Cities today face a myriad of issues, from very bad air quality, to the need to adapt to climate change, to a variety of health-related problems including diet, rising obesity and a lack of physical activity. These are complex and challenging issues to deal with and one potential solution is to explore and develop more integrative, holistic models that seek to tie together these problems, and develop solutions that are integrative and catalytic.

Insights for how to begin to do this can be found across the Atlantic, in the UK. In early March, 2013 I visited the former industrial city of Birmingham, which is now on the cusp of developing a new approach and strategies that will explicitly connect health, nature, and economy.  If it works, it may represent an especially promising new path toward the future, one that might be emulated, if not in its details, at least in its philosophy and approach in many other cities.

Birmingham has already declared its intention to be a green and sustainable city, and has already taken a number of impressive steps. It has set one of the most ambitious greenhouse gas emission targets anywhere in the country, or the world for that matter.

But what is especially promising is the city’s early efforts to tie together so many different strands of this green city agenda, especially through the lens of health. Nick Grayson, who heads the City’s program in Climate Change and Sustainability, has been involved in an ambitious effort to map many of the dangers and health relationships in the city—for instance mapping where future urban temperatures will be the highest, and air quality is the worst. Reforms to the UK’s vaunted health care system are shifting responsibilities to the local level, suggesting that cities will have more opportunities (and perhaps more incentives) to understand how their programs and actions can affect health.

How to address these various health issues, and to think about adapting to long-term climate change, is where the Birmingham approach veers into the innovative. The city is making new connections between health and nature, and exploring new ways to forge co-investments in these things and in developing economic flows that can acknowledge and reward the ways in which urban conservation and nature improve residents’ health.  Much of this new philosophy can be seen in the City’s proposed Green Living Spaces Plan.

A key element in this new planning vision of the city as a green and healthy place are 400 km of mostly above-ground small waterways.  While lacking a large, major river, Birmingham has an impressive blue network that reaches every part of the city. Urban rivers and streams are an important foundation for outdoor living and physical activity in cities.  Nick Grayson explained to me his notion that by opening up access to this network it could become the basis for a city-wide grid of walking trails and pathways.

Problems of flooding in the city and the presence of a network of small streams through the city represent, in Grayson’s mind, not a problem so much as an opportunity. The city can’t engineer its way out of these flood problems, nor should it. His recommendation: “Turn that on its head and work with a grain of nature…and you’d say actually that’s literally a blueprint to make Birmingham the first walkable city.” Unlike in many American cities, these streams need not be daylit; they’re already at the surface. But, according to Grayson: “they are hidden and they’re unsafe.”

For Grayson and the city many medical maladies find their ultimate root cause in chronic stress, and here there is much potential to utilize environment and nature to make people much healthier than they currently are: “Medically what’s been proven in terms of the cause of our health problems is chronic stress…the reason [residents] develop cancer, depression, dementia, cardiovascular problems, etc., etc.” The conditions of the physical environments in which residents are living greatly influence this chronic stress—by creating conditions that inadvertently foster it or alternatively help to diminish or control it. Nature and greenery are key stress-reducing elements in cities.

The city is developing creative new planning tools to advance this more integrated health-nature-economy framework. One important step will be the designation of so-called Natural Health Improvement Zones (NHIZs), which represent places in the city where health conditions and depravations are the overlapping and the most severe. Here investments, both public and private, will be focused and coordinated. Here is where new greening efforts (trees, green roofs and walls, as well as interventions to enhance mobility and walking) will be concentrated to maximize the health benefits to residents.

Toward Natural Capital Cities

Birmingham is also impressively moving forward with the assumption that its environment is its essential natural capital from which economy and health must flow, and has declared its intent to be the UK’s or perhaps the world’s first natural capital city.

There are already insights here about how to protect and leverage this natural capital.  Despite its reputation as a grey industrial locale, Birmingham harbors quite a bit of biodiversity, more impressively so given the highly urbanized context. Nature here includes the only urban National Nature Reserve, the 1000-hectare Sutton Park.

A new comprehensive survey of the flora of the Black Country (the larger urban conurbation that includes the four boroughs to the west of the city) shows remarkable nature. And the process by which the survey occurred—through use of an army of volunteers physically walking 750 1-kilometer squares—delivers important benefits for health and wellbeing, as well. This work will likely continue to help in the re-imagining of the urban areas as a connected urban ecosystem. Birmingham is now one of only 12 Nature Improvement Areas (NIAs, what were originally called ecological restoration zones), resulting from a national competition, and administered by DEFRA (Department of Environment, Food and Rural Affairs) and the only entirely-urban site. This provides some national government funds that have been leveraged (about 6 times over) to generate funds, £43 million pounds in total, over three years.

How to estimate and concretize the economic values associated with nature remains a significant challenge but the connection between health and nature is one place where there are possibilities.  Grayson envisions a future in which the health-enhancing value of those streams might then flow back to the city in the form of funds (from forgone medical expenses as more residents walk and spend time in nature), allowing the city to better manage and maintain them.  He sees a day when the amount a person walks or jogs along these stream trails is automatically recorded and sent to one’s doctor, providing the basis for calculating at least a portion of the health benefit of the city’s nature.

And there are other potential new income streams. Turns out that much of the flooding problem along these streams is a function of clogging from downed trees and delayed forest maintenance. Harvesting and extracting some of this wood serves to reduce flood costs, and through sustainable harvesting of this wood, could be used as a biomass energy source, producing a further income stream and helping to lower the city’s carbon footprint, also resulting in green jobs and employment.

As Grayson notes, this more integrative health-nature-economy agenda is also about linking-up and leveraging funds and programs that already exist in these individual areas.  This is a model of “joint investment” in key things in the city, such as streams and trees, that will deliver multiple benefits.

The city is also imagining a new natural capital metric for reviewing and evaluating development projects in the future—one that would broaden the consideration of the scope and stream of potential  benefits, and expand the range of stakeholders who might benefit (or lose), especially when projects are assessed over a much longer timeframe (Grayson mentions 50 years).  With a natural capital frame, Grayson envisions new stakeholders that might wish to “co-invest” in future developments.  “The water company might get a benefit [from a proposed project] in 30 or 40 years time because it’s pre-programed that it will meet its demand…and won’t overshoot [supply of water].”

While the city will be endowed with its own unique amounts and forms of natural capital, there will always be much to build on. Cities can protect and restore what exists, as well as grow new capital. The value of a city’s nature as the foundation of health and wealth is demonstrated by a new study published in the British Journal of Sports Medicine documenting (with the unusual method of subjects wearing portable EEG caps) the restorative mental value of walks in nature (Aspinall et al., 2013). Building local economy and health around this mounting evidence is the next logical step.

Post by Tim Beatley

*A shorter version of this article appeared in Tim Beatley’s Ever Green column in Planning Magazine, November, 2013.