HORUS Environmental and lifestyle health determinants and outcomes of urban planning

In urban planning, health should be addressed in its broadest sense, including environmental health, healthy habits, and factors which foster the general wellbeing of the public. From this perspective, health can be viewed as having environmental, lifestyle, physical, mental, and wellbeing determinants and outcomes. Horus project partner Bax and Company, and their Healthy Cities, department, facilitate us basic information for gaining awareness of the environmental and lifestyle factors that have an impact in our health.

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Health Determinants

Health determinants are not the specific health outcomes themselves, but the wider lifestyle and environmental factors that are very closely linked to health.

Environmental Healthy environments refer to the changes in the environment – such as pollution levels – that can have a direct impact on health.

01 – Air Pollution Air pollution is a risk for mortality as well as specific diseases such as stroke, heart disease, lung cancer, pneumonia, and cataract. A healthy city should maintain healthy levels of PM 10; PM 2.5; Ozone and NO2 – indicated by an AQI (Air Quality Index) level below 50. Levels are assessed by fixed or mobile recording points.

02 – Noise Pollution Noise is an underestimated threat that can cause a number of health problems, such as sleep disturbance, cardiovascular effects, poorer work and school performance, hearing impairment, and stress. The WHO guidelines for night noise recommend less than 40 dB(A) of annual average (Lnight) outside of bedrooms to prevent adverse health effects. Noise can be measured by decibels, with different measurements by day and night.

03 – Biodiversity Healthy communities rely on well-functioning ecosystems. Human health and well-being are influenced by the health of local plant and animal communities, and the integrity of the local ecosystems that they form. They provide clean air, fresh water, medicines and food security. Biodiversity can be measured by sample site surveys.

Lifestyle Healthy cities support healthy lifestyles and habits in areas that are key to holistic long-term health, like physical activity, socialising, and food habits.

04 – Physical Activity Consists of minutes per week of moderate and vigorous physical activity (with a minimum of 150 minutes per week recommended for good health). Physical inactivity is the fourthmost important risk factor for mortality worldwide, behind only high blood pressure, smoking and high blood sugar. Can be assessed objectively with accelerometers (ActiGraph) which are attached to people’s waists for a week to obtain frequency, duration and intensity of activity. Subjective measurements using questionnaires provide additional detail. The most commonly used questionnaire is the International Physical Activity Questionnaire (IPAQ).

05 – Sedentary Behaviour Sedentary behaviour is characterised by low energy expenditure while in a sitting, reclining or lying posture. Common sedentary behaviours include watching TV, playing video games, driving, and commuting. Evidence suggests that having a high level of sedentary behaviour negatively impacts health independent of other factors including body weight, diet, and physical activity. This is assessed using non-standardised questions about time spent sedentary during the previous seven days.

06 – Social Interaction Healthy city design supports frequent social interaction, helping to build connections and communities that are important for health. The number and strength of your relationships affect your physical and mental health, with impacts on anxiety, depression, self-esteem and even the immune system. Social integration can be assessed by a perception survey.

07 – Food Habits Urban design and planning can influence healthy eating habits by limiting or providing access to healthy or unhealthy foods. A healthy food environment includes access to fresh fruit and vegetables within a reasonable distance, and minimises fast food outlets. A healthy diet is crucial to all aspects of physical and mental health, from having sufficient energy, to growth and repair of the body, reducing the risk of type 2 diabetes, improving heart health, bone health, and maintaining a healthy weight. Perception surveys and food diaries can be used to monitor diets and food habits.

Do you want to know more? Go to the full report here.