We have plenty of open space but no real parks, as noted by a participant in the Airds Bradbury study. When creating a park, including amenities like a cafe or newsstand encourages people to buy coffee or a newspaper and sit down to read, fostering interaction, stated a participant in the Victoria Park study. Even simple activities like chess can encourage community interaction.
Health can be divided into two main categories: communicable diseases, which spread from person to person, and non-communicable diseases, which are tied to genetics and lifestyle choices. Justifying government funding for communicable diseases is straightforward since they rapidly impact large groups of people. Medical infrastructure is necessary to treat patients and environmental improvements, such as access to sunlight, clean air and water, and waste management, help prevent the spread of these diseases.
In contrast, non-communicable diseases, which include chronic conditions such as heart diseases, obesity, diabetes, cancers, and mental illnesses, have complex causes. Factors include personal choices about diet and exercise, leading to debates over whether preventive measures fall under government responsibility. This is considered a “wicked” problem due to the intertwined nature of its causes and effects, making it difficult to assign blame. Nonetheless, governments play a role.
Governments shape employment policies affecting work-life balance, prioritize car-based transportation over more active options like walking, cycling, and public transit, and design urban spaces that should promote walking, cycling, and social activities while offering restorative greenery. They also influence the availability of healthy foods. However, in New South Wales, the government has removed “health” as a goal in planning laws and disbanded the Premier’s Council for Active Living, suggesting a retreat from state responsibility.
Such gaps have consequences. A study of new residential areas in Sydney, “Planning and Building Healthy Communities,” revealed that good intentions for health-supportive environments often fail. Examples include: residents avoiding a regional cycleway due to its unsafe route along a busy highway, restrictive policies limiting use of recreational facilities, a pedestrian and cycle path network that’s too indirect for practical transportation, high-rise residents feeling isolated and finding common spaces too impersonal, and garden maintenance being outsourced, which prevents residents from enjoying physical activity and nature.
A lack of commitment from designers, builders, and managers is one reason, traceable to the idea of “professional detachment.” This is surprising given professionals are meant to be client-focused. It’s likely those professionals share similar health aspirations to the study participants. Beyond practice, research often relies on a linear cause-and-effect model more suited to communicable diseases, which is ill-fitting for the interconnected nature of people-place-health dynamics.
Our study adopted an in-depth, holistic approach, partnering with key health organizations, state health, and urban development bodies, as well as the Heart Foundation. We conducted a comprehensive audit involving fieldwork, shop visits, and observation of space use at various times and conducted interviews and workshops to understand residents’ lifestyles, aspirations, and health concerns better. These methods are available for those wishing to undertake similar research.
Participants in our workshops usually understood the collective effort needed: individual and community action must shape policy, design, and management. As one workshop participant expressed it: “So … you’re asking, what do I do to keep healthy? That’s us. We need to do that. What should I do to keep healthy? That’s [also] us. What is helping me to keep healthy? This is about our community. What could actually help us? By having better gyms, all this sort of stuff … What I need to [do] … that’s where I see the linkage coming through … We’ve got to do that and make the choices…”