Healing Cities Working Group

by Lindsay Clark BA, BS, M.Sc ; Mark Holland BLA, M.Sc, MCIP, LEED, Joaquin Karakas BA, MA, MCIP, Keltie Craig BA, MA, and Nicole Moen, BA, MP NLP, CH

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Abstract

The healing process in the human body is the ability to rebuild, repair and regenerate cells, tissues and organs. Regeneration draws upon the body’s innate intelligence to heal itself.

What would it then mean for a city to be "healed," and eventually to reciprocate and be healing and heal itself, its inhabitants and visitors. Furthermore, what methods and processes would support cities to facilitate healing in the context of sustainability planning? How might the built form and natural spaces of the city nurture and develop its residents' holistic health – to include addressing physical, emotional, mental, social and spiritual needs?

This “healing cities” project explores how to address planning processes and to design cities in a self-reflective way that may foster greater connectivity both to the world around us, and to ourselves – and to thereby make us healthier and more whole. Specifically, the healing cities approach seeks to develop a framework for building and shaping communities in a manner that fosters natural, physical, social and spiritual healing. Planners, designers and health practitioners have an opportunity to open up a dialogue about how different conceptualizations of holistic healing may interact within the healthy cities framework.

This article is a foundation statement upon which we are planning to build research in support of our thesis that spiritual health is a vital and important contribution that urban design can make and enhance in the holistic spectrum of healing.

Key words: healing cities, spiritual awareness, health in cities, environment, spirit and space, spiritual places, spiritual cities, spirit and buildings, healthy cities, healthy buildings, green cities, sustainable cities, sustainable buildings, sustainable communities, spiritual communities, spiritual urban planning, spiritual urban design, spiritual suburb, wholistic health, holistic health, integrative medicine, healthy cities research, integrative health, walkable cities

Key findings in the literature review reveal that healing involves much more than curing physical ailments.  Healing is a multidimensional process facilitated by integrating physical, mental, spiritual, emotional, and social components of a person’s being. Each component affects the others (Gesler 2003, p. 3; Svihus, 1979, p. 478). This awareness changes the relationship between people and their environments because it recognizes that people do not live as isolated islands, but rather are intimately connected to their surroundings and influenced profoundly by a range of factors. For example, studies have found that individuals exposed to natural, garden-like settings can experience reductions in stress, improved immune functioning, better pain control management and improved physical and emotional wellbeing (Bressi, 2001).

The influence of the built environment on physical health has received considerable attention in recent years from public health and planning agencies who are concerned with how to create more walkable, livable and healthy communities (Plante, 2008; Heart and Stroke Foundation of Canada, 2007; SmartGrowth BC, 2006; Torjman, 2004; Ulrich, 1991). The overarching theme in the literature on addressing the physical level of community residents' health is through planning for increased physical activity by providing walkable, mixed-use communities. Such planning can reduce the burden of disease, disability and mortality due to sedentary lifestyles (Barton, 2010).

Todd Litman, of the Victoria Transportation Policy Institute, believes that “environments that are conducive to walking are conducive to people” (2007). This claim is supported by research that shows that diseases associated with low rates of physical activity – heart disease, obesity and high blood pressure – are currently among the leading causes of death (Frank & Kavage, 2008). Thus, when it was discovered that even moderate levels of activity could substantially decrease the chances of these lifestyle diseases, the public health field began to recognize the relevance of urban planning, transportation, engineering and architecture in supporting healthy citizens (Plante, 2008).

Additionally, healthcare providers, architects, landscape designers, and hospital administrators have come to understand that the hospital environment can affect the mood, stress level, and perceived overall health of patients and families (Ulrich, 1991).  Research is documenting the restorative aspects of the built environment on the healing process (Ulrich, 1991). The healing potential of the hospital built environment can be enhanced through attention to the color, light, sound, texture, and other structural-design aspects of the facility.

Environmental psychology research suggests that patients’ wellbeing is usually fostered when physical surroundings provide a moderate degree of positive stimulation. If stimulation from sounds, intense lighting, and bright colors are too high, the cumulative impact on patients will likely be stressful. Similarly, if there is prolonged exposure to low levels of environmental stimulation, patients experience boredom or even depression (Ulrich, 1991). For example, research on intensive care units has shown that sensory deprivation stemming from lack of windows is associated with high levels of anxiety and depression, and with high rates of delirium and even psychosis (Wilson, 1972; Parker and Hodge, 1967; Keep et al, 1980 as cited by Ulrich, 1991).

In the spectrum of holistic health in urban planning, the importance of the mental and emotional components must not be underestimated. For example, mental health is influenced by the design of the built environment. Yet mental health is not often highlighted within community plans, although it has a considerable impact on communities. According to the World Health Organization, mental illness accounts for 15.4% of lost disability-adjusted life years (DALYS). In developed countries, major depression accounts for 6.8% of lost DALYS, which is a more significant contributor to the total illness index than any other single disease except for ischemic heart disease (Barton, 2010). Thus, planners would benefit from giving increased attention to the human emotional and stress responses to the built environment when crafting urban design approaches, particularly with regards to the needs of vulnerable groups, such as children and the elderly (Crawford, 2010).

Recognizing that not all behaviours are environmentally determined, there is also room to explore the positive aspects of how city spaces shape behavior patterns. For example, the restorative role of the Healing Garden was researched by Todd Bressi at the UC Berkeley College of Environmental Design. Bressi found that individuals exposed to natural, garden-like settings can experience reductions in stress, improved immune functioning, better pain control management and improved physical and emotional well being (2001). Bressi's research demonstrates a relationship between health and the landscape itself – separate from the psychological benefits of a person's engagement in the activity of tending to plants. Bressi explains this as a direct response to accessing the healing dimensions of natural spaces. Bressi's research suggests that the way the buildings are structured, as well as how they are nested in natural environments can have substantial impacts on human health and wellbeing (2001).

Although the prevalent urban planning and design approaches seek to address the influence of the built environment on physical and psychological health, there is not yet specific attention given to the full range of holistic health and wellness within urban planning. Our Healing Cities initiative meets the call to action to re-evaluate planning practice and to expand the scope of the mandate to both create sustainable cities, while caring more comprehensively for the people who live in them.

Project purpose and working definition

Healing Cities is an integrated approach to planning and design for the natural and built environment that values holistic health and wellness of people and ecosystems. It’s a radically different way of understanding the urban experience; it recognizes that cities are not built to merely warehouse people in the most functional and cost-efficient manner, but rather to provide for the holistic needs of each multi-dimensional being residing in the city. The Healing Cities framework aims to combine aspects of health and spirit for improved wellbeing of a community within an integrated approach that is tailored to the needs of whole beings.

The framework for our conceptualizations is based on an established planning tool called the “eight pillars of a healthy community” that members of the Healing Cities working group at H. B. Lanarc, (2010) utilize in consultation projects. We are applying a “healing” lens to this framework to plan for physical, social, mental, and spiritual health of communities. The eight pillars include: Complete Community (land use, density); Healthy Mobility (transit); Healthy Buildings (green buildings); Thriving Landscapes (open space); Green Infrastructure (water, sewers etc); Healthy Food System (organic agriculture, nutrition); Healthy Community (facilities, programs); Healthy Abundance (sustainable economic development). The Healing Cities Framework could be used to facilitate planning and design processes for comprehensive community planning or for targeted projects. The aim of this Framework is to shift the focus of planning to address the whole spectrum of people’s needs while working towards sustainability. 

The first version of the Framework will be presented at the Gaining Ground Conference in Vancouver on October 7th as part of the Healing Cities Day. The Conference, titled "Eco Logical: The Power of Green Cities to Shape the Future," is targeted for innovative professionals who are advancing understanding of the intersection of urban design, human health and community well-being. The Healing Cities day will address strategies for fostering community health, connectivity and the creation of whole communities. Content will address the interests of professionals in urban planning and design, health management, health practitioners, related health fields, popular media and social media, social narrative, and community development. It is hoped that the Conference will provide an opportunity for refining the Framework and gathering feedback on the basic approach for crafting Healing Cities strategies.

Healing Cities rationale

The 21st century presents an ever-changing landscape with respect to spiritual and physical health – a landscape where we are constantly learning about new relationships and patterns. Furthermore, this new century brings with it the paradigm of urbanity, where there is on a worldwide level more than a 50% chance of being an urbanite for the first time in our species’ history. Urban form shapes not only the physical elements of our lives that impact our health in terms of noise, pollution, exercise, workplaces, housing, healthcare and mobility, but also the social and spiritual aspects of our well being such as our relative sense of “home” in our neighbourhoods, our level of stress, our interactions with other human beings, our opportunities to connect in meaningful ways to other living beings, and of particular focus in this discussion – to spiritual nurturing and refuge.  It is also a cacophony of sometimes harmonious but often also conflicting energies, expectations, paradigms and customs – all of which profoundly affect our sense of identity and consciousness. The scale of impacts that a typical city produces can range from the extremes of danger, physical and psychological harm or even death, all the way to a healing, spiritually transformative experience, with all possibilities in between shown below in figure 1.

Figure 1. Scale of Impacts 

We all experience these dimensions of perception every day - consciously or unconsciously - and are aware that they have significant impacts on our wellbeing. However, the complex investment and decision-making processes that create cities rarely take personal holistic health into account, except in the most basic way – and almost never consider spiritual health. 

Components of a Spiritual Urbanism

As discussed above, connecting the form and function of a city to our physical health is relatively straightforward, with increasing evidence of the significance of these linkages.  However, humans are more than physical machines – we are animated and motivated by meaning, purpose and a sense of connection to the universe – each of us in our own unique way.

The spiritual dimension of our existence needs to be better framed and integrated into our planning approaches to cities. Planners are concerned with building connections between people, building a caring human community, and nourishing a notion of service to others (Anhorn, 2006). Leonie Sandercock, a noted planner, also discerned three spiritual qualities that some Vancouver, BC planning practitioners have demonstrated in their work, including: a willingness to engage in a multitude of conversations with community members regarding plans with a mindful awareness; a sense of interdependence and compassion with an inclusive ‘we-philosophy;’ and finally, a “genuine sense of magic and sacredness, a sense that something special is going on and that bringing out the best in everyone requires celebration and rituals and art and play” (Sandercock, 2006, p. 66). All of these values could play an important role in practicing a “spiritual urbanism” that recognizes spirituality more explicitly as an important component of the planning and design process for crafting communities.

However, providing a strict definition for a “spiritual urbanism” is no simple task, because it proposes the integration of numerous cosmologies. The intent within the Healing Cities Framework is to include many worldviews to reach the common place of a healthy city. The Framework explores the concept of how individuals search for meaning in life, and how may this individual journey intersect with larger worldviews to enhance the collective health of cities. Furthermore, it poses the questions: How might cities affect this journey and enhance the collective health of their inhabitants? How would a modern reverence for life and for death reconnect generations and ease the trauma within peoples' lifecycles? Does the city elicit a sense of awe or the ephemeral? Does this space challenge those who visit it to be more self-aware? Do we feel a sense of oneness with the place?

Developing a typology of spiritual phenomenology may lay the groundwork for developing a concept of the sacred within urban planning, although it risks the impulse to condense the diversity of differences into one cosmology. Thus the question is: How is it possible to frame an experience of spiritual place and interactions through diversity? Finally, how could planners create spaces for a soulful livability that supports a spiritual awareness and spirit of charity and biophilia, a sacred connection and love of place?

Healing Cities draws on the exploration of stewardship and caring for natural and cultivated land that the sustainability movement calls for (Brown, 2008; Hawken, 2007). We extend these principles here to ask: How may we incorporate the principles learned from ecological studies to care for people through taking a closer look at choice, consequences, and individual and collective responsibility for the health of our communities? How might environments that facilitate health be created and indeed connect to opening up ourselves and our urban spaces to the possibility of including concern for and nurturing of spiritual experiences?

Components of the Healing Cities model

There is a flow of interactions that occurs between values, form, and behavior. Each of these interact with and influence each other. For example, if individuals are able to walk to the neighborhood store to buy groceries, they have an opportunity to reduce their carbon footprint by not driving a car or using fossil fuels for transportation. In addition, walking to the store is a different way of experiencing a neighborhood environment and may in turn influence a person’s relationship to their community and how familiar they are with their neighbors. Caring for one's environment means a participation in the collective experience of living together on our planet, and thereby a contribution to the collective health of all life on our planet and to the health of our planet itself.

Figure 2 illustrates the relationships between values, behavior, and the environment, and suggests that more attention be given to the impact of city spaces in influencing and shaping people as they shape the city. There is a fluid relationship between values, behavior and environment where the elements overlap and are interconnected. For example, the values held by people who buy locally, are also manifested in people’s behavior as they choose to buy locally and thus influence the local environment.

This diagram is also useful in starting a dialogue about how we can gain a better understanding of the dynamics that shape the way people live and interact, and ultimately shape their city spaces.  We suggest that the structure of the city fabric is intimately connected to personal values, and attention to this dimension by prioritizing healthy habits within communities can help planners to better foster awareness that can lead to healthy behaviour patterns and thus lead to broader city shifts in form and interaction.

Figure 2: Values, Behaviour and Environment – a connected relationship

Given the aforementioned relationships between behavior, values, and environment, the Working Group developed the Healing Cities Framework for understanding the variables that compose a healing city. The basic three dimensions are conceptual spaces that are healing for the mind, body, and spirit.

We propose that the urban planning process be given new priorities.

1. The dimension of spiritual health  relates to individual and community health, that includes subjective, intangible, and multidimensional characteristics of spirituality (Tanyi, 2002)

2. The physical health dimension of health(multi-modal transportation, physical experience, pollution-free, etc) explores how the body can be nurtured in order to maintain a high level of health.

3. The healthy mind dimension (balance, healthy relationship with oneself, free from dis-ease, etc.) addresses the mental health components of a healing city.

This model serves as a starting point for discussion. It is complimented by the aforementioned Healing Cities framework using the eight pillars analysis to develop strategies and plans for communities. In order to implement the Healing Cities model, new approaches are required of planning practitioners. Planning sessions should be conducted with more of a focus on techniques that engage people in a deeper, multi-level, conscious way. The approaches used would access methods to focus people’s intent clearly and open people’s capacity for observation to things less tangible to create solutions at both an energetic and physical level and taking both internal and external needs into consideration. Both the model and the Framework are in the pilot stage, and are intended to initiate a dialogue that can be further developed in order to practice a more holistic form of planning for sustainable, healthy communities.

While we are not the first to propose initiatives in these areas, it would require an entire literature review to do justice to the countless dedicated people who are creating brilliant conceptualizations and projects for eco-changes of somewhat similar natures. See for instance the websites http://www.wiserearth.org/ and http://www.bioneers.org/ for tastes of other suggestions and initiatives in these directions. A particularly close cousin to Healing Cities can be found under the 'Transition Town' model for dealing with the challenges of peak oil, carbon emissions and global warming (Hopkins, 2008; Chamberlin and Hopkins, 2009; http://www.transitionnetwork.org/). While the Transition Town model is based around the principles of the 12-step programs that include acknowledgment of a higher force in our lives, they have not been as specifically focused on spiritual factors in urban planning as we are proposing here (Hopkins, 2008; Chamberlin & Hopkins, 2009).

Figure 3: A Healing City

In Summary

The elements of the Healing Cities Project include:

1. A framework: Elements that fully connect human physical, emotional and spiritual aspects to all dimensions of cities;
2. Policy recommendations: Specific guidelines for “understanding” of the elements and considerations for urban spaces that are beneficial to “whole beings.” 3. Design guidelines: A body of research of data showing the connections between health and place, as well as precedents/examples of healing places and spaces and methods for enhancing the healing performance of place.
4. Rating system to look at city wellness indicators for assessing spaces: building upon work of Canadian Index of Wellbeing and other quality of life indicators, this rating system would assess the healing performance of spaces.
5. Workshops: To present the framework, policy and guidelines to use in assessing and designing spaces for “whole beings” and thereby achieve healthier cities.

Perhaps the most important contribution of the Healing Cities Project is the willingness to enter into a discussion of spirituality in connection to health of our cities and other built spaces. It’s risky. As a western culture we have generally been afraid to talk about spirituality out loud for fear of being labeled flaky or not serious. There are also as many perspectives on what spiritual means as there are people who think about it. The notion of developing a framework for this level of integration in planning, design and retrofitting and development of our built spaces is a challenging task – one that requires its proponents to live the principles and practices in order to engage with it in an authentic way.

We know it is possible for urban places and spaces to contribute to spiritual health, so there is an important role for planners to create these with designs that can support the whole spectrum of healing – a process facilitated by integrating physical, mental, spiritual, emotional, and social components of a person’s being. Taking a holistic approach opens up new gateways to new depths in planning practice, particularly when seeking to develop sustainability plans to remedy social, environmental, and ecological issues. The Healing Cities model provides opportunities for the full range of healing and medical practitioners, administrative and public health workers, and particularly planning and development practitioners to engage in healing work in a more open and spiritually-conscious way.

 
References
Anhorn, M. (2006). Spirituality and Planning in a Diverse World. Planning Theory & Practice, 7, 1, 65–97.
Barton, H., & Tsourou, C. (2000).  Healthy urban planning. New York, NY: Spon Press.
Barton, H. (2010). Strengthening the Roots of Planning. Planning Theory & Practice, 11, 1, 91-113.
Bressi, T. W. (2001). Healing Gardens, UC Berkeley, Places, College of Environmental Design. EDRA / Places Awards -- Research. Places, 14(1). Retrieved February 4th, 2010. Available from: http://www.escholarship.org/uc/item/2t9552jb
Brown, L. (2008). Plan B 3.0: mobilizing to save civilization. New York, NY: W.W. Norton & Company, Inc.
Chamberlin, Shaun and Hopkins, Rob. The Transition Timeline: For a Local, Resilient Future. White River Jct., VT: Chelsea Green Publishing 2009
Crawford, J. (2010). Health at the heart of spatial planning. Planning Theory & Practice, 11, 1, 91-113.
Gesler, W. M. (2003). Healing places. Lanham, Maryland: Rowman & Littlefield Publishers. 
Hawken, P. (2007). Blessed Unrest: how the largest movement in the world came into being and why no one saw it coming. New York, NY: Penguin Group.
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Lindsay Clark is an MSc student at the School of Community and Regional Planning, University of British Columbia. With Bachelors Degrees in French, Environmental Studies, and Urban Planning, she brings a variety of perspectives to her study of holistic community planning and sustainable development. Lindsay established the University of Utah Office of Sustainability after successfully organizing the Sustainable Campus Initiative designed and maintained the Office web interface, and orchestrated the signing of the American Colleges and Universities Presidents Climate Commitment. Lindsay then joined the UBC Sustainability Office and worked on social sustainability performance indicators and completed data collection and analysis of the Strategic Plan. Lindsay’s professional project work is centered on developing city healing strategies and techniques as an integral component to holistic sustainability planning.

Mark Holland is a consultant on integrating sustainability principles into the mainstream development industry, with an eye to developing competitive advantage for his clients and their projects. He frequently works closely with development teams to find cost-effective ways of developing in a more sustainable manner, including projects from small infill to large-scale master-planned communities, in both rural and urban contexts. Mark served as the City of Vancouver’s first Manager of Sustainability, and was the sustainable development planner and project coordinator for the Southeast False Creek sustainable urban development project, now the site of the Athlete’s Housing for the 2010 Olympics. His current work with local government focuses on city-wide sustainable development strategies for small and large cities across North America, including recently the City of Albuquerque, New Mexico and many cities in British Columbia.

Joaquin Karakas is an urban design planner with years of professional experience including project management, preparation of detailed site plans and concept plans, development of urban design guidelines, housing research, policy and typology development, and public event and design workshop facilitation. Joaquin has worked with a variety of clients in a range of contexts from large urban centres, to transforming suburban centres, to small rural, resource, and tourism based communities. Joaquin is a Full Member of the Canadian Institute of Planners and a current member of the Vancouver City Planning Commission.

Keltie Craig has a strong interest in the roles physical and social planning can play in enhancing community and individual health. Her project work at HB Lanarc included the development of a workshop for the development community on LEED-ND and Active Transportation. She also completed an update to the Town of Ladysmith’s Cycling Plan. She has brought her generalist planning skills to sustainability planning projects with municipalities in the Lower Mainland and Vancouver Island. Keltie is also a member of the City of Vancouver’s Bicycle Advisory Committee; was on the Steering Committee for the BCRPA Built Environment Summit; and is active in cycling advocacy and community building, including performing with the B:C:Clettes - a bicycle-inspired performance collective. She is a Provisional Member of the Canadian Institute of Planners, and a member of the Canadian Community of Practice in Ecosystem Approaches to Health. She also organizes and works in a local community garden.

Nicole Moen is a practical visionary who helps individuals and groups move beyond goal-setting to inspired wise action that combines creative energy with realities on the ground. She is a seasoned event producer who has been advancing the fields of integrative medicine and environmental/urban sustainability. Broad experiences in project management, facilitation, education, business, government, not-for-profit, health, and the arts consistently offer her the opportunity to expand her natural ability to observe how diverse people connect and how they can help each other in new authentic ways. She helps professional groups integrate whole health aspects into their work. As a synthesizer of ideas and perspectives and a convener of people and community, she facilitates community action on the imperative to address economic shifts, disintegrated communities, unhealthy healthcare delivery, loss of meaningful work, and other issues. She ponders the question: Can we start to see the space around us as space that connects rather than that which separates us? And then, “If we listen deeply enough, can we find a way to heal ourselves, our families, our colleagues, our communities and the spaces where we meet in between, in order to live whole, alive, connected lives?

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