Health Districts: Creating Healthy Cities

Cities are critical to the efficient operation of society. Beyond just issues of quality of life, they are large consumers of natural resources. There is a growing concern that the form of cities may have a profound effect on public health: chronic diseases related to obesity, heart disease, and asthma, among many others. But in general, governments are making decisions about their development in the absence of critical data and analysis that provides direction for these actions. There is a clear need to establish research that provides a scientific basis for rationalizing city planning and urban design. This is an opportunity to use the protocols driving research to inform the methodology of urban and city design. We have, for the past eighty years or so, used a quasi-scientific set of criteria to direct and regulate the design and construction of our cities and districts towns and suburbs. From the very beginning, social-scientific measures formed the foundation of the professional planning movement. In this process, however, the rigors of basic research and scientific methods have been remarkably absent in reflection on the efficacy of planning’s impact on the built environment. Abstract planning principles are translated into operational regulations without a basic protocol for testing, evaluating, and modifying assumptions based on the results of evidence. The reticence of the profession to test and evaluate is further complicated by the fact that planning is ultimately implemented through a series of legal documents – regulations. Once adopted, regulations are notoriously difficult to change, both due to the precedential nature of the legal system itself and the seemingly inherent credibility bestowed upon regulation by virtue of its own adoption. At its core, the planning profession is charged with creating rules and guidelines for the development of urban and suburban places through constitutional police powers: to provide for the health, safety and welfare of the general public. Ultimately, effectiveness of planning means, such as zoning, can and should be measured. For example, Justice George Sutherland states that plans and their regulations must “expand or contract to meet the new and different conditions which are constantly coming within the field of their operation” in the seminal Supreme Court case, Village of Euclid, Ohio v. Ambler Realty Co. (Village of Euclid, Ohio v. Ambler Realty CO, 1926). He went on to say that, “in a changing world it is impossible that it should be otherwise.” What Sutherland knew as a fact, and the planning profession seems unwilling to address, is that planning is only as good as its ability to positively affect the health, safety and welfare of the people in places it impacts. And, if our impacts are not positive, we are obligated by the law to improve our regulations. An internationally supported system of testing and evaluation protocols, both for proposed regulations and adopted regulations, is still absent from planning and urban design processes. Jurisdictions continue to rely on theory and precedents alone when adopting new regulations. Because of the significant impact that the built environment has on the health, safety and well-being of the general population, it seems logical that the profession would adopt scientific research protocols. This presentation will examine several specific cases across the globe, regulated and designed by a diverse group of professionals, that articulate the issues outlined above and provide methodologies to frame a scientific method for planning and urban design at a consistent, international level.