The stories of lived experience provide important nuanced details that are rarely picked up in survey questionnaires or comparing one group with another. One way to capture lived experience is by using “photovoice” – a method of visually recording experiences. This method reveals detailed ways of creating healthy and inclusive communities for all.
Five Canadian researchers used the photovoice method to discover the everyday barriers and facilitators mobility device users face. Participants not only provided photographic evidence, they related what it meant for them as an outcome. Unsurprisingly, footpaths, road crossings and road maintenance and construction featured strongly in their findings.
Photos of environmental barriers provide important information for urban planners. They can see more clearly how the small details matter. This image shows an uneven footpath and no clear access to the bus stop.
Participants in the study captured physical characteristics that both helped and hindered their ability to navigate the environment. Objective assessments such as access audits, do not reveal the complex interaction of social participation and health. Lived experience and the everyday stories, on the other hand, provide this valuable information.
This image shows a woman with a walking aid and a man with a baby stroller need to pass on a narrow path encroached by gravel and mulch.
Image by John Evernden
Key points and themes
Five key themes emerged from the study.
En Route: the usability and safety of the physical path to reach a destination, road crossings and traffic signals. Included in this theme are footpath width, maintenance and surface materials.
Thresholds: Accessibility issues in the transition spaces from outdoors to indoors at a destination. Difficulty getting into shops and other public places limited access to goods and services.
Temporal Rhythms: Fluctuations of accessibility with circadian and seasonal variations as well as urban practices. Differences between day and night where it is easy during the day but not at night. Temporary closures to footpaths due to maintenance meant going back home or trying to find another route.
The Paradox of Accessibility: Fluctuation of accessibility due to inappropriate usage or of conflicting user needs. Participants also found examples of poor attempts at accessibility such as a ramp leading to sand or gravel, or a ramp with a steep grade. The conflict of cyclists using the wider footpaths was also an issue.
Making Change Happen: Actions and solutions to improve the accessibility. Participants were not passive in accepting the status quo. They showed pictures where they had successfully lobbied for changes to a business or a community building. Participants also showed the converse – places where their lobbying had not yet brought about change.
Installing kerb ramps, footpaths and pedestrian crossings are essential physical improvements. However, changing social and urban practices have a role to play as well. The participation of people using mobility devices needs to go beyond tokenism. That means involving users in decision making process – a universal design concept.
The title of the article is, Creating inclusive and healthy communities for all: A photovoice approach with adults with mobility limitations.
Healthy Living Tool
Staying active and being healthy is a good thing. So, what can designers do to encourage active healthy living? And does it go beyond the level of the built environment? How can we encourage people to venture out of their homes and engage in “healing” activity? Two researchers have devised a multidisciplinary healthy living tool to help.
The researchers looked at many theories and design practices to find designs that support healthy behaviour and reduce stress. From this work they devised a multidisciplinary tool to guide design decision for shared spaces. The ultimate aim was to encourage people to engage physically, socially and psychologically in different built environment settings.
Level footpaths, seating, and shade create an attractive and inclusive place to walk and sit.
The recent pandemic tells us to take another look at how we maintain (or not) healthy minds and bodies.
The research paper describes the methods they used for developing the tool for inclusive self-directed healthy behaviours. A matrix of theories was created from urban planning, biophilia, active living and social engagement design. Clear definitions, using a rating system, created a list of criteria from the research.
Although the tool continues to be modified, the article describes an interesting multidisciplinary approach to design for human wellbeing. The process of discussion on design features takes thinking another step forward. The authors found that the dialogue between individuals with different experiences facilitated a blending of knowledge for a holistic, inclusive approach to design.
The title of the article is, Evaluating design features to support inclusive, self-directed, and active healthy living behaviours.
Healthy View of Placemaking
An opinion piece on the Design Council website gives an overview of the study they did with Social Change UK. More than 600 built environment practitioners across the UK completed the survey. They found that healthy placemaking often sits outside mainstream housing, public health and placemaking policy.
The article explains the economic benefits of healthy placemaking. The Design Council defines healthy placemaking as, “tackling preventable disease by shaping the built environment so that healthy activities and experiences are integral to people’s everyday lives.”
Neighbourhoods that enable include:
- Physical activity: To increase walkability in buildings and neighbourhoods and encourage healthy modes of transport
- Healthy food: To improve access to healthier foods
- Social contact: To design well-connected housing and neighbourhoods that provide access to facilities and amenities to reduce social isolation and loneliness,
- Contact with nature: To provide access to the natural environment, including parks
- Pollution: Reducing exposure to air and noise pollution.
This all adds up to compact, mixed-use, walkable and wheelable neighbourhoods with leafy streets and great parks.
Health promoting urban design
The links between urban design and physical and mental health are well established. So how do you take an evidence-based approach to health-promoting urban design and green spaces? Swedish landscape architects wanted to know how to translate existing evidence into design and looked to researchers to help.
Researchers and landscape architects collaborated on a project using participatory action research methods. Researchers used existing evaluation tools and two case studies to test the processes.
Aspects such as safety, vegetation, water flow, and traffic management were considered in the design. Residents with homes and gardens next to the park were concerned that this would attract visitors from other areas. New users were apparently not welcome to “their” space.
The article explains the collaborative processes that involved the researchers, the landscape architects and other stakeholders. The Quality Evaluation Tool was used as the framework for the study. Some landscape architects found it took time to learn how to use the tool. Others found it wasn’t easy to use it either – they needed something simpler.
The title of the article is, Health-promoting urban planning: A case study of an evidence-based design process. There are reflections on participatory action research as part of the concluding comments.
Building health and wellness
We need healthy architecture – that is, architecture that supports human health and wellness. Louis Rice claims that human illness is related to the design of the built environment.
Key issues are discussed in a book chapter that covers social, mental and physical health and “restorative” design. He proposes a “healthy architecture map” based on materials, environments, agency and behaviours. The title of the chapter is A health map for architecture: The determinants of health and wellbeing in buildings.
There is more useful information and research in the book including a chapter from Matthew Hutchinson, The Australian dream or a roof over my head. An ecological view of housing for an ageing Australian population.
The World Health Organization also links health and the built environment in the WHO Housing and Health Guidelines. It includes a chapter on accessible housing.
Health, Technology and Buildings: a review
Abstract: Research into health, particularly social and psychological health, is crucial. Ultimately, an in-depth understanding of social and psychological health will more than promote well-being.
Technology research is indispensable, particularly concerning health and the built environment, given the need to create holistic and supportive frameworks for well-being. Moreover, because literature reviews establish the foundation for academic inquiries, they provide valuable overviews for foresight into grey research areas, particularly multi-disciplinary research like health technology and the built environment.
Hence, this study aims to discover the existing themes on health, technology, and built-environment nexus subjects while revealing the grey areas and suggesting proactive areas for future research.
The title of the paper is, Health, Technology And Built Environment Nexus: A Systematic Literature Review.
Nature-inclusive design approaches
A research paper from The Netherlands poses the need for participatory and nature-inclusive design approaches. A nature-centered perspective prioritises non-human species at the forefront of the design process.
“As we strive for an inclusive and sustainable society, it is crucial to develop and implement new behaviors and design methods that enable individuals to effectively coexist with nature.”
The title of the paper is Preliminary study of participatory and nature-inclusive design approaches.
Nature-inclusive design has the potential to encourage people to reconnect with nature and value non-human species as much as humans. Non-human actors need to be recognised as part of the community and given a chance to coexist in an urban context