1,721,038 research outputs found
Preface [Therapeutic Landscape Design Methods, Design Strategies and New Scientific Approaches]
No full textThe health status—as considered today—is not just an individual protection and
promotion issue, but a collective condition, strongly influenced by the environmental
context; the link between the morphological and functional features of urban contexts
and places, and the Public Health outcomes, opening up to a new scientific and design
scenario about Urban Health research topic.
Referring to this research field, the introduction of Nature-Based Solutions and
Therapeutic Landscape Design approaches into the healthcare contexts, facilities,
and architectures has assumed a considerable importance over the years. The recent
period that saw the healthcare facilities fighting against the COVID-19 pandemic,
highlighted the need, especially in complex periods of lockdown, to use green spaces
to recover health and well-being both in hospitals and in public or private places. The
COVID-19 pandemic is an important demonstration of the dual effects of urbanization on the environment, that is, the intrinsic capacity of the contemporary city to
be a place of economic and social opportunities and, at the same time, places where
multiple risk factors for Public Health and Health Welfare could be developed and
disseminated.
Starting from the experience developed into the six editions of the Training Course
in “Therapeutic Landscape Design”—which has been held since 2015 at the Department of Architecture, Built environment and Construction engineering (ABC) of
Politecnico di Milano, where the multidisciplinary approach of the Lectures involved
helps to provide scientific, technical, healthcare, social and design methodologies to
over 120 attendees—the need to bring together, in a scientific monograph, the contribution of the Professors, Professions, and Practitioners, became crucial as much as
relevant.
A more conscious design of therapeutic green spaces—especially referred to
the Healing Gardens—can give texture and consistency to several unique elements
in the treatment of specific pathologies, to support social discomfort, to develop
healing processes and practices, and to improve the evolution of healthy lifestyle and
accessible built environment for fragile users and people with disabilities. This collection of insights and scientific experiences aims to provide the tools
to plan and create therapeutic places and natural spaces aimed to support the care
process, as well as giving an overview of national and international case studies,
defining design approaches, analysis, and best practices
Cities, Walkability and Health. A multi-disciplinary walking experience at EPH22 in Berlin.
Full text linkThe city of proximity as an Urban Health strategy for the post pandemic neighborhood’s needs
Full text linkThe lockdown due to the pandemic has prevented travels, forcing many people to work at home and reducing the possibility of accessing services in the territory. This condition has further highlighted the importance of urban living areas capable of satisfying basic needs within a reasonably easy range of accessibility. The concept of the “15 minutes city” is a useful vision to represent the city of proximity, where it is possible to meet the needs for sustainable, fair, quality, and healthy living. However, even if the objectives represented are fundamental, the model it proposes - accessibility within 15 minutes - is not always applicable in all urban contexts, mostly peripheral, peri-urban, or low-density ones. This dimension of proximity - to be defined from time to time according to urban contexts - can be central to formulating strategies to improve the quality of urban life. Still, it can also play a role in constructing forms of intervention to improve public health and in ordinary conditions, both in extraordinary and emergency conditions. From this point of view, a proximity area can be an area to be defined with a variety of tools typical of urban analysis but fed by overlapping layers that also refer to the health dimension. A place of proximity, therefore not only defined based on the physical characteristics and people's uses, but also based on the data collected from a public health perspective in which it is also possible to try to test different types of information and build the conditions to suggest suitable policies and projects. Aim of the authors is to illustrate a survey about several case studies considered virtuous at the international level, analyzed in detail to highlight the main urban and architectural features of those healthy experiences and the related health outcomes, such as sedentary lifestyle reduction, increase of the attractiveness of places, reduction of air and noise pollution
Healthy design strategies to promote Urban Public Mental Health, according to the contemporary cities’ climate resilience and the SDGs’ challenges
No full textThe Proximity of Urban Green Spaces as Urban Health Strategy to Promote Active, Inclusive and Salutogenic Cities
No full textUrban Green Spaces (UGS) have several positive effects on Public Health, environmental quality, and cities’ resilience to climate change; UGS are crucial in urban regeneration actions and urban health purposes. Moreover, to better define the UGS’ health impacts, it is important to define and guarantee UGS’ proximity, accessibility, and quality. Aim of the research is a quali-quantitative assessment of the UGS in Italian metropolitan cities, taking Milan, Turin, Florence, and Bologna as preliminary case studies. One of the 1st phases was to draw up dynamic and descriptive GIS-based maps of the relationships between density of population and of urban fabric, UGS’ availability, and their accessibility. Only the areas with a size greater than 15,000 square meters were considered; three buffer zones of proximity were defined: 250, 500, and 750 m. By combining the UGS’ availability with the population’s density, it was possible to quantify the citizens included in the three buffer zones. From the 1st analysis, it is observed that about 90% of the population is served by a quality green area within a buffer area of 750 m; 78% by the buffer zone of 500 m; 49% by the buffer zone of 250 m. Both the elaborated maps and graphs obtained show how population is not equally served by close and accessible UGS. Their geo-localization it’s a preliminary quantitative step (process started in Italy with the introduction of regulations like green areas’ census, mapping, maintenance legislation, and strategic plans), but it’s even more crucial to evaluate the UGS’ quality in terms of accessibility, safety and security features, provision of services and paths
Healthy Design and Urban Planning Strategies framing the SDG 11 Sustainable Cities and Communities
Full text linkAccording to the “Urban Health Rome Declaration” at European meeting “G7 Health” that defines the strategic aspects and actions to improve Public Health into the cities, and referring to the Agenda 2030 in which the 11th SDG argue about “Sustainable Cities and Communities. Make cities and human settlements inclusive, safe, resilient and sustainable”, one of the most expressive syntheses of the challenging relationship between urban planning and Public Health is stated by WHO (2016): “Health is the precondition of urban sustainable development and the first priority for urban planners”. Referring to the Healthy Cities & Urban Health definitions, we can consider Public Health not merely an aspect of health protection and promotion, but an individual and collective condition, strongly influenced by the environmental context and by the strategies implemented by local Governments. The “Health in All Policies” strategy, clearly underlines how health doesn't depend only on the supply of the healthcare services, but also, on the quality of outdoor and indoor living environments. Aim of the Presentation 3 is the share the findings of a literature review about the link between the urban contexts' morphological and functional features; the results are divided into: 14 Health Outcomes, representing the main Non-Communicable Diseases (NCDs) whose come from the urban environment's quality and by the adoption of healthy lifestyles; 8 types of Environmental Risk Factors (Urban Heat Island Effect; soil/air/acoustic/light pollution; vehicular traffic; Safety & Security; weak attractiveness of places); and 14 Healthy Urban Planning Strategies (green/blue/grey infrastructures; biodiversity protection; adverse meteoric events management; public transport systems; vehicular traffic reduction; pedestrian and cycling paths; social and functional mix; urban solid waste's management; renewable energy and efficiency; outdoor spaces lighting; Design for All)
Therapeutic Architecture. Assessment Tools and Design Strategies for Healing Gardens Implementation
No full textSeveral Evidence Based Design studies highlighted the impact of natural elements in the form of Healing or Therapeutic Gardens on patients health and wellbeing. A significant number of users within hospitals and socio-sanitary facilities is represented by medical doctors and nurses. They also spend a significant amount of time inside healthcare buildings and are subject to different risks factors, such as burnout. Aim of the research is to investigate the impact that Healing Gardens have on doctors and nurses perceived wellbeing and to provide tools and strategies for design implementations. A qualitative empirical study has been conducted on a sample of seven case studies selected among national and international Therapeutic Gardens inside socio-sanitary facilities or nursing homes. Both primary and secondary data have been used. The study demonstrates that Therapeutic Gardens can have a positive impact on hospital staff perceived satisfaction, relax improvement and willingness to work with the patients. Different recommendations and design suggestions have been proposed for the improvement of therapeutic open spaces usage. Future research on the topic are encouraged to involve a wider and more various sample
Evidence Based Hospital Design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants' and organizational outcomes
Full text linkINTRODUCTION: Healthcare facilities are complex infrastructures where different features from technological, social, clinical and architectural field interact. In modern healthcare systems there is a growing attention to the need of quality in terms of process and outcome, while the structural (physical) aspects are not often considered. Since the Nineties the theory of the Evidence Based Design (EBD) states that there is significant relationship between built environment and health related outcome. OBJECTIVE: Aim of this paper is to investigate, in the recent scientific literature, which are the most important occupants' and organizational outcomes influenced by EBD hospital built environment qualities. METHODOLOGY: A Literature Review based on Scopus and PubMed databases has been run in order to understand the existing situation in terms of hospital quality evaluation from the physical and architectural point of view and to highlight the current trends. The results of the different reviews, empirical studies and post Occupancy Evaluations have been analyzed according to Ulrich's EBD conceptual framework. RESULTS: 35 peer reviewed papers from the last 2 years were included. The methodologies adopted are very different and data are mainly collected through structured interviews or observations and elaborated with qualitative (33%), quantitative (26%) or mixed (41%) methodologies. The topic is mostly investigated in USA, Australia, Canada, UK and in the Scandinavian region; few contributions come also from Italy. Built environment variables that affect user's or organizational outcomes are mainly the Visual Environment (29%), the Audio Environment (20%) and the Patient Room Design (20%). DISCUSSION AND CONCLUSION: The most recurrent outcomes found to be affected by the built environmental qualities are staff job satisfaction (n=11), patients' stress reduction (n=9), patients' satisfaction (n=6) and patients' fall reduction (n=6). Organizational outcomes are mentioned only two times. Although EBD is an old theory, the topic is both contemporary and relevant. Due to the diversity of the contributions and the limitations of the research, a deep comparison is challenging. Further investigation is necessary to deepen each of the variables identified
Urban design and health
No full textRecent trends such as globalisation and urbanisation, combined with an ageing population and population growth, result in new challenges for public health. To tackle these emerging public health issues, novel approaches are required. The paradigm shift in public health supports this needed change. Public health is moving from a medical model, focused on the individual, to a social model, where public health is the result of various socio-economic, cultural and environmental factors. As stated in the Ottawa Charter1 and the "Health in All Policies" strategies2 of the World Health Organization (WHO), environment and living spaces are considered as global, social and political entities that determine the health status of populations.
This e-collection examines the relationship between built environment and health by presenting evidence from the papers that are recently published in the European Journal of Public Health. This evidence can support decision-makers in innovative policies, strategies and tangible actions in order to face contemporary public health challenges.
Social inequalities and social cohesion. In recent years, urban regeneration has widened its approach not only to give cities a new and more competitive look but also to boost cultural, economic and societal aspects. Those operations might result in gentrification processes which are demonstrated to have negative impacts on the population with a lower socioeconomic status (SES)3. Negative impacts include social relationship and daily routine disruption, psychosocial stress, health accessibility, stigmatization and discrimination resulting in anxiety and depression. Other studies highlight how adults who live in lower SES areas are more prone to develop psychological distress (Erdem et al., 2015). Instead, an inclusive approach to urban regeneration can improve the living conditions of the inhabitants with new services, resources, safety and social relationships (Mehdipanah et al., 2018).
To maximise health gains for the whole population, draft urban policies should be assessed. Pennington and colleagues (2017) present tools to measure the impact of urban policies on the health of residents in urban areas and potential variations within the urban population.
Physical activity and green areas. According to the WHO, over 3.2 million deaths are caused by insufficient physical activity. Physical inactivity is a risk factor for several non-communicable diseases, and as Dallat et al. (2014) underline, an increase of 10% of physical activity could lead to reduced cases and deaths from ischaemic heart disease, type 2 diabetes, stroke, colon and breast cancer. Urban areas with public space, walking circuits, and pedestrian paths can contribute to improved well-being, especially in elderly people (Bailly et al., 2018). A study on children (from 3 to 5 years old) investigating the relationship between obesity risk and the presence of green space, demonstrates that the quality and quantity of green areas has an impact on public health (Schalkwijk et al., 2018).
Nevertheless, the availability of green areas is not always correlated with high levels of physical activity. The perceived quality of green spaces is detrimental, as a study in 13 cities in the United Kingdom shows (Ali et al., 2017). Similarly, Pope et al. (2018) showed that the risk of psychological distress in people with access to lower quality green areas is up to 54% higher than those close to high quality spaces.
Assessment of urban areas and neighbourhoods. The quality of urban areas and neighbourhoods is very important for the public's health. A collection of 13 tools to measure the perceived quality of urban area residents are presented by Hofland and colleagues (2018). These tools survey residents about amenities, landscape, public space, sidewalks, and more. Consulting residents about the quality of their living areas can give insight in important living quality aspects that cannot be retrieved from registries. Innovative methodologies (e.g. mobile applications) could provide tools to receive feedback from residents about the quality of living areas and this information could support policy and decision makers in strategic choices. Furthermore, the importance of using locally based aggregate measures in urban health policy making, is highlighted by Gemmell et al., 2017.
A comparison of the health of people living in urban areas versus those not living in urban areas shows interesting differences between and within Eastern and Western European countries (Koster et al., 2017). In general, people living in Western European cities have a better health status than those living in Eastern European cities. While the urban population in Western European countries are less healthy than the country's average and people living in Eastern European cities are more healthy than the general population of that country.
As the papers in this e-collection demonstrate, there is an urgent need for joint actions in order to involve communities and policy makers as main stakeholders of the urban planning process. Starting from the concepts of evidence-based medicine and evidence-based design, future studies should develop a multidisciplinary approach for evidence-based urban health planning
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