Annual Congress X – Health, Happiness & Wellbeing
Dr Adrian Philips – Director of Public Health, Birmingham City Council
What is public health all about? It’s the people aspect of renaissance or regeneration. Dr Philips talk addressed direct, indirect and confounding issues, and debated whether we’re asking the right questions:
“Direct issues: Cities tend to have lower than average road deaths due to low traffic speeds and lower suicide rates than rural areas, despite taller buildings. Indirect issues: Air pollution is the single biggest issue at the moment – we have a fascination with cars and a big number of deaths are currently due to air pollution (28,000). If we took buses and taxis off the road, the issue would go away. We designed that. It doesn’t matter which city it is, we still get a lift to school and drive one mile to a meeting.
Obesity is another huge issue. It is scandalous that 1 in 4 children in Birmingham are clinically obese, costing £2.6 billion to manage the effects. We did that. We designed our streets so people don’t walk or cycle; they get in the car instead. So obesity and pollution is the same thing and we did both – it is our fault. Obesity is worse in cities. But is it the city or what we do in the city? People migrate to cities for jobs, cheaper housing and opportunities. But cities intensify inequality; people migrating there are often desperate.
The Chadwick Report, published 200 years ago, led to the first Public Health Act, which promoted sewage and sanitation. 200 years on, Victorian reformers created ‘green lungs’ in cities out of an enlightened self-interest due to so many workers dying. Slowly we are recognising the importance of wellbeing; that we cannot just work and work and work. Mental health issues are also more widely recognised now. The New Economic Foundation recognizes 5 steps for success: being active, observing, learning, giving and connecting. Do we build these 5 steps into our city design?
Perhaps we should be asking new questions: ‘Are cities making us happier?’ ‘Are cities making us live longer?’ Buildings and the environment should be for people. ‘Why shouldn’t we design wellbeing into cities?’ For instance, why have all the steps been removed from New Street Station, leading to an increase of 20 tonnes of fat per year? Why is the clocking on card at the office right next to the lift? Why do cars go over and people go under?
Role modelling is very important. If your parents smoke, you are 2 – 3 times more likely to but if your friends smoke, your chances of smoking increase by 20. Conversely, if your friends cycle, you will cycle. How have we reached a point where young people exclaim that they ‘look like a tramp’ if they walk to school?
Our job is to mitigate that intensification of inequality in cities. People in cities already have increased risks of dying early but this is impacted by the design and function of the city. We should be aiming to improve wellbeing because it’s us. We do that. What do the 1.1m other people in Birmingham do to relax and improve their wellbeing, especially those who are unemployed? That’s our job.”
Words by Young Urbanists
