The Importance Of Urban Design And Housing On People’s Overall Well-Being


People may not realize this, but living spaces and health are inter-related. That’s because housing and urban design can actually have an either positive or negative effect on your life.

In United Nations’ Universal Declaration of Human Rights, Article 25 clearly states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family.” And what this includes is the right to have food, clothing, shelter, medical care, security and social services, even during circumstances that are beyond their control.

What researchers have found is that having acceptable housing has major links to one’s mental and physical well-being.

The Housing and Health Guidelines as listed in the Executive Summary of the World Health Organization (WHO) explain that when houses are poorly designed, they can lead to an increased risk of fall, trips, isolation, injury, and stress for the elderly or for those living with disabilities.

Moreover, unaffordable housing and feelings of insecurity about one’s housing can also aggravate feelings of stress. When homes are too cold or too hot, these conditions can intensify chances of indoor air pollution, which can even cause cardiometabolic or respiratory issues. Meanwhile, homes that are overcrowded or have a weak water supply can also escalate the spread of infectious diseases.

Director of the Urban Design Group in London, Robert Huxford, told publication Medical News Today (MNT) that there has been a longstanding relationship between people’s health and housing or urban design.

He explained, “It’s often forgotten that the links between housing and urban design and health go back hundreds of years, such as the 19th-century public health movement, including the Health of Towns Association of the 1840s, or the Model Byelaws issued in the 1870s, that governed urban development in England for the next 50 years.”

He added, “They focused on lighting, ventilation, overcrowding, damp, and sanitation. They specified the minimum width of streets, minimum spaces around buildings, and that habited rooms should have a window at least one-tenth of the floor area. Over 100 years on, developers are bringing forward proposals for windowless flats.”

Huxford also believes that the COVID-19 has exacerbated these historical concerns regarding housing and infectious diseases to the forefront once more.

He explained, “In the 19th century, the main causes of death were infectious diseases, such as tuberculosis, cholera, and typhoid.”

“The public health works of the 19th and 20th-century saw infectious disease brought under control, further aided by advances in medical science. However, the COVID-19 pandemic has shown that we remain vulnerable to infectious disease; and the prospect of drug-resistant diseases is a grave international concern,” said Huxford.

“It is of the utmost importance that housing and urban design provides resilience to infectious disease risk,” he added.

Researchers found another article published in the PLOS ONE journal that shares the same opinion where poor quality housing and COVID-19 infections and mortality are linked in a county within the United States.


Developments That Are Car-Dependent

Also speaking with MNT, Chair of Urban Design Group and Director of Tibbalds Planning and Urban Design, Katja Stille, bigger urban design choices may have a direct negative effect on one’s health.

Stille explained, “the main urban factors that negatively affect a person’s mental and physical health are air pollution from road traffic as well as noise pollution.”

She added, “Living in a car-dependent development will impact negatively on people’s ability to exercise and encourage a sedentary lifestyle that easily leads to obesity, heart disease, and diabetes. The opportunity to be physically active throughout one’s day-to-day life, such as active transport — walking and cycling — is important to avoid obesity.”

Meanwhile, author or Velotopia: The Production of Cyclespace in Our Minds and Our Cities, Dr. Steven Fleming, focuses on the problems of ‘car-centric urban design.’

Dr. Fleming told MNT that a “house with a garage is designed to send you on your way driving, for a day of no exercise whatsoever. An apartment block is only slightly better because the day of walking it was designed to set in motion — with its lift or stairs leading onto the street — will have negligible metabolic equivalent of task (MET) minutes. If you [already have overweight], you’ll be looking for a taxi or bus because walking is painful for [people with obesity].”

As explained by the NIH, MET is measured by “the amount of oxygen consumed with sitting at rest.”

Dr. Fleming also shared, “In my book Velotopia, I detailed, in drawings and architectural jargon, apartment-style housing that would set you on your way on your bike. You would leave your tenth story apartment, and rather than waiting for a slow lift, just ride past all the other apartments arranged around a sloping, typically spiraling, corridor or what we call an ‘access gallery’ or sometimes an ‘aerial street.’”

“That would be the start of a day with far more MET-minutes than the one you started on foot, and that wouldn’t be painful if you [have obesity],” he added.

Huxford also had something to add about the problem with urban and housing designs that are incredibly motor vehicle dependent. He said, “The impact of motor vehicles is significant, brining noise, high intensity street lighting, air pollution, and the risk of injury from collisions into urban areas.”


Housing and Urban Design Issues and Mental Health

Another issue at hand is the way housing and urban design problems can negatively affect one’s mental health.

Director for the Centre for Urban Design and Mental Health, Dr. Layla McCay, told MNT, “homelessness and housing insecurity are a key risk factor for mental health problems.”

She went on to explain, “For those who do have a home, the affordability of the home is key, as economic concerns have links to mental health problems; so too is the quality of the housing, including dampness, noise, pests, and overcrowding.”

“Location of the housing is also important, including neighborhood quality and safety, access to key facilities, including education, jobs, and healthcare. And any aspect of the housing that stigmatizes its residents can also negatively affect residents’ mental health.”

She continued, “Housing that is available, safe, adequate, affordable, and comfortable, and that offers its residents a degree of privacy, while also facilitating multi-generational living where desired, can benefit people’s mental health.”

“Housing has the opportunity to further support people’s mental health by facilitating residents to develop positive relationships with their neighbors, and to foster feelings of inclusion and belongingness,” she added.


Security of Housing and Homelessness

Dr. McCay also focuses on the security of housing as an important factor, as it can affect someone’s mental state if they either own their home or they can’t keep up with their mortgage payments. Other factors such as long-term rental contract, or if they happen to be facing possible eviction without notice, are also things that can affect their well-being the same way that the home’s physical conditions can.

An expert on the intersection of homelessness and mental or substance use disorders, Prof. Deborah K. Padgett of Silver School of Social Work in New York, told MNT that the topic of insecure housing is quite complex, there are also some major root causes as to why.

She shared, “Global housing instability is due to severe poverty and lack of institutional support for ‘public’ or ‘social’ housing that is affordable.”

“The United Nations-endorsed concept of ‘housing is a right’ is, in my opinion, the most contested and least attractive of human rights supposedly guaranteed by governments. This is in part because demand so overwhelms supply as world population growth soars,” she explained.

“But the last decades (since the Reagan administration here in the U.S.) have seen heavy privatization of housing development, and this naturally excludes the poor. In countries like India, the millions living in slums are not considered ‘homeless,’ but this obscures the deplorable living conditions they endure.”

She also shared, “From a personal level, day-to-day survival is a struggle to procure food, clean water, sanitary facilities, etc. – whether living in a slum, a shantytown, or on a park bench,”

Prof. Padgett also believes that one of the biggest factors that causes distress between housing and mental health is actually homelessness. Moreover, many tend to think that mental health issues leads to homelessness, but it’s really not that simple. She explains this in the BJPsych Bulletin journal.

She went on to tell MNT that “homelessness and mental health have a bi-directional relationship, but it’s also complicated. While serious mental illnesses, such as schizophrenia, account for a minority of homeless persons, these individuals are more likely to be chronically homeless and have needs that create more costs for the system — hospitals, jails, shelters, and so on.”

“They are also more likely to be visible in public and thus skew public perceptions away from the fact that most homeless people are families with small children, youth, ‘new’ homeless (older Baby Boomers), and others.”

She continued, “Sadly, the hyper-focus on serious mental illness diverts attention from the trauma caused by being homeless, and this remains under-studied — in part because it is often trauma compounded by childhood adversity and traumatic events earlier in life.”


Issues With Urban and Housing Design and Wealth Inequality

Dr. McCay also points out that another problem with poor health and urban and housing design is the issue of wealth inequality.

Dr. McCay stated, “Housing is inextricably linked to mental health and well-being, but access to housing and the quality of that housing varies according to a wide range of factors, particularly wealth.”

She continued by saying, “Inequalities in people’s access to safe, affordable, good-quality housing can lead to inequalities in their mental health and well-being. People’s mental health can also be affected by ‘segregation by design,’ for example, where people who own their homes are separated by design features from people who live in social housing, even within the same building, creating stigma and exacerbating inequality.”

“During the COVID-19 pandemic, we saw evidence of housing-related inequalities where some people were able to relax and play in their gardens while others had no outside space; some had good quality local parks, and others had to travel outside their neighborhood to find safe and pleasant green space.”

As for one professor of urban design, Peter Bishop, from the Bartlett School of Architecture, University College London, he explains that a number of different types of social deprivation, like poor housing and urban design, are also associated with negative health outcomes.

Prof. Bishop told MNT, “There is a clear correlation between physical and mental health and indices of multiple deprivation. Public Health England lists childhood experience, education, stable housing, and secure employment as the core contributing factors to health and well-being.”


Needing Long-Term Change

As for Katja Stille, governments need to play a part in tightening housing and design regulations that provide ‘clear links between poor housing design and health issues.’

She said, “Governments around the world need to initially acknowledge the link between poor urban environment and housing and reduced life expectancy and higher health care bills.”

“The increasing healthcare costs need to be recognized as a consequence of poor and unsustainable development.”

She added, “Governments need to prescribe mandatory regulations that control the quality of homes, including space and light standards, noise insulation, and private outdoor space. Further Health Impact assessments should be mandatory and require every new development to demonstrate how it leads to a net increase in health outcomes for the new and existing communities.”

Meanwhile, Robert Huxford also said that he believes it’s crucial for urban designers to be “sensitive” when it comes to the needs of the particular community they are working with.

He explained, “We all share basic needs, but there are differences, such as the need for privacy, whether families are nuclear or extended, how strong and connected the community is, and so on. This is shown worldwide in differences in housing design, in streets, and in neighborhoods.”

“Broadly, homes should be designed to reflect and support family structures, neighborhoods to reflect community structures, and districts and towns economic structures; and all the time responding to the natural environment and local climate.”

“The spread across the planet of a standard global corporate urbanism, driven solely by commercial interest that ignores the differences is not something that we should celebrate.”

“Towns need to be sensitive to catering for different needs at different stages in life, time of day, as well as the needs of people from different cultures and ethnic backgrounds,” he continued.

What Prof. Bishop shares is that while housing and urban design are notable factors when it comes to people’s health, the vital area that should truly be targeted is the underlying issue of inequality.

He says, “I would argue that although housing and urban design are important, they are subservient (although related) to more general issues of poverty, education, and equal access to services, particularly health. If society has inequalities within its structure, then the impacts will not be equally distributed.”

Prof. Bishop also goes to point out that governments should consider decent housing design that includes outside space for everyone. Governments should also consider ways to better air equality, lessen motor vehicle use, while improving education, invest in preventive health care, promote sustainable transportation systems and build wider open spaces with facilities for residents to use for sporting or physical activities.