Time for a return to Victorian values?

HLM argues for landscape in healthcare

HLM landscape architect Catherine Simpson was recently invited to present a paper on ‘The Future of Healthcare – within or beyond the hospital?’ at the UK government’s Great Weeks, Expo Milan event.

Coinciding with Expo Milan 2015, the government hosted a series of GREAT Weeks trade missions under the theme ‘Grown in Britain’. The healthcare event, which was put together by Healthcare UK and UKTI with input from HLM, identified three parallel strands in the ‘Future of Healthcare’: digital technologies, advanced genomics and the built environment.

The event was officially introduced by George Freeman, minister for life sciences, and presented an outstanding opportunity for thought leadership by UK companies. He and Howard Lyons, CEO of Healthcare UK, pointed out that, as the global disease burden grows, alongside the impact of an ageing population, increases in non-communicable diseases, rising demand and the impact of urbanisation, so does the need for robust research, debate and innovation to respond to these challenges.

With a focus on the built environment, Catherine Simpson of HLM, Stephen Pimbley of SPARK Architects and Simon Bourke of Buro Happold discussed  the future of healthcare and the built environment, and whether this should be within or beyond the hospital.

The impact of urbanisation

Catherine sought to evaluate the effect that urbanisation has on health at a global level, demonstrating the evidence that shows growing levels of lifestyle disease (obesity, diabetes and heart disease) are, in part linked to poor urban planning and a lack of green space. She said: ‘This parallels the growth in global mental illness, set to increase from 10% to 15% of the global disease health burden by 2020 (WHO, World Bank) and we know some of the reasons that the urban environment may be contributing to this.

‘As interest and understanding grows, compelling studies into people’s behaviour and neural and physiological responses to natural and urban environments are beginning to shed light on a fascinating and important field of study. The relationship of contact with nature or biophilia and healthcare is a growing but serious research area that has the potential to have far-reaching implications for planning and health policies worldwide’

Her presentation examined the latest research which is beginning to illuminate the underlying mechanisms by which mental health may be impacted by urban versus natural environments, and the theoretical underpinnings of biophilia.

‘Ultimately,’ she said, ‘as healthcare moves towards a preventative model and the growing public understanding of disease prevention increases, the built environment and landscape architecture must, and should play a greater role. It is critical that landscape architects champion the essential importance of the natural environment to health and mental wellbeing. Events like the Future of Healthcare at the Milan Expo are important opportunities to share knowledge and frame the debate.

Put hospitals in parks

‘The hospital, while delivering acute and primary care, can also play a part in this conversation. The evidence base is now well established for the clinical benefits of therapeutic courtyards, gardens and views. But we can go further than that. At our company, we champion hospitals within parklands, with notable projects in the UK and overseas. This delivers the health enhancing benefits of green views to patients whilst also giving back to the public in new civic parkland and placing the hospital firmly within the population health movement.

‘Perhaps paradoxically, the Victorians had an intuition about the benefits of nature on human health, and landscape was once at the forefront of healthcare and recuperation as well as healthy city planning, (which in part explains the sheer number and quantity of London parks and green space). In modern times there is an increasing demand for land to build and to develop and to utilise all open space. This is particularly true in much of the developing world where planning can’t keep up with the pace of urbanisation.

In touch with nature

‘While cities confer many benefits, both at a societal and individual level, it’s vital that we don’t lose sight of human needs for proximity to nature. Modern powerhouse cities like London and Vancouver in Canada offer templates for how cities can simultaneously densify and retain greenspace. As evidence and awareness grows, and we begin to understand the underlying mechanisms by which natural environments impact human health, there are major opportunities for landscape architects and planners to make a difference. We are in a privileged position as designers to input directly on people’s health through the environments we create.’

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