respiratory health with social and environmental factors: case study of Cook County, Illinois, USA by Aynaz Lotfata and Alexander Hohl.
Healthy urban waters: how photovoice can facilitate participatory urban blue space development processes
Urban blue spaces inclusive for elderly people provide opportunities for healthy ageing in cities. © Anna Brückner.
Healthy urban waters: how photovoice can facilitate participatory urban blue space development processes.
For the attention of: Urban policymakers, planners and designers; landscape architects
The problem: Urban surface waters (‘urban blue spaces’) provide multiple health benefits for cities. The provision of blue spaces might be particularly beneficial for elderly people, who increasingly form a majority of urban populations due to demographic transition. However, the varying needs and interests of elderly people place different demands on the planning and design of blue spaces. As elderly people are often overlooked in urban development processes, methods appropriate to record their blue space experiences are needed to provide inclusive and age-friendly urban blue spaces across cities.
What we did and why: We conducted a participatory study with senior citizens in Ahmedabad, India. We explored the relationship between older adult’s and urban blue space-health relationship. We wanted to test the applicability of a methodology using ‘photovoice’ for healthy blue space research. Photovoice puts cameras in the hands of people and encourages them to explore and share everyday experiences from their own perspective. One of our aims was to gain insight into underlying mechanisms that could be important in guiding urban policy and planning. Foie example; which landscape elements and characteristics of blue spaces promote health and age-friendliness.
What our study adds: Our study supports understanding about:
• Linkages between urban waters, health and wellbeing, particularly considering certain population groups (elderly people) and how to record demand factors of blue spaces,
• Requirements for providing and designing age-friendly and health-enabling urban blue spaces.
Implications for city policy and practice: We want to highlight four main practical implications to consider in urban policy and design:
• Integrating public health considerations into urban blue space planning and design is crucial; however needs and impact assessments involving various population groups are needed.
• Urban blue spaces can contribute to healthy ageing in cities; however, sensitive and participatory planning is needed as needs and design requirements change during the course of ageing.
• The diverse experiences of age and ageing place contrasting demands on urban blue space planning and design.
• Photovoice is a tool appropriate and useful in facilitating participatory urban blue space planning.
For further information: This study is part of a graduate school which is located at Center for Development Research, ZEF, Germany. On our site, you find a poster and picture exhibition related to this study.
Full research article: Photovoice for enhanced healthy blue space research: an example of use from urban India by Anna Brückner, Timo Falkenberg, Urvashi Kasturirangan and Thomas Kistemann.
MOHAWk: a new observation tool to assess physical activity and other wellbeing behaviours in urban spaces
An observer using MOHAWk in an urban green space.
MOHAWk is a new observation tool to assess physical activity and two other wellbeing behaviours (social interactions and taking notice of the environment) in urban spaces.
For the attention of: Policymakers in local authorities; public health professionals who work with or in local authorities; urban planners; urban designers; private developers; those working with green infrastructure; and other stakeholders interested in generating wellbeing impact evidence in relation to changes in the urban physical or social environment.
The problem: Direct observation of behaviour offers an unobtrusive method of assessing physical activity in urban spaces, which reduces biases associated with self-report. However, there are no existing tools that:
assess other behaviours that are important for people’s wellbeing;
are suitable for urban spaces that typically have lower numbers of users (e.g. amenity green spaces) or that people pass through (e.g. green corridors); and
have been validated in Europe.
What we did and why: To address this gap, we developed MOHAWk (Method for Observing pHysical Activity and Wellbeing): a new observation tool for assessing three levels of physical activity (Sedentary, Walking, Vigorous) and two other evidence-based wellbeing behaviours (Connect: social interactions; Take Notice: taking notice of the environment) in urban spaces. Across three studies, six observers used the MOHAWk in five urban spaces in Greater Manchester and Belfast to test the reliability and validity of the tool.
What our study adds: We provide evidence that MOHAWk is reliable and valid from 156 hours of observation in two residential streets, an urban square, a civic square, and a small park. MOHAWk is therefore a reliable and valid tool for assessing physical activity and other wellbeing behaviours in a variety of urban spaces. A manual providing detailed instruction on how to use MOHAWk is freely provided to facilitate its widespread use.
Implications for city policy and practice: MOHAWk can be used in policy or practice (e.g. by local authorities or urban developers), or in more formal institutional based research projects. This new tool is an easy-to-use and inexpensive method of generating wellbeing impact evidence in relation to changes in the urban physical or social environment.
For further information: A study in which we have used MOHAWk to evaluate the impact of improvements along an urban canal on canal usage, physical activity and other wellbeing behaviours: https://link.springer.com/article/10.1186/s12966-021-01088-w
A study in which we have used MOHAWk to evaluate the impact of low-cost urban green space improvements on on wellbeing behaviours in older adults: https://www.sciencedirect.com/science/article/pii/S2666558121000026
The lead author (Dr Jack Benton) was recently successful in applying for a Wellcome Trust ISSF Pump-Priming Fellowship. Building on his PhD research, he will be developing novel methods using wireless video technology to assess wellbeing behaviours in urban environments based on the MOHAWk observation tool. This work is being carried out with the support of the UKCRIC Manchester Urban Observatory; a unique research group aiming to bring data, sensors and expertise together to improve decision making in cities relating to air quality, urban infrastructure and wellbeing: https://www.urbanobservatory.manchester.ac.uk/
Full research article: Method for Observing pHysical Activity and Wellbeing (MOHAWk): validation of an observation tool to assess physical activity and other wellbeing behaviours in urban spaces by Jack S. Benton (@jacksbenton), Jamie Anderson (@urbanflourish), Margaret Pulis, Sarah Cotterill (@cotterillsarah1), Ruth F. Hunter (@Ruth_HunterQUB) & David P. French (@davidfrenchx)
Permitted development rights and health in England
Homes created through permitted development rights – what is the on health? Credit: Atria House, Slough (Google Maps 19 June 2020).
The first systematic review on housing created through Permitted Development Rights and health, strongly suggests negative impacts which warrants further assessment by researchers and policy makers.
For the attention of: Ministry of Housing, Communities and Local Government, Department of Health and Social Care and Public Health England; Local authorities (upper tier and two tier); Policymakers from countries where deregulation which prevents health and wellbeing of people forming part of the decision-making process is being implemented or considered.
The problem: Permitted Development Rights are a regulatory mechanism in the English planning system where the use of a building can be changed bypassing the standard planning process, subject to meeting prerequisite rules. Other countries, such as Australia, New Zealand, USA, Canada and Germany have similar arrangements. In England, no review into the health and wellbeing impacts of housing created this way has been completed.
What we did and why: This systematic review provides the first overview of the impact of housing created through permitted development rights on health. In total, 1,999 unique records identified from a structured search of 14 databases combined with manual searching for grey literature. Literature published between January 2013 and July 2020, in England, were included. Findings were reported against health impacts (primary outcome) as well as building and neighbourhood features and exposures with known health impacts (secondary outcomes).
What our study adds: We found and reviewed 21 studies in the literature. These showed a greater number of ways that permitted development rights for conversions have negative impacts on health and wellbeing, compared to positives impacts. We also found that permitted development rights for conversions may contribute to widening health inequalities.
This warrants further assessment by researchers and policy makers. In particular, we report a significant gap in research with the occupants of the buildings themselves.
Implications for city policy and practice: This review gives an indication of the health and wellbeing outcomes bought about by one form of planning system deregulation.
Re-using buildings to create housing is in principle a good idea. However, doing so without regulation has been shown in England to be delivering variable and often poor quality housing with detrimental health and wellbeing implications. The lack of academic literature and the quality of the underpinning evidence makes it difficult to draw causal links.
Full research article: The relationship between housing created through Permitted Development Rights and health: a systematic review by Rachael Marsh (@rachaelmarsh), Michael Chang (@HiPNetworkUK) & Joanna Wood (@JoWood04).