City design should focus on health

Urban areas, where cars are now king, need to be reimagined to put people first, ensuring broad public benefits

As the saying goes, "Form follows function." This means the look of something - its shape, movement, physical characteristics - is a result of its purpose. The concept was originally used in architecture, and later applied to industrial design, and even to evolutionary biology.

Form follows function. One only has to look at modern cities to guess what the function is - to support the rapid movement of cars.

Massive boulevards, which cannot be crossed by a pedestrian within the time limit of a green light. Ever-growing ring roads that divide neighborhoods and established communities. Roads without bike lanes. Cars parked on sidewalks. More and more concrete and metal that isolates us from our environment and from each other.

The car is king in the modern city. The built environment reflects that. And it's slowly killing us.

Globally, the urban population is already over half the world total, up from just a third in 1960. Today more than half of China's population lives in cities. By 2030, the number of Chinese living in urban environments will be just shy of 1 billion.

China's cities are some of the best in the world. They offer many opportunities for employment and access to better services. As currently designed and constructed, however, they pose unique risks to our health and wellbeing. China is facing a tsunami of lifestyle diseases - obesity, diabetes, heart disease, lung cancer and more. The built environment has a major influence on China's ability to tackle these diseases.

We have all seen and inhaled the alarming levels of pollution across China. The costs of air pollution due to its health impacts and productivity losses are estimated to be between 3 and 6 percent of China's GDP each year. Beyond pollution, we take health risks as we move from home to work to school and back. Approximately 260,000 people in China die each year in road accidents. More than half of those are vulnerable road users - pedestrians, cyclists and people on electric bikes. Road designs give privileges to car drivers but threaten the lives of walkers and bikers.

Our cities simply aren't built for people. Cities are now built for cars.

But it's not just design. It's also how the design reinforces behavior. Where design prioritizes the rights of motorized vehicles, it fosters a habit of prioritizing machines - cars and trucks - over people.

Our roads are overloaded and the combination of unsafe driving, congestion, road rage and a me-first mentality is a lethal cocktail. Too often the mother with a pram struggling to cross a busy road is honked at and sometimes hit by an impatient or careless driver.

"Form follows function" only works if we have the right function. Shouldn't our cities serve the people who live in them, and not just the cars they drive? What if we reconceived of the physical environment in which we live and the policy priorities we advance in ways that benefit the well-being of the whole community? What if we embraced away of living in the shared space of our cities in away that facilitates sustainable growth, environmental health and individual health?

Changing this requires a healthy-cities approach. It requires people-oriented urban planning, like bike lanes and pedestrianized centers where we can shop or eat in a cafe within walking distance of home. It requires design that builds social cohesion, allows elders to age in place, provides community centers and neighborhood sports facilities and parks, and addresses growing inequities and social isolation.

If our cities, as currently designed, are part of the problem, they also hold the solutions. Cities are the most dynamic environments, often at the forefront of innovation. Reimagining urban life will happen in cities because this is where the inequities are most stark and apparent and, rather paradoxically, because it is in our cities that our common humanity is most clearly felt. It is here, in cities, that mayors and workers breathe the same air, walk on the same roads and send their kids along the same routes to school.

People need - and are demanding - a healthy environment. This demand to rethink our urban experience is what has driven the shared-bike revolution. It is a uniquely Chinese innovation that is transforming how we commute and get around our cities in ways that benefit both our health and our environment. It is an innovation that China will bring to the world.

Health is not only about doctors and disease. We need the leadership - city mayors and urban planners - to prioritize health. These health challenges need to be incorporated into every discussion on the design, development and management of our cities. Health must be an important benchmark to measure the sustainability of our urban policies.

China is extremely fortunate to have a president and other leaders who have placed health at the center of government policies. Putting health at the heart of urban strategies ensures broad public benefits, particularly for the poor and vulnerable.

Our cities need to be reimagined for people. In China's cities, the car may still be king, but, we can hope, not for long.

The author is the World Health Organization representative in China. The views do not necessarily reflect those of China Daily.