Last month I was invited to present at the Global Challenges Summit. Other presenters included Ban Ki-Moon, Francois Hollande, Steve Wozniak, Presidents and Prime Ministers, economists, scientists, futurists, Nobel laureates and business leaders. Topics for discussion ranged from averting World War Three to food security, from women’s representation to colonising space. Urban health was discussed in a panel format, presented by a property developer, Minister of Health, vertical farming expert, an ecologist, water security expert, physician and me, as salutogenic landscape and urban designer.
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Salutogenesis describes a health-promoting, preventative approach. It is the opposite of the standard medical model of pathogenic healthcare which waits until a person is sick and then treats them back to health. We know there is a proven link between environment, design and health. We also know that the incidence of so-called lifestyle-related diseases is rising at unsustainable levels. Landscape architects have a significant role to play in public health as designers and advisers on urban landscapes.  Ecologists understand the need for urban nature connection points, but landscape architects understand how to design those into the day-to-day lived experience of a community. Salutogenic landscapes emphasise soil quality, layered wildlife-attracting, biodiverse planting, seasonal variation. They are low-maintenance, but never low-interest, sustainable, cost-efficient. They absorb stormwater, mitigate urban heat island effect. It is generally accepted that “It is a lot pleasanter, and a lot cheaper, to prevent these [mental or physical health] ailments and even cure them in their early stages by getting back at regular intervals to the peace and quiet of the tall trees, the lakes and rivers, the mountains of our wilderness areas, rather than wait until a real illness develops”. (1) Correctly applied, salutogenic design will be a powerful force for future urban health.
1.            Selhub EM, Logan AC. Your brain on nature : The science of nature's influence on your health, happiness and vitality. Somerset, United States: Wiley; 2012.

This morning I was talking with a doctor about community care, mental health and the government's preference to keep people in the community for as long as possible. I remarked that community care schemes only work if the community actually cares. The classic question "who gives a toss?" is important. If we are to value something or someone we have to know about them in the first place. Just as the environmental movement needs us to know what grass feels like under our bare feet, and what birdsong sounds like, so too we need to know our neighbours. Knowing them is the first step to valuing them. Only then can we begin to care enough so that their welfare is of interest to us. In short we need resilient communities. 

Urban design for health and well-being relies to a large part on creating spaces that foster a shared sense of community - natural playgrounds, community gardens, healing gardens and sensory gardens work to bring people together because they are, necessarily, inclusive, accessible public spaces.

We then went out into the garden and checked on the new chickens , because even busy doctors, and perhaps especially busy doctors, need nature connections in their lives too...

Young and old people living with additional needs, whether due to illness or injury, benefit from time spent in sensory gardens. Over the weekend I chatted with a friend in Surrey who is teaching sports people to fly fish as part of their rehab after reconstructive surgery. He also works with the charity Help for Heroes , enabling men and women suffering post traumatic stress disorder to engage socially and with nature. Both groups benefit from the fly fishing activity in the same way as people do in a sensory garden.

Basic human evolution links us closely with nature. A good sensory garden is designed around this feature of our deep psyche. In this emerging field I have been privileged to work with some wonderful people. Barnados works with vulnerable children and their family groups. Parents and carers are often transitioning from illness, prison, substance misuse, and/or physical disability. Their needs are as profound as those of the children. When we designed the sensory gardens for Barnados in Peterborough they had to meet those broad community needs, in addition to accessibility issues. Centre Algarve was established as Europe's first ever disabled children's resort. When we were asked to design the sensory gardens for that southern Portuguese site we had to be mindful of able bodied siblings and adult family members' holiday needs also. Common features include:

• Water
• Shade
• Trees
• Seasonal displays of flowers
• Seasonal availability of fruit and nuts
• A sense of safe enclosure
• A vantage point from which to admire a view

Sensory gardens benefit not just handicapped people but aid everyone who is stressed, depressed, rehabilitating back to health, or in need of a gentle return to nature. To be fully effective requires design attention to detail. It's often the little things that can make a big difference

Reposted from Portland Family Magazine.
Author and clinical psychologist Kay Redfield Jamison writes, “Children need the freedom and time to play. Play is not a luxury. Play is a necessity.” It is through unstructured, open-ended creative play that children learn the ways of the world. While playing outside, children explore with all their senses, they witness new life, they create imaginary worlds and they negotiate with each other to create a playful environment.

1. Outdoor play is a multi-sensory activity. While outdoors, children will see, hear, smell and touch things unavailable to them when they play inside. They use their brains in unique ways as they come to understand these new stimuli.
2. Playing outside brings together informal play and formal learning. Children can incorporate concepts they have learned at school in a hands-on way while outdoors. For example, seeing and touching the roots of a tree will bring to life the lesson their teacher taught about how plants get their nutrients.
3. Playing outdoors stimulates creativity. Robin Moore, an expert in the design of play and learning environments, says, “Natural spaces and materials stimulate children’s limitless imagination and serve as the medium of inventiveness and creativity.” Rocks, stones and dirt present limitless opportunities for play that can be expressed differently every time a child steps outside.
4. Playing outdoors is open-ended. There is no instruction manual for outdoor play. Children make the rules and in doing so use their imagination, creativity, intelligence and negotiation skills in a unique way.
5. Playing in nature reduces anxiety. Time spent outside physiologically reduces anxiety. Children bring an open mind and a more relaxed outlook back inside when they are in more traditional learning environments.
6. Outdoor play increases attention span. Time spent in unstructured play outdoors is a natural attention builder. Often children who have difficulty with pen and paper tasks or sitting still for long periods of times are significantly more successful after time spent outside.
7. Outdoor play is imaginative. Because there are no labels, no pre-conceived ideas and no rules, children must create the world around them. In this type of play, children use their imagination in ways they don’t when playing inside.
8. Being in nature develops respect for other living things. Children develop empathy, the ability to consider other people’s feeling, by interacting with creatures in nature. Watching a tiny bug, a blue bird or a squirrel scurrying up a tree gives children the ability to learn and grow from others.
9. Outdoor play promotes problem solving. As children navigate a world in which they make the rules, they must learn to understand what works and what doesn’t, what lines of thinking bring success and failure, how to know when to keep trying and when to stop.
10. Playing outside promotes leadership skills. In an environment where children create the fun, natural leaders will arise. One child may excel at explaining how to play the game, while another may enjoy setting up the physical challenge of an outdoor obstacle course. All types of leadership skills are needed and encouraged.
11. Outdoor play widens vocabulary. While playing outdoors, children may see an acorn, a chipmunk and cumulous clouds. As they encounter new things, their vocabulary will expand in ways it never could indoors.
12. Playing outside improves listening skills. As children negotiate the rules of an invented game, they must listen closely to one another, ask questions for clarification and attend to the details of explanations in ways they don’t have to when playing familiar games.
13. Being in nature improves communication skills. Unclear about the rules in an invented game? Not sure how to climb the tree or create the fairy house? Children must learn to question and clarify for understanding while simultaneously making themselves understood.
14. Outdoor play encourages cooperative play. In a setting where there aren’t clear winners and losers, children work together to meet a goal. Perhaps they complete a self-made obstacle course or create a house for a chipmunk. Together they compromise and work together to meet a desired outcome.
15. Time in nature helps children to notice patterns. The natural world is full of patterns. The petals on flowers, the veins of a leaf, the bark on a tree are all patterns. Pattern building is a crucial early math skill.
16. Playing outdoors helps children to notice similarities and differences. The ability to sort items and notice the similarities and differences in them is yet another skill crucial to mathematical success. Time outdoors affords many opportunities for sorting.
17. Time spent outdoors improves children’s immune systems. Healthy children are stronger learners. As children spend more and more time outdoors, their immune systems improve, decreasing time out of school for illness.
18. Outdoor play increases children’s physical activity level. Children who play outdoors are less likely to be obese and more likely to be active learners. Children who move and play when out of school are ready for the attention often needed for classroom learning.
19. Time spent outdoors increases persistence. Outdoor games often require persistence. Children must try and try again if their experiment fails. If the branch doesn’t reach all the way across the stream or the bark doesn’t cover their fairy house, they must keep trying until they are successful.
20. Outdoor play is fun. Children who are happy are successful learners. Children are naturally happy when they are moving, playing and creating outside. This joy opens them up for experimenting, learning and growing.

Forest bathing or Shinrin-yoku refers to time spent walking in forests. In Japan the practice has been studied by forestry, agriculture and health officials. The rest of the world is now catching on to the idea that rather than being a nice-to-have feature, urban forests are vital to balance the health effects of modern life.

In the UK some cities are blessed with urban parks with mature trees. However, some communities lack mature trees, some have decided to remove tall trees due to various pressures, some people like visiting forests but don't feel the need to have them near their home. Perhaps that situation is about to change.

We know that an active lifestyle is necessary for health and well-being. 20-30 minutes walking 5 times per week maintains our mental alertness, blood pressure, body fat ratio and overall stress levels (a leading cause of cancers) at manageable levels. New findings have discovered that walking in forests is even better for us than just going to the gym or taking a stroll down a local pathway. 

Walking in forests (shinrin-yoku) may prevent the onset of chronic illnesses like cancers, reduce blood pressure, heart rate and stress hormones (which may have a preventive effect on hypertension).  It is also credited with creating calming psychological effects through changes observed in parasympathetic and sympathetic nerves. 

Forest bathing appears to increase the level of serum adiponectin--a hormone that in lower concentrations is associated with obesity, type 2 DM (diabetes mellitus), cardiovascular disease, and metabolic syndrome, among other metabolic disorders. A combined study found shinrin-yoku reduces anxiety, depression, anger, fatigue and feelings of emotional confusion.

By developing urban forests we create an oasis in the city, somewhere we can actively balance the indoor air pollution of modern buildings, the information overload and the stress and pressures of the modern world. Sustainable urban planning requires us to include more trees in the urban setting. To mitigate climate change we need more long-lived trees to sequester carbon. Rather than being a nice-to-have feature, urban forests are vital for a cost effective public health system.

Read the full article here

I found this article on the Grand Designs website and thought it might be of interest -

"When it comes to green living, the Germans are light years ahead of us Brits. Slowly, like toddlers being dragged to the doctor, the UK is moving towards more energy- efficient homes, while Germany swallowed its medicine long ago. The latter has fabulous incentives for green home improvements, to say nothing of its support for renewables. Compare this to grubby old Blighty, where millions don't even have decent insulation.

But this means we can learn a lot from the German experience of what it's like to live in an eco-friendly building. So once we ‘power down' our homes and sort out energy leakage, what next?

One issue that has emerged in Germany is the effect on human well-being of the buildings we live in. They even have a term for the study of it, Bau-biologie or building biology. Ironically, its roots lie in the improved efficiency of modern construction - as homes become more airtight, they deny their inhabitants fresh air and increase exposure to toxins in the building's fabric. Such thinking has been used to explain the emergence of Sick Building Syndrome, various allergenic reactions and recent increases in asthma and respiratory diseases.

The result is to emphasise ‘healthy' construction, a home that is good for you as well as the environment. ‘The movement towards healthy building started about 30 years ago in Germany,' says Oliver Rehm, managing director of design-build company Baufritz.

It is safe to say the public has some appreciation of potential problems from humidity, harmful chemicals and lack of fresh air. In the UK, there is also a growing awareness of chemical pollutants that might find their way into the home - from harmful gases in paint known as volatile organic compounds (VOCs), to flame retardants in furnishings.

Baufritz's answer to humidity, toxins and lack of oxygen is to design homes with a breathable skin, a modern equivalent to dealing with moisture that stretches back centuries, and mechanically controlled windows that open and close according to the internal air quality, or a central ventilation system.

Rehm talks of the human body being affected by ‘electrostress' from overhead telegraph cables, mobile phone masts, power stations, digital telephones, wireless networks, electricity cables, microwave ovens and so on. As a result, Baufritz fits a ‘XUND-E plate' to the outside of its buildings, comprising thin layers of carbon on a natural gypsum board. This, says Baufritz, cuts out up to 99 per cent of all high-frequency radiation and low-frequency static emissions. Inside meanwhile, great care is placed on the siting of electrical circuits, avoiding sleeping areas, for example, in order to reduce exposure to potential harm.

The Building Research Establishment (BRE) says it is keen to do more research into the idea of a healthy home - after all, we spend much of our time inside our homes - and that it is not aware of any body of information on the subject. To this end, the Prince's Foundation is currently building a state-of-the-art house from natural materials at the BRE's Innovation Park near Watford, the site for a handful of show homes demonstrating the latest ideas in sustainable living. ‘Research will examine the impact of natural materials on air quality, on allergy resistance and on general sense of well-being,' says the BRE. "

If you have been to see the natural house at the BRE's Innovation Park near Watford, please let us know your thoughts.

Retro-fitting homes is in the news at the moment. Guidance is around making our homes more energy efficient and saving money. The government has approved suppliers and assessors who will come to your home, check its status and sell you 'fixes'. If you are a tenant the government has a Green Deal scheme so you pay only (about) as much as you save on your energy bill to get the fixes your home needs. These solutions make good sense, but are only part of the picture.

Many people live in homes with small windows and little sunshine indoors, either because the house faces the wrong way, the windows are on the wrong wall to receive direct sunshine, or because the windows are poorly placed or inadequately sized. Why do we need sunshine? Sunshine, and natural daylight, have been proven to be essential for our health and well-being  The natural light improves mood, reduces stress, it even reduces healing times after surgery. Sunlight makes us happy. Our homes need as much light as we can get, for them to nurture us and be the havens we need. Our homes need to support us, by being uplifting places to come home to after a busy week at work.

Wasting money on bureaucracy, or anything else, is never a good idea. However planning departments must change and as tax payers we must invest in that change. Whether elected officials or council planning officers, we need people who understand the bigger picture of a healthy community, and the general principles of design for health and wellbeing in response to environmental degradation, climate change and rising energy costs. Some local authorities are forging ahead, while some lag behind.

The planning process needs to be streamlined so people who want / need to retrofit their homes, to make them more energy efficient (thermal slab flooring or walls, larger windows on the south side, smaller windows on the north, opening windows all around), in addition to the usual double glazing, condenser boilers and insulation, can do so.

Privacy is touted as the main reason people can't have windows in their walls!  However, just as climate change is changing the way we live, (snow, drought  deluges of rain) so planners are learning about the benefits of more light, and the environmental imperative of green living, and so are relaxing some of their previously inflexible stance re street review   We cannot go on as before.

With smart urban planning and green urban design planners and elected officials will be championing the new healthy way to (re) design our homes and our towns.

Once you have mapped where the sun shines on your wall and installed new large double glazed windows on the sunny side, added insulation, energy efficient appliances and an efficient boiler , to complete the process you need some planting. With appropriate planting people can have natural daylight, sunlight when it shines, and enjoy a screened view of and by the neighbours. With companies spending millions on research and development of simulated natural daylight options for healthcare, it is time to stop and ask where are the people standing up and recommending windows, the real, opening thing?

Whether you live in an eco town or are interested in living in green cities, retrofitting your home to be more energy efficient, allow more natural light in and retain more warmth is a smart way to save money and save the planet at the same time.

In 1997, the World Health Organization identified that the health “arena”, 
including priority settings and frequently used spaces such as the workplace, schools, hospitals, correctional institutions, commercial offices and public spaces within our cities should be at the centre of health promotion activities in the 21st century.

During the 66th meeting of the General Assembly of  the United Nations this year, the socio-economic challenge facing the world of non-communicable disease was discussed for the first time.

Effectively designed landscaped and urban settings are a powerful and cost effective tool in the fight to reduce the incidence of non communicable threats to health and well being such as depression, type 2 diabetes, obesity.

I've just submitted an abstract to the World Design and Health Congress for a paper on using landscape and urban design for health and well being. Urban planning for social housing must address the mental health and well being of users. In order for green cities to be cost effective, person-centred landscapes the garden design of the whole needs to be investigated in part.

We can all make a difference. 

"Rising levels of non-communicable disease and social pathologies erode economies and communities, putting pressure on limited health and welfare resources. Links between health and the environment have been demonstrated in the literature."  

This week we have been asked to design dementia gardens for care homes in 3 different countries. It has been a busy week, and it's only Thursday! As award winning designers and active researchers in care home gardens and dementia garden design we are commissioned to improve the quality of life of residents, the business bottom line, staff retention and job satisfaction. At times it can be quite a challenge.

Generally though we talk to the care home manager or their architect about what we can achieve. We work in collaboration with staff, and where possible families, carers and the residents to design practical spaces with soul. Too many dementia gardens emphasise care free surfacing - that effectively means the client has been convinced that concrete in its many and varied forms can be therapeutic. Not so! From experience we know practical, abundant planting, set within a low maintenance planting plan can create a calming, stimulating environment in even tiny courtyard garden, roof garden or balcony spaces.

Whenever we are commissioned to design a new dementia garden there is a real buzz in the office as well get excited about the project and the difference we can make. If it sounds corny, it is! We love to use our talent to show the boring old status quo that creative landscapes are a cost effective tool for the management of dementia.

I am fortunate to be staying in a sub tropical resort, accompanying my husband on a business trip. I have left the children, the office and household chores behind for a few days "R and R". Bliss!

The resort's extensive grounds have been laid out with rambling paths, palms and shade trees. It is known for its spa facilities. The view is pleasantly green. Swimming pools and lagoons dot the landscape. Yet somehow there is little to uplift the senses. You could ask if I have been too long in luxurious surroundings and am now dulled to it all?  But no, these gardens and general grounds, while pleasant, lack colour and life.

Waterlilies grow wild in this area but the resort has none. The vibrant bouganvillea grows prolifically in private gardens locally, but the resort has none.Tropical fruits grow well in the area but again, the resort has none.

When we come to a destination such as this there is an expectatation that we will come away refreshed and renewed, our senses uplifted, having experienced something of the glorious environment in which we are staying.

To really achieve all that a resort can provide it needs to provide more than just a green view. Visitors need a taste, a feeling of something of the exotic. We need to feel we are part of this wonderous landscape. 

Any well designed healing sensory garden can provide that sense of recharge and uplift. We can have that truly uplifting resort feeling at home, in our care homes, our schools and even our social housing projects.  It costs no more financially but gives so much more environmentally and socially, enhancing not only our physical and mental well being, but adding bio diversity to a land sorely in need.