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Salutogenic Landscapes are a Blueprint for Health-promoting Design

Authors:
no 106
2019
to
po
s.
ISBN 978-3-7667-2437-3
Healing
Landscapes
60 MIAMI RISING
– The city’s conflict be-
tween its vulnerable cli-
mate and its excess capital
24 BIOPHILIA FOR
HEALTHY CITIES
– Blue-green infrastruc-
ture as DNA for healthy
urban development
82 LANDSCAPE AS
COMMON GROUND
– Creating an holistic
approach to healing and
building in Syria
006 topos ISSUE 106
Contents
THE BIG PICTURE
Page 8
OPINION
Page 10
TALENT VS. MASTERMIND
Page 12
METROPOLIS EXPLAINED
Page 14
LIVING THE ECO-DREAM
Page 40
CONTRASTS FROM ABOVE
How inequalities leave their mark on the landscape
Page 18
BIOPHILIA FOR HEALTHY CITIES
BGI as DNA for healthy urban development
Page 24
LANDSCAPES TO THE MAX
The park La Mexicana and the role green space can
play in improving the quality of life
Page 32
“A CITY IS GOOD IF IT COUNTERACTS
SOCIAL STRESS”
An interview with Mazda Adli on Neuro-Urbanism
Page 38
LIVING THE ECO-DREAM
Hammarby Sjöstad in Stockholm: How ailing
docklands can be transformed into a healthy quarter
Page 40
“WE MUST OVERCOME THE GAP
BETWEEN LANDSCAPE ARCHITECTS AND
HEALTH SPECIALISTS”
Simon Bell on the Master’s programme in Landscape
and Wellbeing of the University of Edinburgh
Page 46
HEALTHCARE DISTRICTS FOR
HEALTHY CITIES
How to plan the healthy places of the future
Page 48
“WE NEED DRAMATIC GREEN INTERVENTIONS”
William Sullivan calls for nature at every doorstep
Page 54
HEALING LANDSCAPES
FACTS AND FIGURES
Page 58
MIAMI RISING
The balancing act between the city's architectural
extravaganza and the desire for sustainability
Page 60
“STREETS HAVE THE BIGGEST IMPACT
ON PUBLIC HEALTH”
An interview with Lucy Saunders on the
Healthy Streets approach
Page 66
GATHER TOGETHER
Tulsa's Gathering Place: How to design a park for
everyone and make a city a better place?
Page 70
“SALUTOGENIC LANDSCAPES ARE A
BLUEPRINT FOR HEALTH-PROMOTING
DESIGN”
Naomi Sachs on human-friendly planning
Page 74
THE RING OF REMEMBRANCE
Utøya: The healing effects of memorials
Page 76
LANDSCAPE AS COMMON GROUND
Creating a Healing Landscape Strategy for Syria
Page 82
EDUCATIONAL CATALYST
How to support development through education?
Ulyankulu in Western Tanzania
Page 88
BATHING BETWEEN TREES
Kengo Kuma's new meditation house brings forest
bathing to the max
Page 94
CONTRIBUTORS
Page 100
CURATED PRODUCTS
Page 102
REFERENCE
Page 106
EDITOR’S PICK
Page 108
BACKFLIP
Page 110
ESCAPE PLAN
Page 112
FROM THE EDGES
Page 114
IMPRINT
Page 113
GATHER TOGETHER
Page 70
Photos: Shane Bevel, Wilhelm Rejnus
074 topos ISSUE 106
VIEWPOINT
The sociologist Aaron Antonovsky coined the
term salutogenesis (from salus, health and genesis,
origin). He juxtaposed salutogenesis, which
focuses on factors that promote human health,
with pathogenesis, which focuses on what causes
disease. Antonovsky’s theory resonated with the
public health field, which has long emphasized
health promotion and disease prevention. Alan
Dilani, founder of the International Academy for
Design and Health, coined the term “salutogenic
design” as an alternative to the physician-focused,
biomedical model of healthcare design. Saluto-
genic design is like preventive medicine: it pro-
vides design solutions that keep people healthy
throughout their lifespan. The practice has
expanded beyond healthcare and can operate on
multiple scales: a healthy plant that provides both
beauty and oxygen; an elegant staircase that
encourages walking; a bicycle- and pedestrian-
friendly city that reduces carbon emissions and
allows people to exercise and meet on the street.
At a time when humans are living longer,
urbanizing faster, and spending less time in na-
ture than ever before, we desperately need saluto-
genic landscape design solutions. In our 2014 ar-
ticle “The Salutogenic City,Clare Cooper Marcus
and I described the salutogenic design strategies
of many organizations and municipalities across
the world. For example, cities in Australia, China,
Denmark, England, Norway, Russia, South Africa,
Sweden, and the US have closed off streets,
shutting out cars and making these spaces safer
for walkers, joggers, and cyclists. The US Center
for Active Design, which published New York
City’s Active Design Guidelines, has expanded
throughout the country and provides publica-
tions and training on how to implement designs
that encourage active living. Many countries are
working to create housing, gardens, and neigh-
borhoods that allow people to “age in place”
rather than move to specifically designated senior
“Salutogenic
Landscapes are a
Blueprint for
Health-promoting
Design
Salutogenic design focuses on health-promoting design and could be the
right answer for planning future human-friendly urban spaces. e
time is right for architects, urban planners, and especially landscape
architects, to consider themselves as salutogenic designers.
NAOMI A. SACHS
Healing
Landscapes
topos 075
is the US “10-Minute Walk” campaign, a collabo-
ration between the National Recreation and Park
Association, the Trust for Public Land, and the
Urban Land Institute. It ensures that every person
has a safe park within a safe 10-minute walk from
their home. I emphasize “safe” because some
communities do have parks within 10 minutes’
walk, but the route to the park and/or the park it-
self is dangerous. Over 200 city mayors have
pledged to provide safe and equitable park access.
Equitable is also a key word. Researchers have
found that the very people who have less access to
nature – those who are poor or disenfranchised
may benefit from it most. Greenspace can act as a
buffer against the burdens of poverty, bolstering
resilience and moderating health disparities. And
it can even become a city’s most famous tourist
spot. The High Line in New York City e.g., built
atop an elevated railroad, brought attention to
linear parks that creatively utilize non-traditional
open space. The conversion of “rails to trails” has
been a successful adaptive reuse of abandoned in-
frastructure in many countries for decades. The
High Line’s success spurred the creation of simi-
lar parks worldwide, from Rotterdam to Australia
to Tokyo. It inspired other creative solutions for
underutilized infrastructure, such as the Bentway
in Toronto, Ontario under the Gardiner Express-
way and the Lowline in New York City, which
claims to be the first below-ground park. On the
downside, the High Line’s success also sparked an
increase in adjacent property values, which priced
many of the original residents and businesses out
of the area. At the 2018 American Society of
Landscape Architects conference, many presenta-
tions focused on how to design and develop with-
out forcing neighbors out. Can there be beautifi-
cation without gentrification? Can there be gen-
trification without displacement? When thinking
about salutogenic design we should always keep
in mind how we can guarantee environmental
justice. In fact, there has been growing interest in
this issue, also from landscape architecture
students. Last year, three students won an ASLA
award for their publication,A Student's Guide
to Environmental Justice.” Over 500 studies have
been published on the human health benefits of
nature exposure. The epidemiologist Richard
Jackson calls landscape architects the public
health practitioners of the design world. To make
nature visually and physically accessible to every-
one, everywhere, is an act of environmental
justice. To find solutions that most benefit
human health – and even global health – for the
long term is to practice salutogenic design.
housing. The list of creative, exciting examples
has grown exponentially. Many solutions connect
people with nearby nature, including pocket and
pop-up parks, community gardens, green roofs
and living walls, indoor gardens, and urban agri-
culture. To name just two: In Philadelphia, the
Pennsylvania Horticulture Society has been
“cleaning and greening” derelict vacant lots
throughout the city for several years. A research
team studied the effects of the initiative and
found that (a) people who lived near the “treated”
vacant lots had less depression and better mental
health than those whose vacant lots had not been
treated; and (b) gun assaults and other violent
crime decreased in neighborhoods with the
treated lots. Shinrin-yoku, or forest bathing, is a
nature-based therapy practice that began in
Japan and has since been adopted in many coun-
tries. In the US, Canada, and several European
countries, the Association of Nature & Forest
Therapy Guides & Programs trains people in the
guided practice of forest therapy. Amos Clifford,
Founder of the Association, asserts that one does
not need to be in a wild forest to experience the
benefits of Shinrin-yoku. This is good news for
the millions of people living in cities. Connecting
people with nature improves human health and
well-being; it also instills in people a love for the
natural world that engenders future stewardship.
Landscape architects can and should work with
other industries, in both the public and private
sector, to complement their efforts. For example,
when designing schools and the open space
around them, designers must make sure that stu-
dents can re-engage with the natural world
through on-site gardens, natural playgrounds,
and nature-based learning. Landscape architects
as well as urban planners have to act as saluto-
genic designers and must ask, “what kind of
landscapes best promote the health of your
children?” Another kind of fruitful cooperation
BIBLIOGRAPHY
Antonovsky, A. (1979). Health, stress and coping.
San Francisco: Jossey-Bass Publishers.
Branas, C. C., South, E. et al. (2018). Citywide
cluster randomized trial to restore blighted vacant
land and its effects on violence, crime, and fear.
Proceedings of the National Academy of Sciences,
115(12), 2946-2951.
Cooper Marcus, C. & Sachs, N. (2014). The salu-
togenic city. World Health Design, 7(4), 18-25.
South, E. C., Hohl, B. C. et al. (2018). Effect of
greening vacant land on mental health of commu-
nity-dwelling adults: A cluster randomized trial.
JAMA network open, 1(3), e180298-e180298.
Spiegelhalter, K., Noto, P., & Ruswick, T. (2018).
Environmental justice and landscape architecture:
A students’ guide, version 1.3.
Ward Thompson, C., Aspinall, P. et al. (2016).
Mitigating stress and supporting health in deprived
urban communities: The importance of green space
and the social environment. International Journal
of Environmental Research and Public Health,
13(4), 440.
ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
Importance Neighborhood physical conditions have been associated with mental illness and may partially explain persistent socioeconomic disparities in the prevalence of poor mental health. Objective To evaluate whether interventions to green vacant urban land can improve self-reported mental health. Design, Setting, and Participants This citywide cluster randomized trial examined 442 community-dwelling sampled adults living in Philadelphia, Pennsylvania, within 110 vacant lot clusters randomly assigned to 3 study groups. Participants were followed up for 18 months preintervention and postintervention. This trial was conducted from October 1, 2011, to November 30, 2014. Data were analyzed from July 1, 2015, to April 16, 2017. Interventions The greening intervention involved removing trash, grading the land, planting new grass and a small number of trees, installing a low wooden perimeter fence, and performing regular monthly maintenance. The trash cleanup intervention involved removal of trash, limited grass mowing where possible, and regular monthly maintenance. The control group received no intervention. Main Outcomes and Measures Self-reported mental health measured by the Kessler-6 Psychological Distress Scale and the components of this scale. Results A total of 110 clusters containing 541 vacant lots were enrolled in the trial and randomly allocated to the following 1 of 3 study groups: the greening intervention (37 clusters [33.6%]), the trash cleanup intervention (36 clusters [32.7%]), or no intervention (37 clusters [33.6%]). Of the 442 participants, the mean (SD) age was 44.6 (15.1) years, 264 (59.7%) were female, and 194 (43.9%) had a family income less than $25 000. A total of 342 participants (77.4%) had follow-up data and were included in the analysis. Of these, 117 (34.2%) received the greening intervention, 107 (31.3%) the trash cleanup intervention, and 118 (34.5%) no intervention. Intention-to-treat analysis of the greening intervention compared with no intervention demonstrated a significant decrease in participants who were feeling depressed (−41.5%; 95% CI, −63.6% to −5.9%; P = .03) and worthless (−50.9%; 95% CI, −74.7% to −4.7%; P = .04), as well as a nonsignificant reduction in overall self-reported poor mental health (−62.8%; 95% CI, −86.2% to 0.4%; P = .051). For participants living in neighborhoods below the poverty line, the greening intervention demonstrated a significant decrease in feeling depressed (−68.7%; 95% CI, −86.5% to −27.5%; P = .007). Intention-to-treat analysis of those living near the trash cleanup intervention compared with no intervention showed no significant changes in self-reported poor mental health. Conclusions and Relevance Among community-dwelling adults, self-reported feelings of depression and worthlessness were significantly decreased, and self-reported poor mental health was nonsignificantly reduced for those living near greened vacant land. The treatment of blighted physical environments, particularly in resource-limited urban settings, can be an important treatment for mental health problems alongside other patient-level treatments. Trial Registration isrctn.org Identifier: ISRCTN92582209
Article
Full-text available
Vacant and blighted urban land is a widespread and potentially risky environmental condition encountered by millions of people on a daily basis. About 15% of the land in US cities is deemed vacant or abandoned, an area roughly the size of Switzerland. In a citywide cluster randomized controlled trial, we investigated the effects of standardized, reproducible interventions that restore vacant land on the commission of violence, crime, and the perceptions of fear and safety. Quantitative and ethnographic analyses were included in a mixed-methods approach to more fully test and explicate our findings. A total of 541 randomly sampled vacant lots were randomly assigned into treatment and control study arms; outcomes from police and 445 randomly sampled participants were analyzed over a 38-month study period. Participants living near treated vacant lots reported significantly reduced perceptions of crime (−36.8%, P < 0.05), vandalism (−39.3%, P < 0.05), and safety concerns when going outside their homes (−57.8%, P < 0.05), as well as significantly increased use of outside spaces for relaxing and socializing (75.7%, P < 0.01). Significant reductions in crime overall (−13.3%, P < 0.01), gun violence (−29.1%, P < 0.001), burglary (−21.9%, P < 0.001), and nuisances (−30.3%, P < 0.05) were also found after the treatment of vacant lots in neighborhoods below the poverty line. Blighted and vacant urban land affects people’s perceptions of safety, and their actual, physical safety. Restoration of this land can be an effective and scalable infrastructure intervention for gun violence, crime, and fear in urban neighborhoods.
Article
Full-text available
Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people's stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant's home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments.
Health, stress and coping
  • A Antonovsky
Antonovsky, A. (1979). Health, stress and coping. San Francisco: Jossey-Bass Publishers.
The salutogenic city
  • Cooper Marcus
  • C Sachs
Cooper Marcus, C. & Sachs, N. (2014). The salutogenic city. World Health Design, 7(4), 18-25.
Environmental justice and landscape architecture: A students' guide
  • K Spiegelhalter
  • P Noto
  • T Ruswick
Spiegelhalter, K., Noto, P., & Ruswick, T. (2018). Environmental justice and landscape architecture: A students' guide, version 1.3.