By Helen Pineo. Palgrave Macmillan, 2022, ISBN: 978-981-16-9646-6

Bomin Kim reviews this excellent book that provides a comprehensive and actionable guide to create equitable, inclusive and sustainable urban environments. The book is accessible to a wide audience and a must read for those seeking to deliver healthy urbanism worldwide through practice, activism and education.

As the planet faces escalating threats from global warming, pervasive inequity, dwindling resources, and rapidly changing economic conditions that significantly impact urban life, this book offers a timely and crucial new model for cities. Recognising the quality of modern and future urban life is at stake, Pineo moves away from treating sustainability and health as separate issues. Instead, a systems-based framework centred on inclusivity, equitability and sustainability is introduced. This innovative approach acknowledges the compounding effects of recent urban syndemics, including COVID-19, climate disasters, and social inequality, demonstrating the urgent need for urban planning, design, and public health to consider how cities impact population health and well-being across different spatial and temporal scales. By weaving together these critical elements, this book provides a comprehensive guide for those seeking to improve the health of cities worldwide through practice, activism and education. Healthy Urbanism redefines the approach to creating healthy urban environments.

Central to the book is the THRIVES framework (Towards Healthy uRbanism: InclusiVe, Equitable, Sustainable), an interdisciplinary framework that combines theories from social epidemiology, sustainable development, and systems thinking, developed through the author’s extensive research and professional experience. The THRIVES framework illustrates health at three levels (local, ecosystem and planetary) across five geographical areas (region, city, district, neighbourhood and building), and outlines actions to improve the urban realm grounded in sustainability, inclusivity and equitability. The approach proposed shifts the focus from individual behaviours and genetic predispositions in health outcomes to addressing structural factors that influence health. By emphasising equity, inclusion and sustainability, the book provides a comprehensive perspective on urban planning and development that assists practitioners in exploring how urban environments impact health at different levels, with specific design and planning goals to consider. Supported by case studies from various global contexts, this approach enriches the narrative and makes the book a valuable tool for those involved in urban planning and public health.

The book is structured around nine chapters that build from understanding global urban health challenges to exploring actionable solutions. Pineo begins by delving into the social and physical determinants of health, using a systems thinking framework to address complex urban issues. Traditionally, health challenges associated with urbanisation have focused on communicable diseases, but Pineo broadens this to include modern urban health challenges exacerbated by extreme weather, social isolation, and long-standing inequities in community design and resource distribution. The book’s detailed case studies and site-specific examples bring the research to life, making it accessible to readers both within and outside the fields of public health and urban design.

The first chapter introduces key concepts and definitions in urban health, establishing a foundation for the THRIVES framework through ecological health models that consider the built environment and its impacts on health as interconnected and dynamic factors, rather than in isolation. Chapter 2 reviews various approaches to healthy and sustainable urbanism, covering historical and contemporary initiatives by international organisations. Chapter 3 further delves into the THRIVES framework, providing an overview of its underpinning theory and concepts, including systems thinking, eco-social epidemiology, and ‘just sustainability’ that outlines planning processes that ensure residents’ needs, perspectives and involvement. Combined with an introduction to epidemiology, the book gives readers a foundational understanding of the evidence linking health and the built environment, reemphasising how urban systems are dynamic with feedback loops that can either reinforce positive changes or exacerbate negative ones, thus requiring a comprehensive health approach that centres on sustainability, inclusivity and equitability.

Chapters 4 through 7 move sequentially through the framework’s three scales of health impact: planetary, ecosystem and local health. Chapter 4 discusses design and planning measures to enhance biodiversity, resource efficiency and zero-carbon systems. Chapter 5 focuses on infrastructural systems ranging from air, water, soil, sanitation, waste and mobility infrastructure. Chapter 6 addresses local health at the neighbourhood scale, such as resource accessibility, culture, public space, food and safety. Chapter 7 explores building-scale issues such as acoustic and thermal comfort, housing affordability, lighting and space. Each chapter provides indicators that can be used to evaluate impact, demonstrating how design and planning goals are interconnected across the five geographic scales.

Chapter 8 focuses on implementing the principles of healthy urbanism in urban policymaking and design. Policy processes and development models are described along with insights for overcoming common barriers to healthy urbanism, including development economics. The last chapter discusses healthy built environment strategies for disaster preparedness and prevention, crucial for future pandemics and extreme weather events. The book also emphasises the need to frame health topics for broader audiences and how complex problems around health, environment and climate change need to be communicated. In a time where reactions to climate change range from climate doomism to denialism, experts need to consider how people process information and the narratives they adopt. Given the scale and urgency of urban health challenges, a solution-focused approach ranging in scale and impact is recommended. Although consideration is devoted to the potential impact of technological innovations and large-scale top-down transdisciplinary solutions, it is noted that smaller projects have the potential for significant impact through greater societal awareness that can shift political agendas.

The case studies underscore how healthy spaces have been integral to city-building for millennia. A variety of cities, capturing both Eastern and Western perspectives is drawn upon. It is argued that while technocratic and engineered climate solutions are popular and prevalent, traditional and vernacular solutions to complex urban problems should not be undervalued. This historical perspective enriches the framework, acknowledging the value of time-tested practices alongside modern innovations. The narrative emphasises that creating an inclusive, equitable and sustainable city is context-dependent, highlighting that there is no single typology or solution to achieving healthy urbanism. This enhances the book’s applicability and relevance to a global audience.

This book contributes to current knowledge and research by reframing urban health through the THRIVES framework. The holistic approach emphasises the interconnectedness of inter-scalar sustainability, equity and inclusion. Although the case studies from various global contexts enrich the narrative, the solutions at times seem more aspirational than practical given the broader systemic issues that prevent large-scale interventions and operationalising initiatives in different cities. Nevertheless, the framework and narrative make it an excellent starting point both for readers new to the subject and for professionals and practitioners who wish to design healthier urban environments.

Researchers will find this book offers a robust theoretical foundation and examples that can guide future research in urban health and sustainability. The THRIVES framework can be used to explore the complex interactions between urban environments and health outcomes across numerous design disciplines and contexts. For policymakers, the book serves as a comprehensive guide to developing policies that promote healthy urbanism. The THRIVES framework can help create regulations ensuring urban spaces that enhance health and well-being. The book is also accessible to the general public, raising awareness about the importance of multi-scalar healthy urban environments.

Pineo’s Healthy Urbanism is a great resource for anyone involved in urban planning, public health or community development. It provides a thorough and actionable guide to creating urban environments that promote health, equity and sustainability. By adopting the principles outlined in the book, stakeholders can contribute to developing healthier, more inclusive and resilient cities. The book offers hope and optimism at a time when urban problems can seem too complex and untenable. Its practical strategies provide a valuable addition to the growing body of literature on sustainable urbanism, offering readers not only theoretical insights but also real-world applications. The emphasis on inclusivity, equitability and sustainability ensures that this book is relevant to a wide audience, from policymakers to practitioners to the general public, making it an essential read for those committed to fostering healthier urban environments and to the field of sustainable urbanism.

Share: