AofU_Provocation 1 Housing and Health

ACADEMY OF URBANISM CONGRESS VI, Glasgow 2011 Provocation Paper 1: Housing and Health Prepared by A+DS

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ACADEMY OF URBANISM CONGRESS VI, Glasgow 2011 Provocation Paper 1: Housing and Health

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The more a neighbourhood can enable participation by the citizen and inform collaboration by the decisionmakers, the more useful it can be as a place”

Form follows finance?

Governments, local and national, are required to think why, where and how they will regulate, manage and invest to change place outcomes for the better.

At the scale of the neighbourhood, these points of intervention concentrate on housing, health and wellbeing of citizens. For some, this tends towards an idea of the neighbourhood as a living space, as locally constituted, as self contained. In fact, everything about the neighbourhood is to do with its relations: the relation of individuals and their choices, the relation of the neighbourhood to other neighbourhoods, the city, the region, the nation.

In this context, the key to successful neighbourhoods is a more dynamic idea of place, which invites flows of ideas, people and finance in different forms. The more a neighbourhood can enable participation by the citizen and inform collaboration by the decisionmakers, the more useful it can be as a place.

The neighbourhood is for most people the sphere of daily life. It is largely inwardly focussed, an area of familiarity, providing convenience, comfort and continuity; characterised by pedestrian movement, personal interaction and spatial repetition. Despite this vital role, many of our residential neighbourhoods manifestly fail to deliver some of the basic conditions for individual and community sustainability. Whether they comprise suburban streets or twentieth century housing estates, they are characterised by sprawl, faceless homogeneity, limited opportunity, and personal alienation.

Lynsey Hanley encapsulates this when she writes of the housing estate she grew up in: “I look back at the domino contest I’ve just passed through, and realize exactly what fascinates me about the estate I grew up on: it’s all houses. That’s what it is: houses everywhere, without a break. That’s what it’s there for. That’s the only reason it’s there.”

Amartya Sen’s notion of capabilities argues that spatial concentrations of bad outcomes (poverty, worklessness) now shape worse outcomes for the future. Mobilising social capital in poorer areas is challenging. Institutional collaboration is equally challenging. Poor outcomes persist. In this context, place policy is about the capabilities of local institutions and individuals to benefit from opportunities. At the heart of place then are the processes of participation and collaboration.

Good places, better health?

Despite these improvements, major challenges still exist. While the quality of the air that we breathe and the water that we drink may be uniformly high, the difference in health and in life expectancy amongst different communities is stark. It is vital, therefore that we achieve a better understanding of the subtle and complex contribution of environment to health and wellbeing.

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ACADEMY OF URBANISM CONGRESS VI, Glasgow 2011 Provocation Paper 1: Housing and Health

We know that the physical environment that surrounds us is key to our health and wellbeing. Historically we have focused (very successfully) on creating environments free from significant hazards. Whilst this continues to be important we now recognise an additional need to create positive physical environments which nurture better health and wellbeing. The relationship between environment and health is complicated and creating safe and positive environments for health requires us to think, plan and deliver in new and more effective ways.

Today’s issues are less about toxic or infectious threats but rather the capacity of ugly scarred and threatening environments to foster hopelessness and stress, discourage active healthy lives and healthy behaviours. When it comes to health and wellbeing, it is often said that ‘everything matters’. Our challenge is to translate this understanding into effective policy and action. Central to this issue is the difference between ‘neighbourhood’ the physical and locational aspect of place, and ‘community’ the organisational and social aspect of place. The citizen sits at the heart. In this context, good places better health is not just an issue of physical regeneration. In the words of the Chief Medical Officer in Scotland, it is about constructing the ‘architecture of hope’, where social capital and opportunity are as important as the built quality of the physical environment.

Institutional collaboration

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todays environmental health threats are less about toxic or infectious threats but rather the capacity of ugly scarred and threatening environments to foster hopelessness and stress”

Concentrations of poor health, poverty and benefits dependency are often found in areas where high levels of housing is provided by the social rented sector. Despite intensive intervention, over several decades, these levels persist. Previous efforts have tended towards the short term, grant-aided, area specific, project level approach which have been difficult to sustain.

Whilst many of these have been successful and have helped improve local practice, the strategic long-term potential of greater collaboration across social housing and health, at the structural level, appears as relatively untested.

All providers of statutory and voluntary public services expect challenges in maintaining current service models. Given this, it may be timely to reassess how common interests in community development, health and wellbeing can be combined in new methods of service delivery under the key areas of: • Physical Environment • Social Environment, and • Enabling Services Appreciating the limitations of the individual, specific, project level approach in influencing institutional level decision making, a sectoral level ‘framework’ for the social rented sector could be built. This would take the form of a series of inter-related demonstration projects, a learning and doing infrastructure. The outcomes would inform decision making at the strategic 2

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We need to understand the difference between ‘neighbourhood’ the physical and locational aspect of place, and ‘community’ the organisational aspect of place”

ACADEMY OF URBANISM CONGRESS VI, Glasgow 2011 Provocation Paper 1: Housing and Health

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Smithfield in Dublin... ...the neighbourhood got bigger on market days. It was less about the buildings and more about the deals”

level. No single organisation could take ownership of the framework. It would be a collaborative initiative, working to achieve economies of scope by working together. Such an approach would: • Be participative and designed around the citizen, the user • Be grounded in real experience • Address broad health determinants • Deliver local service solutions whilst informing strategic level decision making.

• Test current collaborative limitations and advise sectoral level solutions • Build over time as a practice led framework • Inform and support an evidence based policy approach • Support new, long term, forms of service partnership

Fast Finance versus Participation and Collaboration Smithfield in Dublin is in the heart of the Markets area of the city. Much of the traditional housing is municipal, with a mix of social rented and affordable housing. It still has a horse market once a month, although all other signs of the market past in the centre of Smithfield are reduced.

Smithfield used to be a place where citizens, often poor, could participate in the economy of the city through simple sales, negotiation, barter and cunning. It was rough and ready. It was not always nice. It just was what it was.

Today, Smithfield is a regeneration area. New housing takes the form of apartments, private tenure. The transformation of Smithfield, and the openness of Ireland to international participation is represented by the massive European inspired light columns soldiering up the square. It was a big idea, a municipal idea, policy driven, iconic. The market used to sell small things, and lots of them. Back then, big money was about trading horses, ridden bareback through the city streets. The neighbourhood got bigger on market days. It was less about the buildings and more about deals.

The money of the Celtic economy took shape here in a European urbanism; high density, public life, vitality. However, today over 50% of the entire ground floor of Smithfield is empty. Most retail units have failed, and there are varying amounts of residential occupation. The arts cinema closed recently. The landlord has increased the rent by almost 100% to cover the cost of servicing his debts. Today, the place is empty. This seems to be the form that follows fast finance. In the coherence of the urban form, it is hard to understand the neighbourhood. You can see the buildings but can’t sense the drama of a place that did deals as part of its basic identity. Is it healthier?

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ACADEMY OF URBANISM CONGRESS VI, Glasgow 2011 Provocation Paper 1: Housing and Health

Participation How would a framework for health and housing look if we organised it around the citizen? Exploring new ideas often means we need to deal with new people and new institutions – and forge new conversations and new relationships. Participation seems like a good idea to most people – but general support is almost always tempered by specific reservations. These reservations usually find expression in two frequently asked questions.

Isn’t there a danger of raising unrealistic expectations? Yes there is, if you ask people what specific solutions they want built rather than what needs and hopes they want satisfied. It is not unrealistic to have an expectation that people will be listened to about the aspirations they have for the places they want to live in. We want our communities to have high aspirations and we expect the places we create to help turn them into reality..

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If ‘the architecture of hope’ is about building better conditions for better lives, then it can not be an idea done to people”

Why should experienced professionals listen to inexperienced amateurs?

Because it’s their place. Because they will have to live their lives in what the professionals create. Because they are the world class experts about their own lives. And, because the alternative – don’t try to understand or engage with the people who will use your design – is not a credible, responsible way to make great places.

If ‘the architecture of hope’ is about building better conditions for better lives, then it can not be an idea done to people. It has to be a process of design together. Housing is a key element of the health opportunity of people. Better integrated thinking in places, designed with people, with citizens through continuous participation and engagement with the environment, and the services supporting our lives could help make these opportunities real.

References Good places better health - http://www.scotland.gov.uk/Publications/2008/12/11090318/0 Employers in Voluntary Housing - http://www.evh.org.uk/content/ A vision of Health - http://www.ads.org.uk/healthierplaces/features/a-ds-a-vision-of-health Investing in better places - http://www.smith-institute.org.uk/file/Investing%20in%20Better%20Places.pdf Delivering Better Places - http://www.scotland.gov.uk/Resource/Doc/336587/0110158.pdf AOU 10x10x10 Folkestone - http://www.academyofurbanism.org.uk/projects/10x/provocation_folkestone.pdf Historic Area Regeneration Programme, Dublin - http://www.dublincity.ie/YOURCOUNCIL/LOCALAREASERVICES/CENTRALAREA/REGENERATIONPROJECTS/Pages/SmithfieldandHistoricAreaProjectHARP.aspx 5

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