HORUS Direct Health Outcomes

As we mentioned in previous articles, in urban planning, health should be addressed in its broadest sense, including factors which foster the general wellbeing of the people. From this perspective, health can be viewed as having environmental, lifestyle, physical, mental, and wellbeing determinants and outcomes. Today, Horus project partner Bax and Company, and their Healthy Cities, department, bring us again basic information on how urban planning changes and how it can also have direct health outcomes on specific physical and mental health conditions.

Physical: The physical health outcomes of urban planning changes range from general physical health to specific conditions such as heart disease.

08 – General Physical Health. General physical health refers to subjective, self-reported health status. It encompasses mental and physical health, and is predictive of objective health outcomes like disability, morbidity, and mortality. Respondents self-rate their health with example results ranging from poor, fair, good, very good, to excellent. Self-reported general physical health provides a relatively simple way to assess general health changes in an area over time.
09 – BMI. Body mass index (BMI) is a person’s weight in kilograms divided by the square of their height in metres. BMI is an inexpensive and easy screening method for weight, and BMI is
moderately correlated with more direct measures of body fat. A BMI of over 25 is considered overweight, and over 30 is obese. High BMI is strongly correlated with various metabolic and disease outcomes associated with high levels of body fat.
10 – Obesity. Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. Obesity is often measured by BMI, with a BMI of over 30 considered obese.
11 – Premature Mortality. Refers to the number of deaths that occur before the average age of death in a certain population. Mortality rates can be relatively easy to ascertain using population level data, making premature mortality a useful, if general, tool for measuring and comparing health outcomes between areas.
12 – Birth Outcomes. Morbidity indicators related to newborn health and birth outcomes include indicators such as mortality rate, low birth weight, preterm, low height, and low weight for gestational age. Birth outcomes can be measured using health data.


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13 – Type 2 Diabetes. Type 2 diabetes is an impairment in the way the body regulates and uses glucose as a fuel. It is a chronic condition which results in too much sugar circulating in the bloodstream. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves. Type 2 diabetes can be measured using health data.
14 – Cardiovascular Diseases. Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. Cardiovascular diseases can be measured using health data.
15 – Asthma and Respiratory Diseases. Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. Asthma and other respiratory diseases can be measured using health data.
16 – Functional Capacity. Functional capacity refers to the ability to carry out daily activities as needed. Amongst people with disabilities, functional capacity can be used to assess their ability to access their environment. Functional capacity can be measured by surveys or a Functional Capacity Evaluation.
17 – Accidents and Falls. Falls present a major challenge to active ageing. Falls, tripping and other personal injury accidents are a threat to health, particularly of older adults, and can reduce their ability to remain independent. Falls can be measured by self-reported survey, with additional information gathered by interview.
18 – Injury. Injury refers to physical harm caused by road traffic crashes. Injury frequency and severity can be measured using road traffic injury data and surveys.

19 – Pain. Pain refers to chronic pain conditions, pain-related disability, and pain-related challenges to physical functioning. Chronic pain can be measured using health data and surveys.
20 – Heat Stress. Heat stress includes a series of conditions where the body is under stress from overheating. Heat stress can result in heat stroke, heat exhaustion, heat cramps, or heat
rashes. A heat index can be used to measure the likelihood of heat stress in an area.

Mental and Social: The importance of mental health is being increasingly recognised. Mental health can lead to further health issues such as premature death, however it can require relatively low investments to be treated.

21 – Stress. Stress levels can be increased due to environmental factors such as noise or flooding. Having access to a range of green and open spaces is proven to have a positive impact on reducing stress. Stress can be measured using perception surveys.
22 – Anxiety. Exposure to excess noise, such as traffic noise can lead to higher anxiety levels. To reduce anxiety levels, an urban environment should provide access to green open spaces as well as blue spaces, in proximity to residential areas. Anxiety can be measured using perception surveys.
23 – Depression. Depression can be affected in multiple ways by the urban environment: residential and economic density, access to green and blue spaces and quality of housing are all relevant
factors. An indicator for measuring depression can be the number of prescriptions to antidepressants.
24 – Cognitive Function. Cognitive function refers to different mental abilities, such as the ability to learn, reason or problem solve. Street and location connectivity, access to facilities and services, green coverage and access to open spaces are all factors that impact cognitive function. It can be measured using the Colour Trails Test.
25 – Emotional Wellbeing. Emotional wellbeing refers to the ability to manage one’s emotions and face stressful or challenging situations. Proximity to facilities and services, green coverage and a diversity of green spaces can contribute to increased emotional wellbeing. This can be measured by carrying out perception surveys.
26 – Attention Deficit. Attention deficit can affect both children and adults, but is mostly diagnosed in children. Evidence proves that proximity and access to green open space can have a positive impact on children’s mental wellbeing, including attention restoration. Attention deficit can be measured using the Rating Scale for Disruptive Behaviour Disorders.
27 – General Mental Health.  Mental health is a state of wellbeing in which a person is able to cope with difficult moments in life and fully develop vital personal, community and socioeconomic functions. An environment that promotes good mental health is one that guarantees proximity to a range of facilities and services (social, sport, leisure…), access to a variety of green and blue
spaces, as well as universal access to quality housing. An indicator for mental health can be the number of people attended in primary care centres for mental and psychological disorders.

Wellbeing: Wellbeing is linked to one’s physical, mental, emotional and social health. A state of wellbeing is one in which a person can successfully meet all their vital necessities and lead an enjoyable and fulfilling life.

28 – Perceived Safety. It is a subjective assessment of one’s sense of safety, for example in relation to neighbourhood violence or crime. Physical characteristics of spaces that can determine
people’s perception of security are the level of maintenance, lighting and aesthetic quality as well as street connectivity. Perceived Safety can be measured using perception surveys.
29 – Perceived Quality of Life. It refers to one’s own perception of the degree to which they feel healthy, comfortable and able to enjoy daily activities. It’s mainly influenced by proximity and visibility of green spaces and quality of housing. Perceived Quality of Life can be measured using perception surveys.
30 – Happiness. Happiness is defined as a state of well-being and contentment. It can be linked to multiple factors of the built and urban environment, such as proximity to a range of facilities and services, access to green spaces and overall quality of the urban landscape.

Do you want to know more about how to get healthy yourself within an unhealthy urban ecosystem? Go to the full report here.