Design for well-being

Gayle Souter-Brown

The issue

It is widely accepted that prevention is more cost efficient than treatment of disease, crime, and climate change. Recent increased urbanisation and urban densification, coupled with corporate agriculture and horticulture, have changed the environment. Concurrently, digital lifestyles have disconnected people from nature. Stress levels are rising. The housing shortage is described in ‘crisis’ terms in Auckland. Depression is the number one cause of disability. New Zealand’s teen suicide rate is the highest of 41 countries in the western world. Māori and Pasifika peoples are over-represented in negative health statistics. Aotearoa New Zealand also has one of the world’s worst records for bullying in schools. At the same time, New Zealand – with already low levels publicly accessible greenspace in its towns and cities compared to many OECD cities – is selling off and developing its brown and greenspaces. I argue that this is no coincidence.

Adding to the lack of greenspace, an international design trend towards ‘low seasonal variation and clean, straight lines’ has strengthened subconsciously within planning and architecture, to counter the sensory overload of the digital age. A minimalism that was once consciously designed for people on the autistic spectrum is now considered ‘fashionable’ and seen in private homes, schools, urban laneways and public plazas. While ostensibly aesthetically pleasing, the effect of the resulting sensory deficiency on the mainstream population is borne out in the statistics. The form does not match the functional potential of the space.

Although overwhelming evidence links positive outcomes for health and well-being with the stress reducing properties of the environment, a dose of nature, through views and time spent outdoors, is increasingly difficult to find close to urban New Zealand. In contrast, a salutogenic design approach refers to the use of health-promoting environmental design to reduce stress, and hence save money, time and lives through prevention of ill health. That a design approach can also benefit such diverse policy areas as education, crime rates and climate change, makes it of interest to anyone holding a public purse.


Why is it important?

As health, housing and education budgets shrink and are stretched, research linking health and environment is growing rapidly. We know that the environment, the landscape where we live, work, play and go to school has a profound impact on our mental and physical health. A child cannot access the curriculum unless they are healthy, feel safe and enjoy a sense of well-being. School playgrounds developed as natural spaces reduce bullying, improve attendance and enhance educational outcomes. Urban areas with attractive, accessible greenspace draw tourists and investment. Towns and cities with more trees show reduced rates of type 2 diabetes and heart disease. The sensory stimuli of birdsong, seasonal variation, colour and rounded leaf forms are perceived as positive and promote feelings of inclusion.

Unequivocal research reports that nature and natural scenes are vital for health and well-being. However, too many children and adults in Aotearoa New Zealand cannot access nature in their daily lives. Some have no lived experience of a tree. The current design trend towards straight lines and away from the natural variety of nature is both a public health challenge and an opportunity to reshape the way we view urban environments.

Sometimes it is important to look back to move forward. The origin of the term “landscape” was from the 16th century Dutch painters’ view of rural and natural scenes. Over the next 400 years, as people moved to towns and cities they needed to recreate such scenes in their new setting. While communities sought to establish cultural contact with local contexts, landscapes and values, they looked to architects to design buildings and places to facilitate this. Landscape architects became people skilled in the creation of nature-in-the-city.


Why is it an issue for cities?

Where once we looked to verdant neighbourhood gardens and parks for a dose of nature, trees replaced by ‘fashionable’ grasses do not offer the same health benefit, and indeed have been shown to harm well-being. Weekend visits to rural areas boosted our nature experience, but longer work hours and increased transport costs means fewer people can get to the beach or out into the countryside. For Māori and Pasifika peoples, the impact is greater as with recent migration to the city there is disconnection from traditional land-based lifestyles. The challenge this presents to health, education and welfare budgets needs to be addressed.

The theory of biophilia, our innate love of living things, is fast becoming a key instrument in fashioning functional urban design. Kaplan’s Attention Restoration Theory posits that time spent in nature is protective; it promotes and enhances health and well-being. Salutogenesis invokes design to function as a preventive public health tool. Biophilic design, bringing nature into the city, engages landscape architects as public health professionals.

Cities such as Singapore, Paris and New York have set aside areas of their city to provide healthy environments for their citizens.  Berlin countered the myriad social challenges of reunification through parks, urban farms and green school playgrounds, with trees and dirt replacing asphalt. The return on investment for every city has been impressive.

In New Zealand, architects are developing biomimicry options for commercial buildings, but social and affordable housing is developed in a ‘fashionable’ grey colour palette, with low natural light levels, on sites where health-promoting mature broadleaf trees are removed and replaced by health-degrading low stimulus forms, if you are lucky. Modern (or flexible) learning environments – a requirement of all new school builds in New Zealand – feature opaque windows in contradiction of the established science.


What should we be doing about it?

Standard urban planning and design practice no longer matches the multi-disciplinary theories that intersect at well-being. A fresh policy and design approach is required. Fragrance, flowers, broad canopy trees for seasonal shade and flexible spaces to come together socially cost no more than the bland alternative to install or maintain. The benefits however are significant. In the United Kingdom, the National Health Service, Public Health England and the Royal Horticulture Society brought health commissioners, care providers and leading designers together to draft the Health and Horticulture Charter. Scandinavian countries, Germany and increasingly across the United States, have linked education with environment. Aotearoa New Zealand’s well-being needs an update to Health in All Policies.

It is no longer enough for healthcare providers, educators, housing providers to simply ask for a new treatment space, playground or homes. Commissioners and designers need to ask “why do we want one of those? What can we achieve with that?” The evidence base for the health, economic, social and educational benefits of environmental (biophilic) design has come from diverse fields such as psychology, business management, paediatrics, education, cardiology, forestry, and real estate. Landscape and urban designers are now plugging the research gaps to identify how best to provide a dose of nature in our towns and cities. Recent local evidence shows that to achieve health and well-being benefits, the type of environment is important. Healthy ecologies promote human health and well-being, across all age and cultural groups. Spaces that attract people to exercise more, eat better, and sleep better are human scale. Those same spaces reduce anxiety, ease depression, boost productivity and protect against dementias. When biophilia is combined with salutogenesis, landscape architecture and urban design can become a powerful health promotion tool. Health in All Policies was an opportunity to link the seemingly disparate together. With salutogenesis as the key it is time to bring landscape and ecology into the relationship.

Categories: Environment, Housing
Gayle Souter-Brown
About the author

Gayle Souter-Brown

Gayle Souter-Brown is the Founder and Director of salutogenic design consultancy Greenstone Design UK, author of the design text Landscape and Urban Design for Health and Well-Being: Using Healing, Sensory and Therapeutic Gardens (Routledge Press 2015), speaker and educator. She is currently exploring the health and well-being effects of sustainable, salutogenic landscape and urban design within a PhD.