The advance of the COVID-19 pandemic has made evident the need to transform cities into healthier places. Various countries are implementing measures to promote cycling and walking as safe and healthy means of transport. Some are taking advantage of this crisis to launch green infrastructure plans in urban environments and reinforce the 2030 Sustainable Development Goals.
Some educations link air pollution with a higher risk of contagion, and it is, ems that it is also linked to obesity and diabetes. These diseases are directly related to patterns of mobility, consumption and lifestyles in today’s cities.
Older people, the most vulnerable
Another factor of particular relevance is the vulnerability of older people to COVID-19. From the active and healthy ageing paradigm, it has already been shown that living longer is not synonymous with living with a good quality of life.
If we look at the statistics, we can identify the difference between Nordic and Mediterranean countries.
This indicator includes various socioeconomic, health, cultural and environmental conditions that affect people’s quality of life. The urban environment and the quality of the place of residence is a significant factor.
One question that will have to be asked to assess the impact of COVID-19 is the factors that have influenced the high mortality in nursing homes ( more than 50% of deaths in Europe ).
From the opinion view of urban design, the Ministry of Health, Consumption and Social Welfare has recently published a guide with three strategic lines of action that can improve urban environments and their positive impact on health: cities for walking, the inclusion of nature and green spaces and spaces for coexistence (Fariña-Higueras-Román).
Many indicators and factors influence whether an urban environment meets these parameters and is healthy.
In the Department of Urban Planning and Territory Planning of the Polytechnic University of Madrid, we have a working group on this subject for the training of municipal technicians in urban health in three European cities (Alcorcón, Coimbra and Newcastle-upon-Tyne).
The project results, which can be consulted at this link, will be published at the end of this year.
Alternatives to residences
In the current context, the need to transform the residential model to offer different alternatives to the heterogeneous group of older people is also becoming evident. Addressing this issue from the point of view of urban planning is crucial to define a coordinated roadmap between the different agents and establishing an inclusive and sustainable urban strategy.
First, it is necessary to mention that many older people want to stay in their homes or neighborhood. This data is key to establishing a proactive framework for the residential model.
In other countries, there are numerous alternatives beyond cohousing: some of them are housing with services or intergenerational programs.
These formulas allow older people to remain in their neighbourhood for life, maintaining their close social relationships: the community and the family. The subject developed in great detail in the doctoral thesis of the architect Heitor García Lantarón, where he has studied the Danish housing model as a paradigm to promote active ageing.
Secondly, the need to establish recommendations at the level of urban planning that regulate the location, accessibility and design of residences and public facilities for the elderly such as day centres, must considered. Its design must evaluated from a multidisciplinary point of view.
With the crisis of COVID-19, the need to rethink these facilities, the care model in general, and demand management control measures have become evident. It is an opportunity to think about healthy spaces connected to the community.
There attractive residential models abroad (United Kingdom, Belgium, Sweden, Holland…) that must adapted to the Mediterranean climate, context, culture, lifestyles and ways of living.
An adequate design to guarantee health
Nursing homes and day centres must be accessible on foot or by public transport and perfectly connected to the fabric of the neighbourhood, constituting active intergenerational meeting places.
A good design, a mixed program and the relationship of the interior-exterior spaces of both the houses and the residences are essential for health. They must guarantee people’s privacy but allow them to lean out and participate in what is happening on the street or have views of parks and green spaces.
The typology of residences and dwellings (shared or not) related to their way of being inhabited. Significantly, there is a consensus proposal between caregivers, experts, designers and, above all, older people. It is key to vitalist their wishes about how they want to live in the spaces and that the design responds to these aspirations, taking the Person-Centered Care model as a reference.
If the residential model changes, it will also be necessary to review of view of health. Many of the neighborhood areas cities lack proper gerontological planning. Some crucial questions are:
- The accessibility and proximity of green spaces.
- Protection from radiation in living areas during the summer months.
- Access to local shops and markets with fresh and healthy products.
- Safe and accessible crosswalks for all people.
- The existence of squares and gardens allows you to sit down and meet other people.
The WHO Age-Friendly Cities and Communities guide sets out design criteria for public spaces with many parameters.
In this same guide, as well as in other similar ones, the need to have the participation of older people in the community and the design of urban environments becomes evident. Not only would it benefit this population group, but it would also mean a better quality of life for the entire population.
In addition, there is evidence of the need to incorporate health parameters in the design of spaces. Therefore, the objective is to ensure good air quality, thermal comfort, adequate lighting levels adapted to the circadian cycle, incorporate nature as a therapeutic element and facilitate accessibility for people with cognitive problems.
The six design principles for urban environments and neighbourhoods for life published in the United Kingdom include the following factors:
- The familiarity with the surroundings.
- The legibility of the spaces. They must be intuitive and easy to understand to walk around them.
- The singularity and distinction of the spaces. About elements of reference and landmarks that help to orient oneself.
- universal accessibility. It must ensured that people can enter and exit and move around without problems, both indoors and outdoors.
- The comfort. It is related to the absence of noise, adequate temperatures, the convenience of the living places and the beauty of the spaces.
- The security. It integrates several parameters related to the risk of falls, the design for safe environments against the crime of opportunity, accidents due to being run over or cycling on sidewalks and the person’s subjective perception of their safety.
From urban planning and architectural design, it necessary to review renovation strategies and ordinances so that these factors implemented effectively, beyond the fundamental guarantees of energy efficiency and accessibility in terms of mobility, for example.
There is essential to create multidisciplinary teams where design responds to the functional needs of buildings and spaces that value user experience and well-being.
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