Place Potential Think Piece Series: Can we improve health through placemaking? #1

As part of the RIAS ‘Architect in the House’ scheme earlier this year, I visited an elderly couple in the east end of Glasgow. They lived in a rather pleasant Victorian sandstone bungalow and had asked me to look at a loft extension so that their family could stay more often. A routine query, however an inspection of the house revealed much more pressing issues.

They were essentially living in the lounge at the rear of the house and without central heating or any insulation, their house was cold – mainly due to it being very expensive to keep warm with electric heaters. In addition, a 1960s extension on the rear was riddled with black mould, exacerbated by the poor ventilation, no insulation and poor heating system meant the air was constantly damp. As they chatted to me, they both revealed health issues which, at the very least, were exacerbated by their cold damp and moldy house. It is entirely possible their house was slowly killing them both. My recommendation was not the loft extension they had asked me there to discuss, but to put them in touch with a grant for new central heating, insulation and effective ventilation. This is not an isolated case. We make regular visits to houses where the combination of building design, materials and user actions brings down the quality of internal environment to levels that are detrimental to health.

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Our buildings have a fundamental impact on our health. We spend a significant portion of time in them, the exposure to even small doses of mold, chemicals or particulates can build up over many years. In tandem, is the recognition that the environment around our homes has a disproportionate impact on our active lifestyle. There is direct evidence linking poorly insulated homes with up to 27,000 winter deaths in England and Wales (Age UK 2012); there is evidence linking building materials to increased incidence of asthma and cancer (Scottish Ecological Design Association 2008) and there is evidence urban design characterised by over-dependence on cars is related to adverse health effects (California State University 2006). We have a lot of evidence of how our urban environment has a damaging effect on our population’s health but rarely see positive change in new places and buildings.

1157-matt-b-health-4_rsSo why aren’t medics, health professionals, architects and planners getting together? In 2007, England built £13bn worth of new houses whilst at the same time obesity cost the NHS £4.2bn and the economy as a whole a further £11.2bn. There is a clear long term economic imperative to reduce the cost treating the problem by cleverly designing the problem out in the first place.

I was in Amsterdam last week looking at new models of housing provision. Dutch housing estates are designed for pedestrians and cyclists first. The strict liability laws, which legally prioritise pedestrians and cyclists in the event of an accident, do help but the design of the streets is significantly different to ours. Car space is based on performance rather than set standards and housing developers compete on quality rather than price. With stronger physical space planning from the Dutch authorities, than seen in many areas of the UK, people walk and cycle more, meet their neighbours, use local services and bring life to the street. It was reported during our visit that better quality spaces sell houses but crucially there is evidence that the Dutch have generally better public health (Cycling England 2007) due to the walking and cycling infrastructure built into their developments.

1155-matt-b-health-2_rsAs an architect, this brings me back to the purpose of my work – places good for people, their health, wellbeing and spirit. Perhaps the profession should borrow an idea from medical profession, embedding a Hippocratic oath on graduation, “the health of my residents will be my first consideration”, and perhaps without fanfare, the spaces and buildings we all live in will become better for everyone’s health.

Matt Bridgestock is a Glass-House Enabler, a chartered town planner and architect and is a Director of John Gilbert Architects based in Glasgow, Scotland.

Matt Bridgestock is a Glass-House Enabler, a chartered town planner and architect and is a Director of John Gilbert Architects based in Glasgow, Scotland.