In 2018, the Expertise Center initiated a research project that explores the efficiency of urban interventions as a tool to enhance public health. Urban interventions not only determine the shape of cities, but also the way they are used – they impact behaviors and lifestyles. In the past few decades, a considerably body of knowledge has evolved on the differences in health conditions between neighborhoods from different periods, each with their distinct urban and architectural composition, demographic characteristics, and social and cultural aspects. Likewise, there is no lack of studies that link lifestyles to health conditions. The concept of healthy cities, moreover, has accumulated expertise that links urban qualities to lifestyles.
What is notoriously understudied, however, is the actual effect of urban interventions on lifestyles, and hence – indirectly – on health conditions: post intervention evaluations are almost lacking. In a similar vein, the vast body of knowledge embedded in the design disciplines, notably architecture and urbanism, is hardly ever taken into account. Consequently, there appears to be a serious lack of understanding of the way urban interventions impact pubic health – healthy cities advocates promise a lot, but, in practice, do not always underpin their claims with solid research.
To address this issue, UDIHiG needed to select a clearly demarcated urban area with distinct architectural and urban qualities; moreover, the overall public health quality in this area should lag behind those found in other areas. This resulted in the selection of a post-war neighborhood from the reconstruction period – these follow a generic model that envisaged detached modules, separated from their surroundings by green belts and endowed with all facilities needed for everyday life (notably shopping, schools, playgrounds, parks). These neighborhoods have been built in large numbers all over Europe, and all of them reflect the same generic model. What they also have in common is that their public health conditions are relatively poor. As a case-study area, the project members opted for Paddepoel, a neighborhood in the northern periphery of the city of Groningen.
The project started from two vantage points simultaneously. Only lifestyle effects that could be attributed to the architectural and urban layout are taken into account. Most of the available research focuses on the effects of mobility (walking and cycling have positive effects), greenery (either for passive enjoyment or for active use), and social interaction in public space (as a recipe against loneliness); finally there is the issue of healthy food (post-war neighborhoods having been stigmatized as ‘health deserts’). Since the development of assessment tools was key, it was decided to start with a pilot project that only addressed the issue of mobility and singled in the accessibility of the shopping mall for elderly pedestrians and cyclists. The complementary point of departure was the collection of data on the current health status of the inhabitants of Paddepoel. The baseline was an evaluation of present health conditions in Paddepoel compared to that in other neighborhoods, one goal being to get a clear view on the provenance of health conditions that are directly impacted by lifestyles and behavior.
The primary objective is to assess whether or not the intended urban interventions contribute to healthier lifestyles. Key is a design brief that targets the most relevant aspects. This required first of all a clear analysis of the architectural and urban qualities of Paddepoel and, specifically, how the inhabitants use Paddepoel, notably the destinations in the neighborhood they visit, and how they get there – ideally, this results in a clear view on their daily living patterns. The urban analysis is one of the sources of the design brief for urban interventions. It is supplemented with the views of the inhabitants. Questionnaires were used to allow them to outline problems and aspects that need improvement. The healthy cities concept provided the third foundation of the design brief (in order to get a better view on the parameters defined used in this field, it was decided that additional literature reviews were indispensable). Based on the design brief, the atelier of the city architect of Groningen provides a series of urban planning proposals. These range from easy to realize modifications to radical plans (in which the car is practically banned, for example).
One of the principal challenges of the project is how to present these plans to the inhabitants. Since urban plans are difficult to understand even for well-educated people, the planning proposals were translated in Virtual Reality, allowing the inhabitants to really experience the new situation in three dimensional, highly realistic visual imagery. After having strolled around in the new virtual reality, they were asked to fill in questionnaires that provide information on the impact of the new urban layout on their lifestyles – limited, in phase one, to the way they access the shopping mall.
A midterm review of the project reveals that the selection of Paddepoel as a case-study area has been appropriate, and that the identification of a limited set of lifestyle aspects that have been amply proven to be largely determined by the urban layout and that also have a major impact on health was also successful, albeit that, so far, only the accessibility for the shopping mall has been explored. Moreover, the assessment method that combines questionnaires with virtual reality technology appears to be very effective, even with older citizens. In the next phase, the entire neighborhood will be investigated, more lifestyle issues (greenery, social hubs) will be taken into account, and a larger and more diverse share of the inhabitants will be involved.