Few modern challenges are as vexing as health, and as costly it seems.  And the modern dimensions are many, from obesity and sedentary lifestyles, to the rise in depression, to the continuing toll of cancer. In the US we spend an astounding $2.8 Trillion on health care, nearly 18% of our GDP, and yet we are comparatively unhealthy, when contrasted to other countries and cultures that spend much less.


Giving nature a more prominent role in our lives, and actively promoting the design and planning of biophilic cities, we feel is one of the important steps in the direction of enhancing health.

In a recent conference sponsored by the UVA Center for Design and Health, entitled “Healthy Environments, Healing Spaces,” we explored some of the ways cities can be greener and healthier. It was a long and very productive day, with terrific presentations and discussions of some of the key dimensions of design of built environments that might form a more holistic view of a healthy life: a sustainable and nutritious food system, design for aging and the multiple stages of life we will all encounter, design of built environments to foster walking and bicycling, and hospitals and health facilities that will be uplifting, hopeful (and biophilic!).

We still seem to be stuck in a model of health that emphasizes primarily the curative—the entrenched notion that we humans, with busy lives, move along until, unluckily, disease strikes. And while there has been much attention to lifestyle factors and preventative health strategies, the orientation is still largely about avoiding disease rather than advancing and fostering good health overall.

Aaron Antonovsky, an Israeli-American sociologist, famously offered an alternative frame of reference, and his name came up early and at several times in our UVA conference. Antonovsky coined the term “salutogenesis,” to refer to an approach which seeks as the primary goal not the curing of disease (or even the preventing of disease), but the promotion of good health. It has been a helpful counterbalance to the prevailing pathogen-based medical (and societal) view of health. In the dominant pathogen-based view we are dichotomous human beings—either healthy or diseased—and if the latter, we are beset by a particular illness or malady, as in the case of cancer or diabetes, requiring a particular medical intervention. Antonovsky’s salutogenic approach on the other hand, understands human health as profoundly more complex, and seeks to understand what will lead to a long, healthy and meaningful life.  For him, a combination of factors lead to what he calls Sense of Coherence: “a generalized orientation toward the world which perceives it, on a continuum, as comprehensible, manageable, and meaningful.” The desire and ability to cope with life’s stressors seems a major part of this, and nature helps with this in so many ways.

Biophilic Cities can do much to set the framework for happy and meaningful lives, and come close to creating the conditions for salutogenesis. Living in the context and setting of nature, we know from the growing research, delivers immense mental and physical health benefits. New research utilizing portable EEG caps , for instance, further strengthens even the neuroscience arguments for the power of urban nature. Biophilic design elements in cities—from trees and bioswales to green walls—will provide both direct health-enhancing benefits and significant more indirect benefits as well. We are more likely to walk, stroll, bicycle, in environments that are full of trees and greenery. And we are really just in the early stages of understanding the full value and cumulative benefits of the complex systems and outdoor nature we aspire to have in nature. Sound, for instance, is one incredibly important (and often under-valued) dimension. Nature sounds are incredibly soothing and therapeutic in myown life, and the emerging health-enhancing role of bird song is highly believable. One powerful example can be seen in the work of UK sound artist Chris Watson who has collaborated with a children’s hospital to bring the calming and soothing sounds of bird song (captured from a nearby park that patients and staff could see but not hear). These natural sounds have proven especially helpful during stressful times, for instance when children are given shots. But why not imagine living environments drenched in the sounds that make us happy and reduce our stress?


It is not a surprise, then, that we feel happier and healthier when we hear the sounds of nature, those background sounds of the aural world we evolved in. Here is perhaps the essence of the idea of biophilic cities as healthy cities: the insight that we will likely live profoundly healthier lives in cities and built environments that are closer in their in natural conditions to the earthly nest we evolved in. Disease and pathogens will still need tackling, and medical interventions will still be essential, but a more holistic approach to designing and planning green living environments, that reduce chronic stress, that calm us, and that create the conditions for sharing and generous social interactions, are likely a better (and more cost-efficient) bet in the long run.  So, we need Biophilic and Salutogenic!

Post by Tim Beatley