Urban design for mental health

Front cover of the Urban Design and Mental Health Journal, Aging City Edition.Walkability has been the focus of good public spaces to encourage physical health. However, the recent pandemic increased our awareness of the need for urban design for mental health. The Aging City Edition of the Journal of Urban Design and Mental Health looks at the dimension of cognitive decline. Here’s what’s in the 7th edition of this academic publication:

The Editorial focuses on the need for new directions in interdisciplinary research

Dementia-friendly neighbourhoods is about the methodological challenges and opportunities

The role of green spaces in preventing cognitive decline calls for “research-by-design”.

Older residents’ mental health status is compared in suburbs versus traditional neighbourhoods is compared to find key design solutions. 

Case studies include Guy Luscombe’s Age n Dem Toolkit, the role of community square dancing in China, and a look at design culture to to empower older people. City Case Studies are Lagos and Sydney. 

Although this is an academic journal, the research and findings provide direction for urban planners and support the need for more pedestrian friendly neighbourhoods. 

Urban planning and Coronavirus

Aerial view of a major intersection in the Melbourne CBD.The daily disadvantage of marginalised groups is more clearly revealed as others fall into the ranks of disadvantage during this pandemic.  A discussion paper from Berkeley argues that this current pandemic is an opportunity to consider similar urban health reforms that followed previous epidemics. Promoting inclusive and healthy cities for all is the bottom line in this thoughtful discussion.

The discussion paper takes the perspective of people with functional limitations. For many people worldwide, disability is about health, human rights, and poverty. It’s an urban development issue and time to move from the medical model to the social model of disability. Also discussed are how people with disability are left out of economic responses, such as one-off support payments, and not included in planning to prevent future crises.

The authors provide recommendations for how this pandemic can best support people with disability and how this makes cities healthier for all. They warn that pandemics also run the risk of exacerbating further marginalisation through racism and segregation. The abstract below is the essence of the paper.

The title of the paper is, Disability, Urban Health Equity, and the Coronavirus Pandemic: Promoting Cities for All

 

Community driven design

Architectural competitions can bring design quality to cities. But the design competition process misses the opportunity to engage deeply with the public. And that means social value could be missing too. The process of community driven design competitions addresses unequal access to design decisions and cultivates social ties.

“Design has a role in building social capital. During a design competition, there are opportunities for placemaking and designing in social connectors.” Georgia Vitale

Image: 11th Street Bridge Park. Courtesy OMA + OLIN

An aerial view of 11th Bridge Street Park which spans a river. It was community driven design.

Community consultation takes many forms, some of which are perfunctory while others are more meaningful. That is, meaningful for the public – the users of places and spaces. The judges of architectural design competitions are other architects. So how does community consultation and engagement fit into this process?

Vitale’s article explores the drawbacks of limited or no meaningful public participation or interaction with users of the building or place or other stakeholders in design competitions. This is at a time for an increased need for social capital to be included in the planning and design process for more socially sustainable communities.

Social infrastructure, shared spaces and streets, and public transport are the outputs of design. However, community engagement with diverse community members helps create new connections. it also encourages people to become involved in the lives of their neighbours. That’s the social benefit of community driven design competitions.

Case Study

Vitale uses 11th Street Bridge Park DC as a case study. The goal is to knit together the two communities on either side of the river. And that’s without displacing people in the marginalised neighbourhoods on the eastern bank.

Bridging community and design: a new way forward is the title of the article in The Fifth Estate. See the original article for links to cited research and case study.

Fair share for walking

Are pedestrians getting a fair share for walking and wheeling on our streets? Or are they forced to drive because footpaths are either not present or poorly maintained? Lack of seating, shade, and too few pedestrian crossings all add to a preference to take the car. More significantly, poor pedestrian infrastructure prevents people with disability and older people from making the journey at all.

Most people value walkability, yet most communities underinvest in pedestrian facilities. We need more investment in footpaths and pedestrian crossings to better serve community.

A black car is approaching a pedestrian crossing. The pedestrian and background are blurred to give the appearance of speed.

Todd Litman summarises the key points in a research paper from the US, which looked at walking rates among countries. The graph below shows Australia and the US at the bottom of the list.

Graph showing Australia and USA at the bottom of the walking list with 
 European countries doing much better, led by UK.

The percentage of total trips made by walking by country

People who cannot drive or own a car are most disadvantaged because they have little choice but to walk or wheel. If the infrastructure is unsupportive or feels unsafe, many will avoid an area or just not make the journey. Consequently the prevalence of disability is invisible to planners.

Assumptions about older people all living in aged care also makes invisible the 95% of older people living in the community. However, plans or designs recommended as suited to aged care locations can, and should, be applied throughout the community.

Why people don’t walk

A graph from Litman shows the reasons people don’t walk by age group. The graph supports statistics of prevalence of health issues in the community. While it is expected that older age groups would cite health as a reason for not walking more, 25-30% of younger age groups also cite health.

Graph showing the reasons different generations don't walk more than they do. Older people cite their health in greater numbers than other generations, but younger cohorts are in the 25% to 305 range of health condition too.

Not feeling safe due to traffic is another factor with an average of 40% saying this is an issue. The lower statistical count on this question for older people is likely due to only making journeys where they feel safe as they are more risk averse.

Walkability solutions

The solutions rest on a connected network of footpaths and to services such as shops, cafes, and medical centres within walking distance. These footpaths need to clearly separate pedestrians from cyclists and motor vehicles. Shared paths are particularly problematic for older people, people with dogs, and people with vision and hearing impairments.

The title of the Todd Litman article is Fair share for walking. He mentions universal design standards for footpaths that are smooth and wide. They also need kerb ramps compliant to standards for all pedestrians. Cost arguments need to be met with counter arguments of the human and environmental cost of not creating pedestrian environments that encourage walking and wheeling.

The research paper mentioned in the Litman article is titled Overview of Walking Rates, Walking Safety and Government Policies to Encourage More and Safer Walking in Europe and North America. European countries have shown the way on how to encourage walking and wheeling.

From the abstract

This paper documents variation in walking rates among countries, cities in the same country, and in different parts of the same city.

Our international analysis shows that walking rates are highest for short trips, higher for women than for men, decline with increasing income, and remain constant as age increases. Walking fatality rates are much higher in the USA compared with the other countries we examined, both per capita and per km walked.

Government policies for increasing walking rates and improving pedestrian safety include: integrated networks of

  • safe and convenient walking infrastructure;
  • roadways and intersections designed for the needs of pedestrians;
  • land-use regulations that encourage mixed uses and short trip distances;
  • lower city-wide speed limits and traffic calming in residential neighborhoods;
  • reduced supply and increased price of parking;
  • traffic laws that give priority to pedestrians;
  • improved traffic education for motorists and non-motorists;
  • tax surcharges on large personal vehicles; and
  • strict enforcement of laws against drink and distracted driving.

Teenagers and architecture

How about introducing architecture to children and teenagers in school as a means of getting better architecture? Teachers can use architecture as a learning resource for other subjects as well. De-a Arhitectura Association thinks bringing teenagers and architecture together is a good idea. It’s also a good way to give voice to children and teenagers and what they want from the built environment.

De-a Arhitectura has a network of built environment professionals who share knowledge with children and teenagers.

Image from a De-a Arhitectura workshop.

A picture from the De-a Ahitectura workshop. A teenager is putting a pin on a large map on a wall

The way professionals understand the built environment and the way the public see it are quite different. One group often left out of consultations is teenagers. Consequently, De-a Arhitectura set about finding out how to give voice to teens.

Using workshop methods, participants analysed their city for facilities and how it feels to be in the city. One workshop focused on the experience of pushing a stroller, being in a wheelchair, and pulling luggage. The research paper describes the workshop methods used in the project.

The follow up project provided a way to raise awareness that teenagers perspective should matter. Teenagers have a language of their own and the researchers found they had energy and innovative ideas. They engaged younger and older people in their lives in the stories they create. And they provided a fresh angle or perspective on things.

The researchers conclude that teenagers have their own visions and benefits from interacting with public space and the activities they carry out.

The title of the paper is, Empowering Teenagers Through Built Environment Education While Experimenting (In)The Public Space. Published in the proceedings of the 2023 World Congress of Architects.

From the abstract

Teenagers may not be the most obvious left-out category of people, but in the design and use of public spaces they are often left out. Public space belongs to everyone, yet teenagers have few ways make their voices heard. How do they demand their own space, which represents their identities and offers a creative and comfortable environment in which they can socialise and evolve?

De-a Arhitectura Association began to develop the Urban Up educational program in 2016. It was a starting point in diversifying its portfolio with teenagers, aiming to be inclusive of all categories and backgrounds.

Throughout the past years, Urban Up has tried to hear their wishes and expectations from the built environment and the public spaces they use. We used different hands-on activities (extracurricular) and with a design thinking methodology for improving their schools.

Trying to constantly find better communication channels and to reduce the generational distances, we started a fellowship program for students in different study fields connected to the built environment (multidisciplinary teams), in order to bring teenagers and young adults together.

The students became mentors for the high school students, in workshops they co-designed, aiming to engage them in better understanding and using public spaces. It is our belief that the more aware and involved teenagers are today, the more active and responsible citizens they will be tomorrow.

Walking – tourists and locals compared

A group of researchers compared the walking experience of tourists and locals in two New Zealand cities. The research was in the context of accessibility and active travel. They chose to compare Christchurch and Wellington because of their differing topography and architecture. There are no surprising results from the study, but they confirm the need for good footpaths and wayfinding for everyone.

Overall, both tourists and locals were generally “satisfied” with their walking experience in both cities. However, the age of participants was skewed to younger age groups.

Image of Christchurch Post Office.

Christchurch post office a tourist destination.

Participants were asked to rate the presence of a good and wide walkway condition, absence of closed roads (culs de sac), signage, flat terrain, and accessibility for wheelchairs and prams. Overall, both locals and tourists appreciated well designed level walkways with good signage for wayfinding. However, walkers would like to be alerted to construction works so they can take alternative routes in the same way as motorists.

In Wellington, tourists indicated that they expected more accessible routes so that people with differing abilities could walk or wheel. This was the most significant finding in the survey because it was the only score to fall below the statistical neutral line.

Image of Wellington.

View of Wellington harbourside showing the hilly terrain in the  background and yachts moored in the foreground.

Christchurch has less steep terrain which means it could satisfy the accessibility criteria better than Wellington. Tourists liked the grid pattern of the city which removed the culs de sac that existed before the earthquake. However, poor or narrow footpaths were a concern for both tourists and locals in the central area. Lack of signage at intersections was not regarded well by tourists either.

In Wellington footpaths and signage were also a major concern for locals and tourists alike. While the footpaths were wide, they were poorly maintained.

More signage for tourists

It’s not only signs that people need – landmarks work as well. Wellington has a good natural landmark in the form of the harbour. The Avon River in Christchurch also helps with navigation. However, tourists would like more signage, especially at intersections.

The title of the paper is, The walking tourist: How do the perceptions of tourists and locals compare?

From the abstract

This research addresses the question of how visitors perceive and evaluate the city they are visiting when they walk. Comparisons are made with the experience of local residents. The paper examines the relatively overlooked domain of tourist walkability and investigates the extent to which accessibility and topography may influence walking experiences.

Data were gathered from a Walk Diary in which respondents evaluated the environment along a single walk. Responses were received through convenience sampling from 132 people in Christchurch and Wellington. The Walk Diary provided an effective way of capturing differences between locals and tourists when they walk. Insights from this study will be particularly useful to those tasked with enhancing people’s urban walking experience.

Gender inclusivity in streetscapes

In 2010 the Los Angeles Department of Transport published a report on gender inclusivity in streetscapes and transportation planning. The findings showed women and girls, especially those on low incomes, were at a disadvantage in this car-centric city. So what to do about it? The Department of Transport devised infrastructure design strategies that also included amenities in streetscapes.

While there is discussion about gender differences in transportation needs, little improvement has been made to solve the issues. And this is not just in Los Angeles. The first transportation report, Changing Lanes, provided the baseline information. The follow up is a report, using case studies, provides design strategies.

Case studies

Five case studies from different cities informed the recommendations.

  • Street Lighting: Seattle
  • Public Seating: New York
  • Bus Stop Amenities: Portland, Oregon
  • Pedestrian Infrastructure: Minneapolis
  • Bicycle Infrastructure: Austin

Photo credit Steve Morgan for TriMet, Portland Oregon.

Three different bus stops in Portland, Oregon. One is a pole with a perch seat attached, one at night and one in the daytime.

Note the small seat or shelf on the the bus stop pole. Perhaps a perch seat higher up the pole is better for people who cannot rise from a seat placed so low. The bottom right photo indicates a cycle lane between the bus shelter and the boarding platform. However, there is space for prams and wheelchairs under the shelter. Backrests on the seats would add extra comfort.

Planning recommendations

Six recommendations for improvements are based on the case studies.

  • Take a proactive approach to identifying deficiencies in infrastructure
  • Use geospatial data to prioritise
  • Set quantitative goals with success criteria
  • Establish goals between city agencies for partnerships and cooperation
  • Collect self-disclosed information on the gender of participants during public outreach
  • Include a gender equity component in project prioritisation methods
Front cover of the report  Designing Streetscapes for Gender Equity.

This is an easy to read report which supports other research on inclusive and accessible infrastructure. For example, wide level footpaths, kerb extensions and pedestrian safety islands.

The title of the report is Designing Streetscapes for Gender Inclusivity, published by UCLA Institute of Transportation Studies. There are some good examples applicable to many other jurisdictions.

From the abstract

Within the US, Los Angeles has been at the forefront of making efforts to factor gender inclusivity into transportation planning. In 2021, LADOT released Changing Lanes: A Gender Equity Transportation Study. This study found that LA’s current transportation system is not adequately serving low-income people of colour, women, girls, and gender diverse groups.

To address these inequities, LADOT is taking the next steps to implement gender-inclusive transportation infrastructure design strategies. This paper presents case studies that support walking, biking, rolling, and waiting.

Semi-structured interviews were conducted with planners from five transportation agencies. Transportation guidelines and plans produced by these agencies were also reviewed. From the information gathered, five case studies were developed.

Each case study focused on a different strategy for improving gender inclusivity in streetscape design. That is, pedestrian street lighting, public seating, bus stop amenities, pedestrian infrastructure, and bike infrastructure. The implementation of these design strategies can ensure the needs of women, girls, and gender diverse groups who rely on active transportation and public transit are met.

Architectural design for dementia

A student in the Netherlands has attempted to get to grips with the complex area of architectural design for dementia. Iga Potok’s research is based on two case studies of community living in Europe. She wanted to find out how architectural design can provide stimuli to prevent or delay cognitive impairments. In addition, Potok looked at dwelling design, and neighbourhood design that fosters contact between generations.

Kalkbreite Housing Cooperative by Müller Sigrist Architekten. This project used collaborative building processes using residents’ opinions. Quotes from the participants provide the back story. Photo credit Martin Stollenwerk.

A four storey apartment building with lots of open space for people to gain planned and unplanned social interaction.

The second case study is WohnProjekt Wien Co-Housing in Vienna, which used the same three part method. Part 1: Collaborative building processes and opinions. Part 2: Design of communal spaces, and Part 3: Design of living and half private spaces. This collaborative housing project is home for 67 adults and 25 children.

Some conclusions from the study

Feeling like part of a community was the most significant overlap across the ages. Residents in both housing projects put emphasis on communal functions in the bousing block. Opportunities for social interaction were supported by visual connections between all floors and a sufficient amount of light. Combining multiple collective functions and placing them in a visible location next to busy circulation spaces maximised their use.

The intergenerational aspect was important for all generations. Various apartment types and sizes allows for a healthy mix of people from all walks of life. Flexibility of apartment design offers multiple possible arrangements and future-proofs the space.

In terms of preventing cognitive decline, social interaction was the key element. Architectural design that inspires physical movement reduces the probability of developing dementia and depression. That’s the conclusion of the author.

The title of this chapter of the thesis is Prevention of Cognitive Impairments Through Architectural Design.

The chapter is presented as an illustrated book with many drawings and sketches. With some text presented as drawings, and small font, the accessibility of the document is not optimum. Indeed, some of the script-like text is difficult to read even with good eyesight.

Feeling safe, walking and wheeling

If we want to get everyone walking and wheeling for their health, and the health of the environment, a few things have to change. If people don’t feel safe on our streets, they will avoid the journey or take the car. Many people who are blind or have low vision fear a collision with vehicles and cyclists. That makes them feel unsafe on our streets, and means they are less likely to venture from well-known routes in their community.

Pedestrians who are blind or have low vision have difficulty knowing when it is safe to cross at non-signalised crossing points. This is compounded by traffic volume and speed. Not every person with low vision uses a cane or dog indicating to drivers they have reduced vision.

Two young women stand at a pedestrian crossing. One is holding the arm of the other. There is a car in the background on the crossing. Are they feeling safe walking and wheeling?

If you want to know more about the issues encountered by people who are blind or have low vision, take a look at the study by Victoria Walks. They conducted a survey of people with vision impairment and carried out some street audits. The aim was to gain a better understanding of the road and footpath safety issues encountered by this group.

“Difficulty in judging whether it is safe to cross the road” was the biggest overall concern, followed by tripping hazards on the footpath. Crossing the road at non-signalised intersections was not an option for many. Given that most mid-block crossings and intersections are not signalised, this severely limits this group’s mobility. But they are not the only ones. People with poor depth perception and some cognitive conditions find it difficult to judge when to cross.

Interaction with other road users

Drivers are required to give way to pedestrians. However, at traffic lights for example, motorists failing to give way was the biggest concern for people who are blind or have low vision. Failing to give way to pedestrians on the footpath across driveways was another real problem. Shared paths with cyclists, pedestrians with dogs, and just other pedestrians were also an issue.

People who are blind or have low vision are not the only ones with poor road and footpath experiences. Consequently, if we can get it right for this group, every pedestrian should benefit.

An older woman wearing a straw hat, carrying an orange bag, and using a walking cane, crosses the road.

Site audit issues

Issues common to most areas audited were:
– Tripping hazards and obstructions on the footpath such as low hanging tree branches, shop sandwich boards, and outdoor dining.
– Poor kerb ramp design that potentially sends pedestrians with a vision impairment into the middle of an intersection rather than directly across the road.
– Differences between the width of a crossing and the width of the kerb ramp used to access it causing a potential trip hazard.
– Missing or poorly functioning Tactile Ground Surface Indicators (TGSI) or audio tactiles.

The title of the report is Road Safety for Pedestrians who are Blind or Have Low Vision. There is more detail about each audit location in Victoria and what was recommended. Also more detail from the survey, all of which is instructive.

What happens when tactiles fail

Taking another perspective, Dean Homicki has some short videos explaining the details that matter and why. His latest video is the placement of tactiles at a railway crossing. He titled it, “Why the chicken shouldn’t, couldn’t and didn’t cross the rail-road“.

A toilet on every high street

The economic value of public toilet facilities is often overlooked. We all have to go sometime and some of us sooner and more quickly than others. The availability of clean public toilets can make or break a shopping trip or social outing. People with bladder problems will restrict their movements to where they know the toilets are.

The Helen Hamlyn Centre for Design had a good look at this issue. Their report outlines how they went about finding an alternative model for high street toilets. The project was titled, Engaged: a toilet on every high street.

This design research project was about a simple concept of reusing vacant high street units as toilets (plus commercial or community space). It explored the idea before thinking about how to implement it.

A drawing showing a row of toilets in an outdoor setting with a cafe.

The research explored how this idea would fit into current systems and infrastructure. People within retail, community safety, government and urban design were consulted. Then they spoke with council officers to see how they could make it happen.

Pub staff responsible for toilets talked about the problems with toilets. Public toilet provision is complex. A lot can go wrong. The aim therefore was to understand what the public want, what councils can achieve and where the pitfalls are.

The key areas or outcomes for Engaged were the issues of:

  • Closed and Temporary Toilets
  • Future Inclusive Toilets
  • Lootopia and the High Street
  • Toilets in the 24-hour City
  • Talk Toilets
Standard toilet block in a rural area signed as Ladies and Gents.

The report explains these dot points in greater detail using case studies, and accessible toilets are included in the discussions as well as criminal behaviour.

Everyone needs a toilet

Everyone needs to use the toilet, and people shouldn’t be ‘designed out’. People who spend all day outside, such as rough-sleepers, rely more on public toilets than most. Yet privately-owned, publicly-accessible toilets may not be accessible to them, either from exclusion or from feeling that they would be permitted. Other groups who may feel excluded include teenagers and people of colour. Discrimination that associates groups with anti-social or criminal behaviour reduces the number of toilets that people can access.

The researchers found their findings match similar surveys by the Bathroom Manufacturers Association, and AgeUK London. ‘High streets’ was the main location where respondents thought public toilets were not good enough (70%), ahead of parks (47%). This data is useful for showing the value that public toilets bring to the high street. If people leave early due to a lack of toilets, that will hurt businesses and the wider community, as well as limiting people’s participation and quality of life.

The title of the report is, Engaged: a toilet on every high street. The Helen Hamlyn Centre for Design did the research published by the Royal College of Art. It is a good example of talking to stakeholders before even thinking about solutions.

Everybody poops

A Canadian briefing paper, Everybody Poops: Public toilets are a community issue, covers similar ground. Although these facilities are an important part of the community, local authorities are not keen to provide them. Solutions are around advocacy and partnerships. The paper has a link to The Safer Bathroom Toolkit, which has a focus on people who use substances.

Accessibility at neighbourhood scale

There are many tools for measuring environmental sustainability features in the built environment. But measuring access for all, is based on legislation and cost rather than user-based. Indeed, building standards for disability access have filled this knowledge gap but in the process, held back learning at the same time. That’s because you learn how to complete checklists but you don’t gain understanding of the issues this way. This is one reason that architect Mary Ann Jackson says built environment practitioners do not understand disability.

Neighbourhood scale accessibility measurement tools show how improvements can be determined in a planned way rather than ad hoc reactions.

A Melbourne street scene showing pedestrians and a tram.

Built environment knowledge and the lived experience of people with disability need connection. We need a tool that measures the overall accessibility of the built environment by incorporating the lived experiences of people with disability.

Increasingly, assessment of the built environment is becoming interdiciplinary. However, despite all the many built environment performance tools, input from people with disability are often left out of the equation. The move to co-design methods for new work is helpful, but does little to deal with existing built environments.

The title of Jackson’s 2019 article is, Accessing the Neighbourhood: Built Environment Performance for People with Disability. It explains the rationale behind the the development of the Universal Mobility Index. The key aim is to address the fragmented nature of current access across all areas of the built environment.

From the abstract

The existing built environment still fails to meet the needs of people with disability. This is despite rapid urbanisation, population ageing, failing infrastructure, and evidence that the built environment affects health and well-being,

In a parallel universe, improving built environment ‘sustainability’ performance, via measurement, receives much attention. Analysing the built environment at micro-scale (buildings), meso-scale (neighbourhood) and macro-scale (city-wide) is undertaken from various multidisciplinary perspectives.

Built environment performance is measured in many ways, but accessibility performance for people with disability, at neighbourhood scale, is rarely considered.

People with disability continue to experience lack of meaningful involvement in research, participation in decision-making, partnership equality, and direct influence over policy, with the built environment arena increasingly becoming a private-sector activity.

The actors involved, however, have little understanding of either the accessibility needs of people with disability, or the inaccessibility, particularly at neighbourhood scale, of the existing built environment.

This paper explores the design, planning and politics of an inaccessible built environment. Assessing the accessibility of the built environment for people with disability, at neighbourhood scale, is an essential component in the process of built environment accessibility improvement. As a result of collaboration between the domains of the built environment and disability, a new tool, Universal Mobility Index, has emerged and is undergoing further development.

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