Future cities: liveable, walkable, healthy
As Melbourne grows to become a city of 8 million by 2051, the biggest public health challenge is keeping its world-renowned liveability intact. Billie Giles-Corti shares her thoughts on how it might be done.
By 2051, Victoria’s population may exceed 10 million and Greater Melbourne could exceed 8 million, according to government forecasts. Just over 60 per cent of that growth will be fuelled by interstate and overseas migration, so building an inclusive community that welcomes and supports new arrivals is important.
Equally important is keeping Victorians healthy and active, especially as the population ages and our working lives extend to age 70. So how can we plan to keep Victoria’s people healthy, connected and living their best lives?
Distinguished Professor Billie Giles-Corti, Director of the Urban Futures Enabling Capability Platform at the Centre for Urban Research, RMIT University, already has a checklist for what’s needed: a dwelling density of 25 dwellings per hectare; frequent public transport with shopping and other amenities within walking distance; and employment within a 30-minute commute.
Yet delivering those communities on the ground is less straightforward. What could Victoria’s public health sector do to ensure new developments are actually designed for people?
Q: There is a huge amount of knowledge about what is needed for healthy, liveable communities, but how can public health organisations make sure that what we already know is actually implemented?
Distinguished Professor Billie Giles-Corti: The first thing is to get the policy levers right, to make sure that it’s a good, evidence-based policy – and researchers should be able to help here.
But even then, a policy is only as good as its implementation.
So the second thing we need is a better understanding of what gets in the way of good policy being implemented on the ground. Why aren’t policies delivering the sorts of communities that are health promoting?
For example, Plan Melbourne came out in Victoria in March 2017. And I think we all agree – health and planning academics, practitioners and policymakers – that generally Plan Melbourne’s aims are good. We all want to create liveable, active ‘20-minute communities’ where people have access to public transport, local amenities and public open space, and are close to jobs, and it is easy to walk or cycle everywhere.
But the devil is in the detail. How do we actually do that?
Agreeing to a great principle or mission statement isn’t enough. What’s needed is making it work on the ground: how do we implement these great principles.
Public health organisations need to be pushing for the concept of liveable communities to run across and between every level of government. It should be that the prime minister, state premiers and city mayors all demand their departments work effectively together and contribute to creating a healthy liveable Australia. It will only be delivered through integrated planning.
Q: How could the public health sector be more involved in decisions about planning and infrastructure?
Giles-Corti: There’s an important leadership role for the public health sector. We can highlight to other stakeholders just how important these passive interventions are in improving a community’s health and liveability: things like having places where people can walk to, and interact with each other, so they don’t have to travel out of the suburb to do that.
Health needs to be around the table when decisions are being made, when the big policies are being put together. (Plan Melbourne, for example, had input from the health department, the Heart Foundation, as well as transport and water and planning.)
But if we want to be at the table when the big development decisions are made, we need a specialist workforce who can understand city planning and also explain and be alert to the health issues.
People in public health must be able to hold their own with stakeholders such as urban planners, transport planners and landscape architects.
Every group has its particular priority. For example, the traffic planners are concerned about traffic congestion and mobilising a growing population, and the urban planners are concerned with fitting in the growing population and issues of sustainability and housing affordability.
People in public health need to be trained in these other areas, so we can see what perspective they’re coming from – why something is important to them – and so we can perhaps help work out an alternative cost-effective solution.
But, equally, we need to get people outside the health sector to be more educated about public health and liveability issues. They need to understand the unintended consequences of the decisions they make daily in, say, transport planning.
We can’t do their jobs for them, but we can provide the evidence and support them with health arguments to achieve the goal of healthy, liveable communities.
For example, growing concerns about climate change, traffic congestion and obesity can be addressed by increasing opportunities for active transportation. That’s an example of a win-win intervention with co-benefits to multiple sectors.
This is going to become more and more important, for example, as we hurtle towards autonomous vehicles. It’s not enough to say they will be safer because of fewer traffic accidents: what will the chronic disease and mental health impacts be, and how can these be avoided?
Now is the time to get all the evidence we have accumulated over decades into policy. The public health sector must play a role in this.
Q: Of course, measuring outcomes is equally important.
Giles-Corti: In my view, the starting point of creating healthy, liveable communities is getting the policy right, but then levels of implementation need to be measured and that’s not happening enough.
We need to measure what is working well and what isn’t working well, and how policies can be changed to promote health and wellbeing.
In the 1990s, planners in Western Australia got very excited about the concept of ‘new urbanism’. The aim was to try to build more sustainable, pedestrian-friendly neighbourhoods that would increase walking, use of public transport and sense of community.
The WA Liveable Neighbourhood evaluation I led at The University of Western Australia ran over 10 years and compared 74 different developments.
One of my PhD students, Paula Hooper, unpicked the policy and created 44 measures based on the policy itself, which allowed the policy to be benchmarked and monitored.
The policymakers knew what they wanted to achieve with the policy, and we were able to measure this against what actually happened on the ground. We were able to tell them exactly how well the policies had been implemented.
We found that for every 10 per cent increase in the policy being implemented, people were over 50 per cent more active, there was 20 per cent more sense of community, mental health improved by 8 per cent, and the likelihood of being a victim of crime decreased by 40 per cent.
However, the policy was only 47 per cent implemented. This meant that the policy principles appeared right, but policy implementation was the challenge.
"A policy is only as good as its implementation."
In explaining the gap between policy and its implementation, we came up with the idea of the leaky tap. We start off with a policy and use this to create a new community’s structure plan. It’s based on good evidence and all approved, and then along the way local governments, other government agencies, utilities and the developers get involved. And at each point there is ‘leakage’ of the original policy intent.
By the time policies are delivered on the ground, there’s not that much of the intent of the original policy left. So why and where do those leakages, or compromises, occur?
At each point, different actors make compromises for whatever reason, and the end result does not match our aspiration for more healthy liveable communities.
Perhaps a better approach is to focus on the outcomes; to work with developers that have a good reputation for delivering on what our policies are trying to achieve.
Perhaps we just say, ‘We want to maximise the number of people walking and cycling locally.’ Then we carefully monitor and evaluate what they achieve on the ground.
The thing is we all want to build better communities – these are great aspirations – but the players don’t appear to be working together, and the outcomes on the ground are not achieving our overall aspiration.
Q: Are developers being let off the hook too easily when it comes to new developments?
Giles-Corti: Developers can’t take the complete blame for this. True, there are some who aren’t developing the communities we want, but there are others who are attempting to do the right thing.
Really, it’s a systems problem. At the moment it seems incredibly complicated.
For example, local governments and utility companies in different areas within cities often have different policies to one another. Developers complain about the time and complexity it takes to deliver their projects.
We need to create the conditions for the developers to deliver the sort of communities we want, incentivise the good guys, and penalise the laggard developers. We, and they, need to do better.
We need to make clear what’s required for a liveable community. We need to spell out exactly how close people should be to public transport and amenities, and the dwelling densities needed to ensure there are enough people to deliver these types of services.
Then we need to evaluate the implementation of those policies, and provide feedback to individual developers. Perhaps we even need to publish the results so the public know whether or not they are buying into a healthy, liveable community.
It requires integration and commitment from all parts of the system – developers, local government and state government planners. That’s how we will create healthy communities. It’s not just the developers’ problem.
Q: So you’re advocating a much more integrated approach?
Giles-Corti: Most definitely! I recognise that none of this is easy, but it’s been done before. The origins of planning and public health were in tackling the health impacts of rapidly industrialising 19th-century cities. Today, the issues are preventable chronic diseases and promoting mental health.
We have growing evidence about how city planning can contribute to promoting healthier lifestyles but, as the World Health Organization argues, we now need to go further to not only gain political support, but also to guarantee implementation, whether that’s through legislation, norms and standards setting, or investment.
In short, we need to work together and use whatever means, to translate this mounting body of evidence into policy and practice.