On Wednesday 27th July members of the Urban Health Council and additional attendees came together. They ideated and envisioned an urban system that recognised ecological health in policy and practice, set in context to how urban life in 2035 will be more challenging from the various planetary dysregulations causing climate change.

What happened?

The attendees were randomly assigned into 3 groups to scenario model a day in the life of a chosen demographic. They reviewed how the stresses their character might experience could be mitigated by centring the lived experience within built environment and healthcare practice.

The chosen elements to ideate on were a Design Code, Health Impact Assessment and GP Urban Health Survey. These apolitical areas of practice have the potential to create a healthy urban environment when approached with insight, care and due diligence.

The demographics and their backgrounds were:

Brenda, a fully abled 78 widower who lives independently in her flat of 55 years in Tower Hamlets;
Hussein, 11 year old boy with climate related PTSD living in a multi-generational home in new area;
Sam, a 32 year old Black Transwoman living in a house of multiple occupancy on the edges of a city whilst working in the evening economy.

The groups were presented with 4 key climate change related elements to Brenda’s, Hussein’s, and Sam’s urban life and asked to respond on a working document.

What were the outputs of the exercise?

**Group 1 - Brenda’s life reflected in a Design Code from a local planning authority.**

Top insights from the group
Set a target for canopy cover. Some studies suggest that 40% canopy cover is needed for maximum cooling
Spaces for fire breaks and for safe evacuation during wildfire
Designated cooling/heated areas for extremes
Retrofit of shutters and shaders on existing buildings
Build in smaller retail to residential blocks that help prevent Brenda not have to travel long distances
Community ownership of utilities and ability to sell excess off grid
The need for a Retrofit Design Code in addition to a new-build Design Code

**Group 2 - Hussein’s life reflected in how a Health Impact Assessment is performed**

Top insights from the group
HIAs are not mentioned in Policy Boxes of the new London Plan 2021 - only in a general Objective GG3 and therefore has little weight. One of the worst consequences of the Examination process that the London Plan was put through.
Taking an intersectional view that considers the potential effect of race, ethnicity, cultural identity, class.
The need to start today reviewing in longitudinal study form the impact of HIAs
Are homes adapted to child specific healing
Understanding the microbiome quality of the green and blue spaces
Observing the daily patterns of children like Hussein; how much they sleep, school, play eat in reality through communication with surveys or health groups.

**Group 3 - Sam’s life reflected in how a GP might perform an Urban Health Checkup**

Top insights from the group
Ask questions about safe they feel around in public using transport/open space
How often they are able to spaces of wellness (creative/community/parks) where they feel safe
Experiences historically with health services in general - trying to understand experiences of mistrust and how we look for help/support (do you feel comfortable).
Do you feel able to cook well for yourself in your home
What is home life like, how does it make Sam feel?
GP to sign off time from work to access gyms/wellbeing that may be far away
Community data hubs and data sets - that allows us to infer patterns but protect the data of individuals - allowing marginalised communities to have ownership of data
n.b. an Urban Health Checkup does not currently exist, this was an imagining of something completely new.

What does this all mean?

In a 30 minute exercise a diverse, experienced, caring group of people were able to bring answers to problems that create health inequities.

They demonstrated that an improved communication pathway between medical practices, local planning authorities, and private change-makers can help deliver a more humane urban environment.

The ‘Planetary Dysregulation’ theme articulated, from the macro perspective, how industrial contamination of planetary systems is leading to climate change, and from the micro perspective, how already marginalised communities face even greater challenges if we don’t start applying simple changes today.

The group’s collectively identified these changes to methods and practices.

We ask you to ask yourself whether those who have declared climate emergencies, want to reduce health inequities, and deliver communities for all are asking these questions. If not, put them forward and champion the people that are and support our journey at the Urban Health Council in enabling health justice in cities.

With thanks to the session’s attendees:

Alisha Mulhall - Impact on Urban Health

Christine Murray - The Developer

Chris Church - Member of Public

Fanechka Fernandes - TPX Impact

Farah Ahmed - Julie’s Bicycle

Frances Wright - Town Developments

Guppi Bola - Decolonising Economics

Hannah Yu-Pearson - Member of Public

Robin Brown - Just Space

Joanna Lane - Natural Resource Wales

Kyle McFadden - Greystar Europe