A whole-building approach to building conversion projects

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This presentation will explore the myriad opportunities to solve several challenges facing modern cities – housing shortages; an affordability crisis; and decarbonisation to mitigate our climate crisis (to name a few) – in a time of continually increasing urban expansion, by converting underutilised, outdated and/or unwanted commercial buildings into modern mixed-use multifamily residences. The two speakers, a team of architects who are working in this space, will explore how to qualify conversion projects, utilising a bespoke approach applied across US and Canadian cities, to support their long-term objectives. These goals include: increasing walkability; public transit use; resiliency and greenhouse gas emissions reductions; as well as to take advantage of key legislation that is bolstering and incentivising such conversions in various hot spots, such as in the City of Calgary (Alberta, Canada). This approach includes how such conversions provide opportunities to weave in the following components into the reimagining of these existing buildings, many of which were unincorporated at the time of their initial creation, owing to their vintage:

1) affordability;
2) indigeneity;
3) heritage and architectural character;
4) operational excellence;
5) diversity and Inclusion (accessibility); and
6) sustainability, wellness and resilience.

From there, the presenters will detail a process for mapping out a conversion project, illustrating key points through built and in-progress case studies, which starts with the preserving and improving of architectural envelopes, before moving to considerations for mechanical systems, plumbing systems, clean energy production onsite, and, finally, to specifications considerations for new materials added to complete said conversions that support a balancing of operational carbon and embodied carbon impacts. While these case studies will represent projects from across North America, the lessons learned from this presentation will be internationally transferrable, with the goal of serving as a model for how global cities can rethink their ageing building stock, and central business districts, by transforming them into newer, higher, better, and more diverse mixtures of live-work-play use types that improve cities, increase the quality of life within them, and meet future demands today.

Learning Objectives

• Participants will learn how to balance decision making, which impacts operational carbon and embodied carbon impacts when redeveloping heritage buidlings.
• Participants will learn rules about how to qualify a project for adaptive reuse/conversion from Commercial to Residential uses.
• Participants will learn about an "envelope-first" methodology for how to approach adaptive reuse, heritage and/or building conversion projects.

In sickness and in law: A closer look at the legal battles driving healthcare infrastructure activism

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This paper evaluates what judicial reviews challenging the configuration and closure of health infrastructure across the UK suggest about the deeply held social attitudes on NHS resilience. A constructivist perspective suggests that collective beliefs about who “owns” the NHS, whether it be government, clinicians or communities, are actively shaped and reshaped during these high-profile court proceedings. Through the comparative analysis of case studies like Lewisham Hospital and Royal Brompton, the paper observes how public narratives, media coverage and grassroots campaigns construct a shared meaning of the NHS as a community asset instead of a purely governmental service.

An important point of tension interrogated is that between localism and national policy imperatives. While centralised policymakers look for efficient, large-scale reforms, local campaigners find judicial review to be a requisite safeguard to preserve accessibility, trust and social equity. Through drawing on publicly available case court documents, the paper identifies recurring themes of citizen empowerment, contested professional expertise, and the symbolism of the NHS as too important to fail. The findings also reveal that judicial reviews become focal points for broader debates about social justice and place-based wellbeing. Where the context of healthy city design is concerned, these legal challenges show how planning, policy and investment decisions must integrate community voices to sustain the legitimacy and resilience of health services.

The paper concludes that judicial reviews function not just as an important legal check and balance but also as a socially constructed forum where competing visions of health infrastructure come into dialogue. The constructivist reading highlights how these disputes influence public understanding of resilience and accountability, reinforcing the NHS as a collective, enduring symbol embedded within healthier cities and communities.

Learning Objectives

• Recognise the role of judicial reviews in shaping public discourse on NHS resilience
• Evaluate the constructivist perspective on health infrastructure disputes
• Identify strategies for inclusive consultation, engagement and investment decisions

Designing healthy cities: Barriers to implementation

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This paper explores the practical challenges involved in creating healthier urban environments. While there is extensive guidance on how to design healthy homes and neighbourhoods, far less attention has been given to the systemic and structural barriers that obstruct implementation.

The first potential barrier is inconsistent guidance issued by government departments and professional bodies. For example, does guidance on the design of new housing and places align with the separate guidance on designing healthy homes and neighbourhoods? This may be an issue. A 2024 report on the design quality of new housing developments reported significant inconsistencies between design statements in national policy and the more detailed guidance that followed it. This confusion makes it much more difficult for architects, housebuilders and developers to follow guidance and for planners to enforce it.

The second barrier concerns the lack of adherence to existing guidance. Evidence from audits and academic studies reveals that a significant proportion of new housing developments are of mediocre or poor design quality, with less affluent areas disproportionately affected. Key failings include poor sense of place, dominance of car infrastructure, and minimal provision of green space – all detrimental to public health. Recommendations include the use of site-specific local design codes, stronger design review mechanisms, and integration of design standards into the planning approval process.

The third barrier is institutional capacity. Many local planning authorities (LPAs) lack the resources, expertise, and statutory powers to uphold design quality. This is compounded by developer resistance, the limited enforceability of planning conditions, and vulnerability to appeals. Proposed solutions include increasing the number of planning officers, including those with design expertise, fostering early collaboration between stakeholders, and improving alignment between planning and highway authorities.

To address these barriers more systematically, the paper proposes closer integration of the network with central and local government and external professional bodies. One option would be to set up a ‘What Works’ Centre for Healthy City Design (or join up with one of the ten existing centres). This could increase the network’s links with central government policymakers and enable it to work with others on addressing the wider determinants of health – including housing, education, income, and employment.
Ultimately, the paper argues that without better alignment of policy, guidance, and implementation mechanisms, the goal of creating healthy, well-designed urban environments will be hard to achieve.

Learning Objectives

• To understand the barriers to implementing well designed neighbourhoods that promote health
• To identify practical ways of overcoming these barriers.
• To identify options for influencing central and local government policy makers on creating healthy cities, towns and neighbourhoods

From Zimbabwe to Salford: Adapting the Friendship Bench for enhanced student mental wellbeing in a digital age

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This paper explores the innovative Salford Friendship Bench Initiative as a case study for addressing the burgeoning student mental health crisis within a broader healthy city agenda.

Recognising the overwhelmed traditional mental health services and the persistent stigma surrounding help-seeking behaviour in UK universities, this initiative adapts the empirically supported Friendship Bench programme from Zimbabwe for a modern university context. The Salford model combines strategically placed physical benches on campus – serving as accessible, stigma-reducing spaces for in-person connection – with a comprehensive digital platform. This digital component, accessible via QR codes on the benches, offers mood tracking, conversation prompts, and a robust resource directory, thereby shifting from analogue to digital support and enabling proactive, preventive care.

The initiative emphasises community-based, peer-to-peer support through trained student volunteers, aligning with the transition towards community-first health services and empowering local communities in health promotion. By integrating physical spaces with digital technology, the Salford Friendship Bench Initiative offers a replicable model for urban universities seeking to create sustainable, accessible, and integrated mental health support systems that contribute to healthier and more resilient urban environments.

Learning Objectives

• Understand the rationale behind integrating physical spaces and digital platforms for mental health support i
• Identify key components for adapting an evidence-based community mental health intervention,
• Analyze how the Salford Friendship Bench Initiative aligns with broader "healthy city" agendas

Climate urbanism and low-carbon gentrification in the urban Anthropocene: A case study of Holt Town, Manchester

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This research investigates the intersection of urban regeneration, gentrification, and sustainable imaginaries through the case study of Holt Town, Manchester. Drawing on theoretical frameworks, including the urban Anthropocene, climate urbanism, and low-carbon gentrification, the study interrogates how eco-friendly urban developments may reproduce socio-spatial inequalities, even while pursuing climate resilience and sustainability.

The thesis explores the hypothesis that the regenerative vision for Holt Town, branded as a “woodland town” and “urban regeneration exemplar” by Manchester City Council, embodies a broader narrative of the “good Anthropocene,” in which cities are framed as solutions to climate change. This framing, however, risks obscuring the tensions between sustainability and social equity. The research asks: is the built urban Anthropocene inherently tied to gentrification, and can sustainable regeneration be truly just and inclusive?

Methodologically, this project adopts a qualitative, critical approach. Data collection includes critical discourse analysis of the neighbourhood development framework, guided by Norman Fairclough’s framework of social wrongs with a focus on environmental justice. Complementing this are semi-structured interviews with key stakeholders – including urban planners, architects, council members, and local residents – and an autoethnographic field visit to Holt Town, capturing photographic and spatial impressions. Interview data will be transcribed, coded, and analysed thematically to uncover patterns related to sustainability, displacement, and inclusion.

Preliminary findings suggest that while Holt Town’s design emphasises low-carbon infrastructure, active travel, and green public spaces, the regeneration narrative is heavily shaped by top-down imaginaries of urban futurity. These visions may marginalise resident voices and risk displacing vulnerable communities through processes of low-carbon gentrification.

The study contributes to emerging debates in critical Anthropocene urban theory by foregrounding the social implications of climate-conscious urban planning. It calls for more grounded, inclusive approaches to regeneration that genuinely engage local communities and centre social equity alongside environmental goals.

Learning Objectives

• To understand how sustainable city models intersect with urban inequality and gentrification.
• What practical strategies can urban planners and designers adopt to ensure sustainable regeneration projects meaningfully engage with local communities and avoid socio-spatial exclusion?
• How can urban policy frameworks better balance climate resilience with social equity to support inclusive, low-carbon urban futures?

The hospital of the future: Sustainable, innovative and focused on new care needs

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The project “Hospital of the Future, Sustainable System“ was born from the attempt to answer the question: “How does one guarantee the sustainability of a new hospital, adequate for today's healthcare, in a constantly evolving world?“ The question arises from the daily experience of professional life which, over the years, has highlighted the rigidity and conceptual antiquity of hospital structures, unsuitable for facing new challenges.

The “Hospital of the Future, Sustainable System” model was born as a synthesis of the organisational and management issues that affect the world of healthcare. A multidisciplinary study and research team was formed which, sharing the initial question and contributing to a unitary vision of the hospital system, redesigned the place of care. A model created to respond to the challenge of healthcare sustainability, “Hospital of the Future, Sustainable System” is a building that develops horizontally (space for diagnosis and therapy) and vertically (space for care) around a gravitational centre that connects all the health, logistical, and technological modules. The central space is the hub for all hospital areas, facilitating orientation and reducing routes. Around this hub, the building can be adapted to different healthcare needs, increasing or reducing building volumes without losing its original layout.

Who needs it? The “Hospital of the Future, Sustainable System” model is a product for all subjects, healthcare and non-healthcare, who have the task and need to evaluate, analyze, identify the needs of new hospital constructions.
To consider the different healthcare, economic and financial options, the model is supported by a web tool, called “Configurator” linked to the “Hospital of the future, Sustainable System”
model that facilitates planning the feasibility study. The model is prepared for the subsequent design phases

Functional: The healthcare process shapes the building structure, and determines simple paths for all users with aggregation of clinical functions by intensity of care and multidisciplinarity;
Flexible: The architectural and plant structure must not be a limit to clinical and technological innovation but must, with its continuous change, guarantee continuity of care.
Scalable: To meet the clients' needs, different functional modules can be aggregated around the original structural system.
Sustainable: The strategic vision of management is 360°: From functional aggregations to the useful operating surface, from energy efficiency to the safety of patients and healthcare workers.

The web application that allows you to customise the model can be found at: https://demo.ospedaledelfuturo.it/ You can initiate it after we send you a password.

Learning Objectives

• focused on new care needs
• healthcare sustainability

Participatory action research on connecting processes, collaboration and knowledge for a healthier living environment for residents in Nijmegen, Netherlands

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It is crucial that residents' health be sufficiently taken into account during the processes and decision-making of spatial projects order to achieve a healthy living environment. This attention to health in spatial processes is currently limited because of the lack of cross-domain collaboration, resident involvement, and the lack of process understanding. Relevant health-related data hardly plays a role in this. To address this issue, participatory action research was conducted in Nijmegen in collaboration with key stakeholders. The research aimed to identify the necessary collaboration, procedural structures, and content to strengthen the integration of health into spatial planning.

This action research has first resulted in an active and broad network of professionals from policy, practice, and research, as well as from the social and physical domains. This network will continue to work together through the initiation of a concrete project in a neighbourhood. Furthermore, the process of spatial projects has been unfolded, detailing the instruments used in each phase and identifying opportunities for incorporating health considerations throughout. From the numerous interviews, group discussions, and case studies, it also became clear that there is a pre-phase in projects. This pre-phase is not an official phase and is not described anywhere, but all the ideas, expectations, casual conversations, and meetings during this period before the project have a significant impact on the course and choices of the project. Another result is that by combining relevant spatial and health data and projecting this onto a map, it contributes to making it clear for professionals where important areas of focus are, areas that have sometimes been overlooked until now. Lastly, conversations with residents, particularly from groups who do not generally attend participation meetings for spatial projects, provide interesting and new information about how different elements of the living environment interact and influence their living environment.

The first conclusion of this participatory action research is that it is possible to study the various aspects (collaboration, process, and content) that are important for creating a healthy living environment in an integrated way, making the complexity of the issue understandable to everyone. Secondly, that health must be integrated into spatial processes in various ways and at different times, even well before a project has started. Thirdly, that through the integration of mapped data and resident perspectives, new areas of focus emerge that are relevant for policy and implementation in spatial projects.

Learning Objectives

• The undefined period before a spatial project has a significant impact on the course and choices during a project.
• By combining spatial and health data on a map, previously unknown areas of concern for a healthy living environment can emerge.
• Participatory action research is an appropriate method to ensure that cross-domain collaboration gets started.

The Black Systemic Safety Fund

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The Black Systemic Safety Fund was an 18-month process designed and facilitated by the Ubele Initiative and Reos Partners using a social lab approach. Core to the process was a desire to put power into the hands of Black and racially minoritised communities to define for themselves how safety might be understood and interpreted within their own localities.

It was a process designed to understand how more community-driven interpretations of safety might shape and influence the allocation of resources to address local safety challenges using a participatory grant-making (PGM) approach that shifted decision-making beyond understandings of safety influenced by funders and other public systems, crime and justice to truly ensure the thriving Michael Hamilton and Yannick Wassmer adopted facilitation approaches. These approaches centred on the use of music, art, play and creativity as a means of moving through ‘stuck problems’ . Within residential workshops, this involved working alongside Drew Sinclair, a multidisciplinary artist and creator with a specialism in community work. The approaches employed throughout the process were guided by Theory U, an action-research and awareness-based method for changing systems and addressing complex social issues pioneered by Otto Scharmer.

The learning partnership team took an ethnographic approach to learning work. This involved participating in and observing group processes and workshops, gathering a range of additional data, and reflecting collectively on emerging insights throughout the project. These insights were used to inform, refine, and make improvements to the work of the implementing partners – Impact on Urban Health, the Ubele Initiative, and Reos Partners – over the duration of the process. The analysis took place over three key phases:

Phase 1: Initial and in-depth analysis of interview transcripts to identify core and sub-themes and learning;
Phase 2: Critical reflection on core and sub-themes to explore issues of power and coloniality – e.g., identifying silences, the unsaid, and other elephants or sticky issues to be surfaced; and
Phase 3: Sharing and facilitating a discussion of all learning and analysis with participants at the project’s final workshop in order to sense-check and identify points of resonance and dissonance among participants.

The interviews conducted with 15 participants (60 per cent) served as the largest source of data for this report. Apart from one interviewee, the majority who shared their perspectives at interview were involved from the beginning to the end of the process, and they were generally more engaged in participant-led initiatives, such as learning journeys and prototyping activities.

Learning Objectives

• How to design responses to safety created by the community with lived experience
• How to develop new ways of allocating resourses based on the communities own perception of its need
• How to develop social lab methodology that centered the voice of the black community

A review and prospect of urban environment research from a gender-inclusive perspective

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With the development of society, the gender inclusiveness of urban environments has become an important issue in urban planning and governance. Since the 1960s, the international community has begun to explore the field of gender inclusiveness, and the concept of women-friendly cities has gradually become an academic hotspot.

Based on existing literature and research results, this paper systematically reviews the origin, core concepts, and practical applications of women-friendly cities in urban environments. It also discusses gender issues in urban environments, such as gender differences in urban space design, public service facilities, and gender equality in urban policies, under the topic of "gender inclusiveness". Secondly, this paper points out the future research focus based on the development trend of environmental research from the perspective of gender inclusiveness: deepening inclusive urban planning and design and building a multi-dimensional urban gender evaluation system; strengthening relevant policy guarantees and implementation mechanisms; and promoting interdisciplinary research and co-operation.

The aim is to provide theoretical support and practical references for the implementation of the gender inclusiveness concept in urban environments, and thereby promote the development of spatial equity.

Learning Objectives

• Understand the concept of gender inclusiveness and its application in urban planning
• Identify gender issues in urban environments and their research hotspots
• Master the future directions of gender inclusiveness research and its practical significance

Scenarios for future heatwave adaptation in the UK

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Climate change is causing heatwaves to become more common in the United Kingdom (UK). In 2022, extreme summer temperatures resulted in approximately 4500 mortalities across the UK. The risk of heatwave mortality and other health-related impacts varies by the vulnerability of residents in their personal and living circumstances, building archetype, and geographical location.

It is likely that residents will begin to adapt their lifestyles and their homes to cope with the health implications of extreme summers. However, predicting exactly what combination of solutions will emerge is difficult. They may include staying indoors, keeping blinds shut, installing shutters, and using fans and air conditioning units. Neighbourhood-level solutions could include more green infrastructure, community cool spaces, and community energy systems. These solutions must be considered alongside current transitions around climate mitigation, such as the decarbonisation of heat and electricity, building retrofit, and behaviour change.

This research project explores the complexity of these factors by developing future heatwave adaptation scenarios. Scenarios and futures thinking are methods used to inform future policy planning. The scenarios can be used as illustration tools to share with wider stakeholders, for consensus-building, or to explore the impact of specific policy decisions at different governance levels.

The scenarios are developed through thematic analysis of semi-structured interviews with key stakeholders, including developers, policymakers, designers, charities and housing associations. The results are collated into three visions for how communities and homes might look in the future, based on specific technological or social adaptations. Scenarios include: a passive-first approach using shading and urban planning, a cooling-centred approach, which is integrated into heating decarbonisation and climate mitigation strategies, and a micro-adaptations approach using both passive and active short-term and temporary measures.

There are many policy goals associated with heatwave adaptation, such as: reducing mortalities; improving climate resilience; reducing energy and carbon; and delivering comfort. The scenarios therefore aim to explore the trade-offs between these policy priorities and how they might impact technological solutions for specific residents in their homes. Exploring heatwave adaptation in this way illustrates the impact of contrasting policy goals across multiple governance levels, and what that means for occupants in their homes. The scenarios aim to draw out the impacts on the most vulnerable residents, and as such a set of possible solutions that protect them from the extreme impacts of heat.

Learning Objectives

• Clarity in policy drivers for heat resilience
• Inclusion in delivering heatwave solutions
• Developing scenarios for future heat resilience research + modelling

Build for Health: An industry-led campaign and blueprint for building healthy places

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This proposal is submitted for consideration by the Healthy City Design Congress to run a workshop on a new campaign – introducing participants to the campaign and its mission, updating on progress, seeking feedback and support, and launching a call to action to the wider community.

Build for Health is a nascent campaign emerging from recent research, “Building Health Equity: The Role of the Property Sector in Improving Health”, led by Sir Michael Marmot and presented at the Healthy City Design 2024 Congress.

This research consolidated evidence on the links between homes, places and health equity, and proposed an approach to collaboration among industry leaders to acknowledge and adopt best practice in the development of homes and places that improve health equity.

Industry support for this proposal was mixed, with little appetite for immediate action. However, sharing the evidence has catalysed interest among industry leaders to acknowledge, understand and challenge how they can influence health outcomes. More importantly, it has provided a platform to drive innovation in the design and delivery of healthy places. Inspiring industry to lead on setting a blueprint for building healthy places has taken on a new urgency, as government aims to meet its ambitious housing targets while, at the same time, reorganising and re-focusing the NHS from acute hospital care towards community-based care.

This is the backdrop to Build for Health – seizing the urgency and opportunity to create a code of practice developed, supported and implemented by industry leaders that will inspire the development of healthy places.

The blueprint is being drawn up and will be debated and codified at a workshop at Hawkins\Brown in July, where we will convene a wider group of cross-discipline professionals. Between July and October, we expect to promote and seek support for the blueprint more widely so that by the Healthy City Design conference in October, we will have some compelling content for a workshop on the Build for Health campaign, the blueprint itself, and future actions.

Learning Objectives

• how industry can collaborate to change practice
• wider participation to chage industry practice
• innovation in developing healthy places

Digital placemaking for healthier cities: Reimagining place through technology, spatial practice and co-design

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Building on earlier research for the NHS – ‘Digital placemaking for health and wellbeing in North East London’ – this poster presents a concise and visually engaging exploration of how digital placemaking can contribute to healthier, more connected urban and community environments. As cities face increasing pressures on public health, social cohesion and environmental sustainability, there is a growing need to reframe how we think about the role of technology in shaping our shared spaces.

The poster is structured around three core learning objectives:
1. Understanding the conceptual foundations: I introduce the concept of digital placemaking – the strategic use of digital tools to enrich the experience of physical place – and explore its relevance in promoting health and wellbeing. Visual elements and brief case studies illustrate how digital interventions such as interactive installations, location-based storytelling, and sensory experiences can foster a sense of connection, encourage physical activity, and support mental health in public spaces.
2. Reshaping spatial practice: Through diagrams and annotated examples, the poster demonstrates how digital technologies are transforming our relationship with place. It invites delegates to consider new modes of spatial interaction and mapping.
3. Applying a Practical Framework: The final section introduces a user-friendly spatial framework developed to guide urban professionals, designers, policymakers and community leaders. The framework offers principles and prompts for identifying opportunities to use digital placemaking in ways that are inclusive, context-sensitive and aligned with local health and wellbeing goals.

By synthesising theory, practice and design strategy, this poster aims to inspire action and reflection. It is intended as a springboard for further conversation and action about how we can embrace digital placemaking as an essential tool for shaping cities that are more emotionally resonant, socially inclusive and resilient.

It is hoped that discussion around the poster will lead to a further iteration and an accompanying resource for place professionals and communities to use. The video will follow the same structure, expanding on each of the three elements. The aim of this submission is to create readily digestible and useable insight to make our places healthier.

Learning Objectives

• Understand the Conceptual Foundations: To define digital placemaking and explore its relevance in urban and community health, highlighting how digital tools can enhance public spaces, foster social connection and support wellbeing.
• To consider how digital technologies are reshaping our understanding of place: offering new ways to imagine spatial practice and the experiential dimensions of public space.
• Apply a Spatial Framework: To introduce a practical framework that guides policymakers, urban professionals and community leaders in exploring digital placemaking activities that contribute to healthier, more connected and resilient communities.

Maximising buildings’ cooling efficiency: The impact of Passivhaus retrofits in extreme hot climate

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Cooling in extreme climatic conditions is a pressing energy efficiency issue for buildings. The residential sector of Qatar also faces the same condition, with one of the world's highest per capita energy consumption rates, and cooling space alone for residential use taking up to 80 per cent of overall residential energy. Traditional building construction practices, too often incompatible with the Gulf's hot-arid climate, add to inefficiencies by transferring temperate climate design paradigms.

This study addresses this issue of Qatar building performance by investigating the effectiveness of Passivhaus-inspired building envelope retrofitting to improve the energy and environmental performance of typical Qatari houses. Two common house typologies were modelled: a one-storey traditional villa and a multi-storey modern villa. With the IESVE dynamic simulation platform, high-fidelity energy models were developed and tuned to real utility data with a Mean Absolute Percentage Error (MAPE) of below 5 per cent, as per CIBSE TM54 standards.

Baseline simulations revealed that the old villa was more energy-efficient than the new villa, 149 kWh/m²/year versus 185 kWh/m²/year, despite being older, and so emphasised the contribution of building form and envelope design. Retrofits modelled on Passivhaus standards produced staggering improvement of 41 per cent and 40 per cent reductions in energy consumption for the traditional and new villas, respectively. Airtightness enhancement was the most effective measure to test, followed by improved glazing and roof insulation. Thermal comfort measurements confirmed indoor temperatures were generally within ASHRAE 55 comfort levels, with discomfort during unoccupied times only. CO₂ concentrations were below the ASHRAE 62.1 threshold of 1000 ppm in both instances, indicating indoor air quality was good.

The findings confirm that envelope upgrades, specifically airtightness and insulation, can deliver significant energy savings even in very arid desert conditions. Dynamic simulation software was discovered to be central to realistically simulating building performance and informing retrofit strategies. Confirmation of the implementation of Passivhaus standards in the Gulf region vindicates a promising direction for reducing cooling loads and improving indoor environmental quality across the region's residential sector.

Learning Objectives

• Review design strategies for enhanced building performance
• Develop a computer simulation and validate the model to measured data
• Simulate and analyse performance improvements using building performance strategies selected in the literature review

Neighbourhoods, growing up and mental health: Evidence from a longitudinal study

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Introduction: Mental health problems are highly prevalent in Ireland. To prevent them, childhood is an important time to intervene. The social conditions we grow up in may be an important target. However, as Ireland becomes more urbanised, our neighbourhood social conditions may be changing. This study investigated how urbanicity (the degree of urbanisation) and neighbourhood social conditions are longitudinally related to child mental health.

Methods: Data from a population-based longitudinal study of children were analysed. The urbanicity of where the child lived at age 5 was categorised as high or low. Caregiver-reports of neighbourhood disorder, safety, cohesion and the built environment were measured at age 5. Mental health problems were measured using the caregiver-completed Strengths and Difficulties Questionnaire total difficulties score (TDS) at ages 5 and 9. Regression analyses were conducted, controlling for socioeconomic factors and age 5 total difficulties score.

Results: Among 6483 children, living in a high urbanicity area was associated with a 0.0064 (95 per cent CI 0.0016-0.0169) increase in age 9 TDS. Neighbourhood disorder, safety, and cohesion explained 20.7 per cent, 22 per cent, and 9.8 per cent of this relationship, respectively. The built environment was found to have a small countervailing mediating effect on the association between urbanicity and TDS via neighbourhood disorder, safety and cohesion.

Conclusion: Urbanicity, neighbourhood social conditions and mental health problems were related among children in Ireland. Although the relationship was small, on a population level it is comparable with the effect sizes of existing public health interventions. The findings demonstrate the importance of a Health in All Policies approach to addressing population mental health by creating safe, cohesive urban places with built environments that support these conditions.

Learning Objectives

• Health in All Policies
• Urbanicity and mental health
• Social conditions

Child malnutrition in million-plus cities of India: A cluster-based geospatial approach to estimating urban health information

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Introduction: Health surveillance and monitoring in India have traditionally concentrated on state and district-level. In recent years, the growing focus on urbanisation and the availability of advanced geospatial tools have enabled a more granular analysis of health outcomes at the city level. While most urban health research in India has focused on slum populations or urban poor, this study adopts a citywide cluster-based geospatial approach, covering entire city boundaries to provide representative estimates of child malnutrition in India’s million-plus cities.

Data and methods: This study utilises data from the National Family Health Survey (NFHS-5), 2019–21, integrating raw survey data with geospatial cluster information. Million-plus cities were identified according to the Census of India (RGI) urban classification. To estimate child malnutrition prevalence (stunting, wasting, underweight), multilevel modelling techniques were employed to adjust for sampling variability and ensure robust city-level estimates.

Objective: To generate city-specific estimates of child malnutrition indicators in million-plus urban centres in India using a geospatial, cluster-based analytical framework.

Results: The analysis reveals significant intra-urban disparities in child malnutrition across million-plus cities. Sixteen cities exceeded the national urban average for stunting, with Varanasi reporting the highest prevalence (48.3 per cent) and Kollam the lowest. Cities such as Nashik, Gwalior, Raipur, Thrissur, and Greater Mumbai also demonstrated high stunting levels. Eighteen cities surpassed the national urban average for wasting, with Pune (55.2 per cent) and Jamshedpur (46.4 per cent) ranking the highest. Pune also recorded the highest rate of severe wasting (30.3 per cent), while Allahabad and Coimbatore reported the lowest. Furthermore, nineteen cities exceeded the national urban underweight prevalence, with Nashik (46.9 per cent) and Pune (43.1 per cent) leading. The variance partition co-efficient (VPC) indicated substantial variability at the city level, emphasising the urgent need for targeted urban nutrition interventions.

Conclusion: The findings underscore the heterogeneity of child malnutrition within urban India and highlight the necessity of city-specific, data-driven nutrition strategies.

Learning Objectives

• Understand the Limitations of Traditional Health Monitoring and the Need for City-Level Analysis
• Apply Geospatial and Multilevel Modeling Techniques to Urban Health Data
• Interpret Intra-Urban Disparities and Advocate for Data-Driven Interventions

Strengthening health and planning integration through co-design. A case study of a collaborative workshop held with the Essex Planning Officers’ Association

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The importance of planning decisions on population health and wellbeing has been recognised since the 19th century, when town and country planning emerged as a tool to improve health conditions and quality of life, particularly in urban areas. The seminal 2010 Marmot Review and 2020 update drew attention to the need to recognise planning as a system that can create conditions for people to be healthy and prevent illness. However, reducing health inequalities and creating conditions for health requires long-term strategic thinking and cross-sectoral collaboration within our planning system.

There is growing recognition that building strong interconnections across policy jurisdictions and sectors can help solve complex problems. Research demonstrates the need to facilitate environments that encourage cross-departmental working, modify existing practices, and enable collaborative capacity and confidence within councils.

OURI Labs, in partnership with Quality of Life Foundation, engaged with Essex County Council's strategic planning and public health lead to deliver a collaborative workshop for the Essex Planning Officers’ Association (EPOA), public health and NHS ICB estates across the County of Essex. The EPOA represents 12 local planning authorities in Essex, plus two unitary authorities. The workshop aimed to aid the development of a health and planning protocol, due for implementation in autumn 2025, by bringing stakeholders together to identify priorities for inclusion in the protocol.

The workshop used experience mapping and collaborative logic model development to map inputs, activities, outputs, and outcomes for strengthening collaboration between public health and planning departments across Essex.

Key findings included:
• to improve current health impact assessment (HIA) processes, including better sharing of information on HIA scope, type, and best practice;
• to increase understanding and learning on the strategic direction of S106 contributions in supporting health infrastructure, service needs and broader community benefits;
• building confidence in inter and cross-departmental working by establishing communication paths, engagement processes, and feedback loops; and
• developing evidence-based standards for healthy development through appropriate metrics and design interventions.

As national and local government face political pressures while improving health outcomes, building collaborative capacity within local authorities becomes increasingly important. This workshop demonstrated how external facilitation can help stakeholders understand current experiences and collectively discuss how to build collaborative capacity and accountability within Essex. The protocol development will embed systematic collaboration frameworks within planning processes, which will help towards building a culture of confidence within their planning and public health teams.

Learning Objectives

• The role of collaborative workshops in developing a cross-departmental and cross-organisational protocol for health and planning integration
• Benefits of logic model methodology for mapping complex stakeholder relationships and implementation pathways
• Importance of addressing capacity constraints and communication gaps between health, public health and planning collaboration

Urban Health Index: Unlocking local insights to tackle health inequalities

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Background: The Urban Health Index (UHI) is a locally tailored social progress index, developed by Impact on Urban Health to better understand and address the deep-rooted health inequalities affecting communities in Lambeth and Southwark — two of London’s most diverse and densely populated boroughs. The UHI brings together a wide range of social and environmental indicators across the domains of basic needs, wellbeing and opportunity, revealing how these social determinants influence health outcomes across neighbourhoods.

Purpose and methods: To better equip partners and communities with actionable insight, we undertook a major refresh of the UHI in 2025 to improve its utility, accessibility and strategic relevance. This included updating all indicators with the most recent data and, for the first time, integrating council-held datasets. For example, revised indicators on overcrowding, housing benefits and homelessness were introduced to help deepen understanding of how housing conditions relate to health inequalities.

Alongside the data refresh, we are significantly enhancing the functionality of the UHI. A new suite of interactive dashboards is being developed to make the Index more intuitive, visually engaging and accessible to a broader audience, including funders, policymakers, and community organisations. These dashboards aim to support users who want to explore and act on health inequalities in their area.

Finally, to further support the insights available from the UHI, we are partnering with Impera Analytics to undertake a more detailed analytical piece of work. This includes advanced statistical methods to explore how health and social outcomes vary by neighbourhood type, with a focus on housing and its relationship to other indicators, such as deprivation (IMD).

Results: The refreshed UHI highlights areas of compounded inequality and offers clearer insight into how topics such as housing intersect with health. The redesigned dashboard improves access to this evidence, equipping users to apply it to policy design, neighbourhood planning, resource targeting, and community-led advocacy. Findings will be presented at the conference in an engaging and interactive format, with practical reflections on how attendees might adapt this approach in their own cities.

Conclusions and implications: The UHI shows how place-based, equity-focused data tools can support transitions to healthier cities by shifting investment and planning towards prevention, community wellbeing and long-term impact. While rooted in Lambeth and Southwark, this model is adaptable for any city seeking to embed health equity in local governance, strategy and design.

Learning Objectives

• Understand how localised, place-based data can support equitable planning, investment and service delivery
• Explore the connection between housing quality, neighbourhood conditions, and health inequality
• Learn how to design public data tools that translate evidence into action across systems and communities

Envisioning the 15-minute city in the Indian context: A localised approach to promote active mobility and urban wellbeing

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The concept of the ‘15-minute city’ is popularising globally, including in India. This notion advocates access to essential amenities within a 15-minute walk or cycling radius from home. It could facilitate reducing the need for motorised transport and promote active mobility while contributing to a healthy lifestyle and improved overall wellbeing.

However, this idea is not completely new to the Indian context. Many Indian cities, especially Tier 2 and Tier 3, already function as ‘X-minute cities’, with local neighbourhoods often meeting daily needs. Unlike Western cities that follow a centralised model of urban planning (city centre oriented), Indian cities typically grow in a decentralised manner, making them well-suited to localised planning. The current priority must therefore be to retain and strengthen this existing ecosystem in the right direction rather than allowing unplanned urbanisation to erode it.

This paper briefly looks at the existing non-motorised transport policies in India and argues for a more context-sensitive reinterpretation at a neighbourhood level, which emphasises making active mobility more than mere exercise in peoples’ everyday lives. Drawing from recent global case studies, such as Shanghai’s 15-minute community living circle and planning toolkits, several factors that influence walking and cycling have been understood. On one hand are aspects such as the use of public art and creative placemaking to encourage urban pedestrianism, and on the other are challenges such as thermal discomfort, poor pedestrian quality, and safety concerns that discourage active mobility users.

Overall, a clear, locally rooted framework is essential to embed active travel into urban residents’ daily routines for a more sustainable environment and healthy living. Achieving this shift requires behavioural and mindset changes, supported by the right policy frameworks and strong community participation. This paper aims to contribute actionable insights for policymakers and planners by providing some hyper-local recommendations to improve active mobility aspects in neighbourhoods. And it further addresses how these neighbourhoods may become stepping stones to achieving 15-minute cities across the Indian context.

Learning Objectives

• Identifying areas for improvement in the existing Non-Motorised Transport Policies of India in terms of actionable strategies towards creating self-sustainable neighborhoods
• Understanding trends across Indian neighborhoods and providing design/ policy recommendations that promote active mobility
• Exploring avenues for community participation to tailor these recommendations to their neighborhoods' specific needs

Masterplanning for a “College for the City”: The George Brown College Approach for Sustainable Urban Growth

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This paper explores the George Brown College (GBC) Campus Masterplan in Toronto, addressing urbanization challenges like rising demand for amenities, connectivity, and sustainable growth. It serves as a model for regionally relevant and globally scalable urban masterplanning.

The GBC Masterplan presents a forward-thinking physical growth strategy for its downtown Toronto campuses, focusing on creating complete campus neighbourhoods. Faced with the challenge of a limited urban footprint, GBC's physical growth strategy aims to enhance access to diverse resources, such as student housing, while fostering a cohesive campus identity that unites GBC's distributed presence, ultimately empowering its student body and the wider community.

Future physical growth at GBC focuses on creating campus neighbourhoods designed for walkability, with essential services located within a 15-minute walking radius. This approach enables the institution to concentrate on academic resources while fostering integration with the city. By inviting the public into campus areas and ensuring amenities are within a 5-minute walk of college hubs, the plan aims to develop accessible and complete neighbourhoods that reflect the self-sufficiency of Toronto’s vibrant urban districts.

The plan, still in its early stages, focuses on a flexible development framework that incorporates diverse perspectives and approaches. It seeks to enhance GBC's identity as a "College for the City" by leveraging its urban location, fostering community engagement, and promoting ecological regeneration. Key priorities include creating safe, pedestrian-friendly areas and integrating nature within GBC's urban landscape. To manage growth in a space-constrained environment, the plan proposes sharing resources and amenities with the city, benefiting both students and the wider community.

The GBC Campus Masterplan has significant implications for urban development and serves as a model for global urban planning. Its "Living Story" methodology emphasizes the importance of historical, ecological, and Indigenous contexts that ground “place with land”. It offers a framework that builds resiliency in GBC's built environment, prioritizing student and community interdependence, health and wellness, walkability, and mobility options. The plan embraces Equity, Diversity, Inclusion, and Belonging (EDIB) to create inclusive, culturally sensitive environments that foster belonging. It was shaped through engagement with students, faculty, the community, Indigenous Peoples, and experts.

The GBC masterplan presents a growth strategy that is resilient, culturally rich, and contextually relevant by embracing the unique characteristics of their city and fostering mutually beneficial relationships with the surrounding community. The plan offers valuable insights that can be applied to broader urban masterplanning strategies.

Learning Objectives

• Understand the principles of "healthier city design" as applied to an urban campus context, including the importance of walkability, access to resources, and the creation of localized, interconnected communities.
• Identify the core principles and methodologies of the GBC Masterplan, including the creation of complete campus neighbourhoods, shared city resources, and the Living Story methodology for a contextual and resilient urban growth strategy.
• Analyze the broader implications of the George Brown College Campus Masterplan as a model for urban development and global urban planning, particularly its emphasis on community engagement, ecological regeneration, and integration of EDIB principles.

Opinions matter: A county-wide study to inform effective zero-waste strategies in Minnesota, USA

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The average US resident disposes of more than 1800 pounds of solid waste per year, including trash and recyclables. Most of this waste makes its way to landfills, and some is incinerated to reduce volume. Both approaches have detrimental environmental effects with potential health implications for communities. While effective and sustainable solid waste management is critical for population health, it is often not top of mind for residents of communities most affected. And major policy and practice changes to reduce solid waste require broad public knowledge, support, and participation.

Every six years, Hennepin County, Minnesota’s most-populated county, completes a solid waste management plan to address how it will support the state-mandated goal of 75 per cent recycling by 2030 for the Twin Cities metro area. For the recent plan update, the county integrated its climate action plan, which envisions a zero-waste future. The county’s climate-action and zero-waste goals require transformation of the county’s solid waste system to a circular economy that values raw materials and prioritises reuse.

Knowing that public participation and resident advocacy are essential to achieve these goals, the county undertook a community-wide representative study to understand residents’ waste disposal and recycling knowledge, attitudes, and behaviours; and assessed opinions on recycling and organics recycling programmes and support for needed policy actions. The presentation will comprise key findings, including:
• level of support for a range of specific policy actions;
• differences in organics recycling participation across county areas, despite no differences in awareness of these programmes;
• attitudes about and perceived ease of participating in organics recycling programmes, and use of on-site composting as the primary way to dispose of food waste; and
• usage of recycling drop-off centres and battery recycling, and differences based on household income.

Based on findings from this study, the updated plan includes a range of strategies specifically targeted to increase recycling and organics recycling participation across resident groups, and to build policy support. In addition to informing the updated plan, the knowledge and behavioural measures from the study will serve as benchmarks for future surveys to assess progress on Hennepin County’s ambitious goals towards zero waste, reducing carbon emissions by 45 per cent of 2010 levels by 2030, and achieving the 2050 goal of net-zero carbon emissions.

Learning Objectives

• 1. Learn why effective and sustainable solid waste management is a critical task to achieve healthy communities
• 2. Articulate what it means for a population study to be demographically representative, statistically valid, or both; and how this is important in developing effective strategies for behavioral change
• 3. Engage in findings of a community-wide waste disposal survey, and how these findings directly translated to strategies and programs anticipated to change community participation in zero-waste efforts

Make My City Thrive – an impact assessment framework for measuring the wellbeing benefits of urban greening

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The role of green infrastructure in towns and cities is growing rapidly, with benefits ranging from climate mitigation, flood prevention, air quality and noise reduction, to improving biodiversity, economic value, human health and wellbeing. Charities, non-governmental organisations, landscape architects and developers are increasingly implementing these initiatives and typically monitor impacts in terms of objective measures, such as environmental quality, number of people engaged, and money spent.

But what do we understand about the effect of in-situ urban green interventions on more subjective outcomes, such as psychological wellbeing? How could these subjective aspects of social and environmental impact be monitored, evaluated and optimised, helping to build a wealth of evidence on the in-situ benefits of designs?

Make My City Thrive is a mixed-mode impact assessment framework designed to capture and communicate the effectiveness of urban landscape designs and how they affect our access to nature, environmental quality and wellbeing. It comprises seven themes: landscape; habitat; environmental quality; access to nature; use and behaviour; inclusivity; and health and wellbeing, each with sub-metrics and methodologies that use secondary data and GIS analysis, observational and environmental surveys, and primary psychological surveys and innovative micro-journaling methods.

The framework is being developed by Tranquil City, in partnership with the University of Surrey’s Environmental Psychology Research Group, and is built to provide a consistent yet flexible approach to impact assessment that considers equity and engagement of the community, and enables its use by both resource-limited community garden groups and large-scale housing developers.

In this talk, the framework will be outlined, showcasing examples of the tools, methods and outputs developed with several non-academic partners within urban case studies. Reflections will cover how developing the framework in a live environment, in two locations in Inner and Central London, has allowed the team to gain insight into what is needed to effectively engage, involve and communicate with stakeholders and the local community in order to showcase the wellbeing impact of their interventions to funders.

Learning Objectives

• Practitioner assessment of the impacts of urban green infrastructure interventions on subjective wellbeing
• Mixed-mode data gathering and analysis methods to support inclusive, holistic assessment approaches
• To enable in-situ assessment of urban greening interventions to support design and planning

The impact of neighborhood green spaces on alleviating urban loneliness

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This study suggests that urban environments should be designed to be inclusive and welcoming for all age groups. This includes creating spaces that encourage social interactions and community participation among the elderly, thereby enhancing their quality of life.

Mental health can be improved through social factors as well as urban layouts and designs. Based on the analyses and findings aligned with the main objective of this research, the following recommendations are proposed:

• Strengthening neighbourhood cohesion and creating inclusive spaces that not only meet the needs of the age group examined in this study but also respond to the needs of future generations through sustainable designs. Ultimately, this can contribute to reducing mental disorders as a precursor to social crimes, corruption, addiction, and other influential issues.

• Planning should aim to increase dynamic environments with flexibility and permeability in psychological dimensions, and provide the necessary per capita green space. Additionally, it is important to note that planning to increase green spaces not only has positive psychological effects but also helps reduce noise, visual, and ecological pollution.

Learning Objectives

• Strategic planning for psychologically responsive urban environmentsprioritizing flexibility, permeability, and mandated green space allocation per capita alongside initiatives to reinforce neighborhood cohesion through universally accessible spaces,
• , ultimately advancing quality of life via sustainable development frameworks
• Increase dynamic environment

Spatial accessibility of multi-campus hospitals: A case study of Tianjin, China

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China adopts a hierarchical medical system, which classifies hospitals into primary, secondary, and tertiary tiers. Tertiary Grade A hospitals, representing the highest tier of medical facilities, account for less than 10 per cent of all hospitals. With the growing demand for high-quality medical resources, developing the new campuses of the tertiary Grade A hospitals are perceived as an effective way to increase and balance medical resources. This study aims to explore the spatial accessibility of multi-campus hospitals and to test whether it serves the above purpose.

We chose Tianjin, which is one of the four municipal cities in China and possesses relatively abundant medical resources, as the case study. There are 11 multi-campus hospitals, including 27 campuses in total. Utilising multi-source datasets (road network data from OpenStreetMap and geolocation data from Guihuayun) combined with the dataset "National-scale 1-km maps of hospital travel time and hospital accessibility in China", the spatial accessibility variables of each campus were calculated using ArcGIS.

The results illustrated that:
1. The new campuses were mainly located in the central areas before 2020, then moved to the outskirts before returning to the centre in 2023. Five were located in areas with the inadequate medical resources, five in relatively adequate areas, and six in adequate areas among the 16 new campuses.
2. Distances between the new and original campuses for each hospital were classified as three types: long distance (>25 km), medium (10-25 km), and short (<10 km). Five hospitals are of the long distance type, with significant differences in the accessibility between the campuses. Their branch campuses may supplement medical resources. Two hospitals are of the medium distance type, with relatively sufficient accessibility. It's assumed that the two campuses can complement each other to meet residents' medical needs. Four hospitals are of the short type, with sufficient accessibility. Their service areas overlap within a 30-minute travel time, which may lead to an over-concentration of medical resources.

This study analysed the spatial accessibility differences among multi-campus hospitals and classified the development models preliminarily. In the future, it will combine with the surrounding population need and hospital scale, type, and operational status to provide empirical experience for guiding the multi-campus hospital construction.

Learning Objectives

• Know China's tertiary medical system and multi-campus hospital construction
• Establish the correlation between the spatial distribution and accessibility of multi-campus hospitals
• Learn about the different development models of multi-campus hospitals

From SimCity Hospital to real-world care: Reimagining simulation for inclusive healthcare environments using Utility AI

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This paper argues that AI-driven healthcare simulation must evolve to reflect a broader spectrum of human diversity in order to remain both clinically rigorous and socially responsive. Drawing inspiration from game design methodologies, particularly the behavioural logic systems used in the game The Sims, it proposes the development of AI personas with a range of physical, sensory, cognitive, and emotional needs that can be integrated into spatial simulations to capture the nuanced ways people interact with healthcare environments. The central hypothesis is that AI simulations have the capacity to account for disability and behavioural variability, and that doing so can produce more accurate insights, enhancing both infection control strategies and the quality of care experiences.

This position builds on and challenges the current trajectory of simulation in healthcare, such as Autodesk’s Covid-19 research, which used agent-based modelling to visualise people-pathogen interactions. While these tools have demonstrated value in reducing transmission and optimising layout, they typically rely on assumptions of normative behaviour and ability. Such assumptions exclude the lived experiences of millions, overlooking how access needs alter movement and interaction, both of which are directly relevant to infection dynamics.

In this theoretical framework, Utility AI, adapted from video game environments, is introduced to generate decision-making agents with context-sensitive motivations. For example, a wheelchair user may prioritise direct routes to avoid exhaustion, which in turn could delay or limit access to hygiene facilities, while a neurodivergent person might avoid overstimulating areas potentially bypassing check-in points, or sanitation stations. These altered behavioural patterns are not only clinically relevant to infection transmission pathways but also reveal where design choices may unintentionally exclude or endanger certain users. By capturing such variations, the simulations can expose overlooked spatial, procedural, and perceptual barriers with real implications for public health and equitable care.

This reframing has two key contributions: first, it advances simulation as not only a technical tool but a reflective one, capable of surfacing equity gaps and rebalancing design priorities. Second, it affirms that inclusive modelling is not merely an ethical add-on but essential for clinically accurate healthcare planning.

To exclude disability and behavioural diversity from simulation under the guise of complexity or neutrality is itself a design flaw. This paper advocates for interdisciplinary collaboration among architects, AI developers, clinicians, and disabled communities to ensure that simulation technologies lead to environments that are not only safe and inclusive but also accurate and reflective of real-world diversity.

Learning Objectives

• Understand the limitations of current AI-driven healthcare simulations in representing diverse user behaviours, particularly those related to disability and neurodiversity.
• Explore the application of game design methodologies, such as Utility AI from The Sims, to develop context-sensitive personas that enhance spatial and behavioural modelling in healthcare environments.
• Evaluate how inclusive simulation practices can improve clinical accuracy, infection control, and equity in healthcare design by identifying overlooked spatial and procedural barriers.

Urban parks as mental health sanctuaries: Insights from a mixed-methods study in Islamabad

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As urbanisation intensifies across the Global South, equitable access to green spaces is becoming increasingly critical for promoting mental health and psychological resilience. Yet despite growing global recognition of the restorative benefits of urban nature, empirical research on this relationship remains limited in South Asian cities, particularly in low- and middle-income contexts where urban density, socioeconomic disparities, and infrastructural neglect often exacerbate mental distress. This study addresses that research gap by exploring the association between urban park usage and mental wellbeing in Islamabad, Pakistan, a rapidly urbanising capital that has comparatively abundant public green spaces.

A cross-sectional mixed-methods design was employed. A total of 354 residents completed a bilingual (English/Urdu) questionnaire, distributed both online and in-person through convenience and snowball sampling. Psychological distress and positive mental wellbeing were assessed using two validated tools: the 5-item General Health Questionnaire (GHQ-5) and the 7-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS-7). Descriptive statistics and regression models were used to analyse associations between mental health outcomes and predictors, including age, gender, park visitation frequency, and perceived accessibility. Thematic analysis of open-ended responses captured residents’ lived experiences, motivations, and perceived barriers to park use.

Findings revealed that older adults, frequent park users, and individuals reporting greater perceived accessibility showed significantly higher wellbeing and lower psychological distress (p < 0.01). Thematic analysis highlighted four key benefits of park engagement: emotional restoration (e.g., relief from stress and anxiety); physical activity; social connection; and creative reflection. However, access to these benefits was not equitably distributed. Women and residents from underserved communities reported disproportionately greater barriers, including safety concerns, poor infrastructure, time constraints, and a lack of gender-sensitive design features.

These findings highlight the essential role of inclusive urban green spaces in promoting mental health in rapidly growing cities. For parks to fulfil their health-promoting potential, urban design must address barriers to access through improved safety, infrastructure, and outreach, particularly for women and low-income groups. By embedding mental health considerations into public space planning, cities can foster greater social cohesion, resilience, and health equity, offering replicable strategies for the urbanising Global South.

Learning Objectives

• 1. To examine the relationship between urban park usage and mental well-being among residents of Islamabad using validated psychological assessment tools.
• 2. To identify key demographic and environmental predictors, such as age, gender, frequency of visitation, and perceived accessibility that influence psychological distress and positive mental health outcomes in park users.
• 3. To explore residents’ lived experiences, motivations, and barriers related to urban park access and use, with a focus on how issues such as safety, infrastructure, and gender-sensitive design impact equitable mental health benefits.

Cities that heal: A role-playing workshop on regenerative urban futures

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Regenerative design represents a critical shift in urban development – moving beyond sustainability towards the creation of built environments that actively restore ecological systems and promote human wellbeing. This workshop introduces participants to regenerative design as a data-driven, interdisciplinary practice that integrates public health, biodiversity, climate resilience, and urban planning to reimagine the way cities are shaped and experienced.

Grounded in epidemiological data and climate modelling, regenerative design triangulates environmental, demographic, and health metrics to inform context-sensitive interventions. This approach addresses the root causes of urban ill health, such as exposure to pollutants, lack of access to nature, and social fragmentation, while regenerating natural systems within the urban fabric. It incorporates insights from biomimicry, biophilic design, circular economies, and environmental microbiome research to shape spaces that foster physical, mental, and social resilience.

This workshop will introduce participants to these concepts through a collaborative role-playing simulation based on a speculative urban scenario. Drawing on formats tested at Arup and similar participatory design events, attendees will be assigned diverse stakeholder roles, such as a six-year-old school child, a local activist, a mayor, a planning officer, and a parent of three. They will be asked to respond to a proposed urban regeneration scheme. Each table will work as a multi-perspective planning team to co-develop a regenerative design strategy that balances ecological restoration, social equity, and public health goals.

The case study will focus on an area facing increasing climate pressures – such as wildfire risk, heat islands, and biodiversity loss – while also experiencing demographic shifts and rising non-communicable diseases. Participants will be challenged to move beyond single-discipline solutions and engage in collaborative, systems-oriented thinking.

This workshop aims to:

• introduce the principles and practices of regenerative design;
• demonstrate the integration of health and climate data into urban decision-making;
• foster empathy and interdisciplinary collaboration through role-play; and
• explore how co-created urban strategies can strengthen wellbeing, biodiversity and resilience.

Aligned with the conference theme, this session offers a hands-on approach to designing compact, vibrant, and health-centred cities. It invites participants to think ecologically, act collectively, and imagine new possibilities for a regenerative urban future.

Learning Objectives

• • Understand key principles of regenerative design
• • Apply epidemiological and environmental data to urban design scenarios
• • Experience participatory design through role-play methodology

Reviving urbanity: Assessing public spaces in Peshawar for sustainable urban development and inclusivity

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Public areas are essential to the economic, social and cultural life of cities, impacting city identity and daily life. This research examines the connection between public areas and sustainable urban development in Peshawar, Pakistan, from the perspective of ‘urbanity’ – a notion that involves socio-cultural vibrancy and spatial quality. Although historically known as the "City of Gardens," Peshawar currently faces declining public spaces and unorganised commercial expansion.

Employing a mixed-methods framework involving expert interviews (n=33) and public questionnaires (n=260) at the four priority sites of Tehsil Park, Gor Khatri, Chowk Yadgaar, and Bazaar Kalaan, the research assesses inclusivity, accessibility and spatial quality. The major findings show lack of gender-inclusive facilities and pedestrian environments, visual dissonance, and eroded public security. Statistical analysis presents a strong negative correlation between land use and walkability, which reflects planning imbalances.

The research findings indicate that urban rejuvenation through inclusive planning, preservation of heritage, and improving pedestrian infrastructure is the key to sustainable urban development. Targeted interventions can assist Peshawar in reclaiming its identity and reclaiming its public spaces as inclusive, active and sustainable urban spaces.

Learning Objectives

• Urbanity
• inclusivity
• placemaking

Therapeutic hospital gardens – guidelines to transition to healthy spaces

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This paper introduces the Therapeutic Hospital Garden Guidelines (THGG) for healthcare professionals to integrate purposefully designed therapeutic gardens into hospital environments. The THGG are based on Guidelines for each of the three sectors fundamental to making therapeutic hospital gardens (THG) a reality: healthcare designers, healthcare decision-makers, and clinical practitioners.

These THGG are the ultimate guide for all healthcare professionals globally. They inform architects, landscape architects, and health planners (the healthcare designers), hospital CEOs, government executives and consultants, (the healthcare decision-makers), and healthcare delivery, medical and hospital environment practitioners (the clinical practitioners) to each design, plan and budget for, and then establish THG.

These guidelines direct architects, landscape architects and health planners in learning about operational and clinical requirements, and thereby design gardens that offer respite and therapy for the needs of hospital users, including patients, their families, visitors and staff. The guidelines for healthcare decision-makers guide hospital CEOs, government executives and consultants on how to make informed decisions about the benefits and value of THG, based on the health and financial value of planning for and including gardens in hospitals that are therapeutic. And for clinical practitioners, they can guide healthcare delivery, medical and hospital environment practitioners who want to include THG in their treatment of patients, to adequately plan and design garden spaces that have spatial and environmental qualities for relaxation and cognitive, occupational and behavioural therapy.

When these three sectors – healthcare design, healthcare decision-making and clinical health – each contribute their expertise and work together, then THG can be designed for, planned and budgeted for, and then established successfully in every hospital. Embedding THG into healthcare supports holistic patient care, staff and visitor wellbeing, and positions THG as a mechanism for transitioning to healthier hospitals.

Learning Objectives

• Conference participants will be introduced to the Therapeutic Hospital Garden Guidelines (THGG) and the recently established therapeutic hospital garden definition.
• Conference participants will be provided with key resources, including sources including best practice examples and references to deepen their understanding of therapeutic hospital gardens (THG).
• Conference participants will be able to able to appreciate the parallels between THG as vital health infrastructure for hospitals and green spaces for cities to shape the urban realm to enable healthier lives and choices.

Design for wellbeing: How we design for and measure wellbeing in the built environment

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This global research report, completed in 2024, explores the role of design for wellbeing; in particular, how we measure wellbeing in housing. The research tour included project visits and interviews across ten cities in New Zealand, America, Canada, the UK and Austria, along with a detailed literature review to provide a comprehensive look at how we can consider the science of wellbeing with measurable impact.

Disconnection, loneliness and poor mental health outcomes are recognised government priorities across the world. Housing is a critical foundation for quality of life that influences many social determinants for mental health, including the availability of jobs; health and education services; and access to clean air, green space and recreational facilities. How we live can also improve mental health outcomes through communities, and neighbourhoods connect people, support civic pride, and build social resilience. While the built form alone is not the only answer, design choices made early in major housing projects can substantially strengthen protective factors, prevent mental ill health, help with recovery, and build sustainable neighbourhoods.

Wellbeing is a complex construct, experienced differently by every person and community. This research aims to provide a practical overview of wellbeing science, best practice case studies, and outline the design processes that can be applied in any project or community. It includes not only theoretical wellbeing frameworks but also real world built and research projects at the scale of the building, place or community.

It has been written to help developers, planners, councils, architects, researchers or members of the public consider the science of wellbeing and avoid ‘wellbeing washing’. With strong focus on wellbeing measures and policy, we hope to inspire government to apply a research-led and data-informed process to the delivery of social and affordable housing. More broadly, we hope it inspires everyone involved in the built environment to consider their role in improving community wellbeing.

This research was sponsored by the Byera Hadley Travelling Scholarship, awarded by the NSW Architects Registration Board and Perpetual in 2023.

Learning Objectives

• To understand the correlation between housing and mental health outcomes.
• To learn practical ways to design housing and our communities to support wellbeing based on international case studies..
• To understand global examples of how we can measure wellbeing in the built environment.

Innovation levers and barriers: Healthcare innovation needs a different approach to overcome challenges

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Healthcare is the most critical sector in need of digital transformation – not just for efficiency but because lives depend on it. The warning signs of system strain are increasingly visible: academic reports, rising absenteeism, workforce strikes, and even preventable deaths. Yet, despite the urgency, healthcare remains among the least digitally mature sectors.

Unlike other industries, traditional levers that drive digital transformation – competition, margin pressure, consumer demand – are often neutral or act as barriers within public healthcare systems. This is particularly true for administrative innovation, which is too often overlooked with mounting demand for reactive daily changes and acute, treatment-focused advancements. The result is a growing gap between demand and capacity, especially on the frontline.

Publicly funded healthcare systems operate with finite capital and rising expectations. To succeed, innovation must directly address root-cause problems and enable incremental resource generation – creating a self-fuelling cycle of improved capacity and value. A value-based care approach, when coupled with a focus on administrative transformation, offers a path forward: not just for cost reduction but for regenerating time, energy and trust across healthcare systems.

Learning Objectives

• What are the root causes of systemic strain in healthcare systems?
• What are the levers and barriers to administrative innovation in healthcare?
• What are the new sustainable models for healthcare innovation?

Developing a social appraisal model for community land trusts on NHS surplus land: A participatory workshop

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Background: Poor housing costs the NHS £1.4bn annually, yet there is limited understanding of how alternative housing models like community land trusts (CLTs) could reduce these costs while addressing health inequalities. Current land release mechanisms lack frameworks for evaluating the social value of community-led housing developments. Our research programme aims to co-design a social appraisal model to guide the release of NHS surplus land for CLT projects, demonstrating how community-led housing development can create pathways to improved health outcomes and long-term community wealth building.

Purpose: We propose a participatory workshop to test initial assumptions detected in our research. This will focus on identifying barriers to unlocking surplus NHS land, and exploring what components need to be included within a social appraisal model to strengthen opportunities and processes for land release.

Methods: A guided mapping exercise to identify barriers to releasing land and opportunities for community-led development. Using Social Life’s social sustainability framework as an underpinning framework to the workshop, we will facilitate a discussion to develop a social appraisal model that can help identify and unlock land. The workshop welcomes engagement from NHS stakeholders, health innovation agencies, other public health stakeholders (local authorities), housing organisations, and community representatives.

Results: Participants will develop a framework for evaluating the health and social benefits of CLH/CLT developments, exploring applicability across different community contexts in England.

Conclusions and implications: The evidence generated will be used as guidance for our wider research and be developed into building a business case for community-led housing development that addresses housing affordability and health inequalities simultaneously.

Learning Objectives

• 1. Understand the connection between housing insecurity and health outcomes for community-led development (focused on Community Land Trusts).
• 2. To collaboratively develop a social appraisal framework that captures both tangible (community infrastructure) and intangible (belonging, social integration) factors for releasing NHS surplus land
• 3. Map pathways for cross-sector collaboration for this form of development.

Co-creating urban food futures through grassroot community engagement

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'Think it – Make it – Grow it' is a research project that aims to bring community members together to co-create low-tech, low-cost, and accessible urban food projects. The underlying research explores whether community involvement at the very early stages can lead to the improved legacy of urban growing projects, by enabling stakeholders to share ideas and design together through fun and playful workshops. The goal of the project is to bring people together to grow food in a structure that they designed and helped create.

In 2024, a series of co-creation sessions were held in Oldham, Clayton, and Blackburn. Using a design sprint methodology, each community was invited to join two co-creation sessions. During these sessions, community members were brought together to explore ideas about urban food production and share their thoughts on how this concept could be integrated into their communities. This involved design tasks interspersed with talks from invited experts. The process was enriched through open discussions and voting to ensure that everyone’s ideas were reflected in the final designs. Later, the final outcomes were fabricated and installed on-site.

The projects are still in their infancy but activities are already starting to take place in these communities. As part of an ongoing partnership, the University of Salford will continue to support these projects for as long as they need, to help ensure their legacy and to use these projects as a catalyst to develop new community food projects across the North West of England.

Learning Objectives

• Everyone is a designer (they just need the opportunity to discover it)
• Co-creation helps to embed ownership and legacy
• We become better designers by inviting others to participate

Compassionate places, human-centric design and neuroarchitecture: Case studies in practice

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There is increasing recognition of the built environment’s profound impact on people’s lives, health, happiness, and the way we come together as communities and society. However, the business-as-usual practice of architecture, urban design, planning and development does not typically integrate knowledge and research from many other disciplines that address how people are affected by places. Neuroarchitecture is an interdisciplinary research field that brings together neuroscience, environmental psychology and architecture to focus on how individuals interact with built environments.

This talk will share the long-term development and implementation of a transdisciplinary design approach; the Compassionate Places Method. This focuses on practically bringing science-informed, human-oriented design into industry. The presentation will share case studies of the development and application of neuroarchitecture design methods, such as biophilic design, in practice on a range of live projects in combination with socially conscious, inclusive and arts-based approaches to consider a wide register of human impacts holistically.

The presentation will reflect on the introduction of a new specialist design discipline in the context of a large-scale, mixed-use development project, working alongside a typical multidisciplinary design team. Through a structured method for the systematic consideration of human benefits and end user wellbeing in the design process, this case study project in progress offers insights into introducing human-centric design and neuroarchitecture as a standard part of the design and development process. This project involves working in close collaboration with a neuroscience researcher at University College London (UCL), who is a co-director of the Centre for NeuroArchitecture and NeuroDesign. By considering design as a tool through which to achieve tangible change, there is a significant potential to better support people’s health, wellbeing, and flourishing by putting these drivers at the heart of how the built environment is shaped in practice.

Learning Objectives

• 1. Learnings and insights from change-making in practice
• 2. Multidimensional and transdisciplinary approaches
• 3. Barriers and opportunities towards wider industry change

Bumping places: How to help a city thrive through facilitating connection

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We are facing a loneliness epidemic in our cities, and we must put forward accessible, intuitive, and actionable solutions.

Over the past three years, I have utilised photovoice, interviews, focus groups, and participatory geographic information systems to learn where and why people feel most and least connected in cities. Access and accessibility are recurring themes of my research. We can see social connection is felt more strongly in contexts where people can access others, regardless of how superficial or fleeting an encounter can be. We must recognise access as a fundamental enabler of social connection. An actionable point for this could be strengthening access points through community groups, public spaces, education sessions, and local initiatives. Further, addressing barriers to participation, particularly for marginalised and vulnerable populations, would enable facilitation of connection both within and across various demographics, fostering a sense of belonging, community and integration.

A solution that my research proposes is the idea of ‘bumping places’ – places that facilitate impromptu, convivial and natural interactions, which help mitigate experiences of loneliness and poor outcomes associated with this.

Learning Objectives

From microbiome to mental health: Integrating ecourbanism, salutogenic design, and ecosystem services for resilient cities

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Cities drive economic growth, conferring many advantages on citizens, but the significant adverse effects to human and environmental health should be considered together. Long-term illness blights lives, affects human productivity, and raises healthcare service costs. Salutogenic design can cut healthcare costs and improve resilience of ecosystem services in cities. Requirements to improve biodiversity should be linked to these issues. A requirement for environmental net gain would be an enabler for development and long-term economic growth.

Non-communicable diseases (NCDs), the prime cause of death and disability, fall into five main categories: cardiovascular diseases; diabetes; chronic respiratory diseases; cancers; and mental health conditions. Recent research shows mental disorders co-exist and share risk factors with other NCDs. By 2019, around 12 per cent of the global population suffered from mental disorders, but there has been a significant deterioration since Covid-19. The greatest burden is Major Depressive Disorder (MDD), affecting quality of life, cognition, employment status, and productivity.

Humanity co-evolved with microbes into metaorganisims, comprising host cells and an ecosystem of microbial organisms. The diversity of the human microbiome, in and on the body, is reduced by urban living. Lower microbiome diversity is associated with obesity, inflammatory bowel diseases and metabolic disorders, and depression and physical inflammation are linked. Ecourbanism embraces whole systems thinking instead of addressing issues in separate silos, to seek common ground between issues while limiting tradeoffs, and the environment/health nexus is a useful point on which to capitalise.

Planning a foundation for better mental health includes: 1) pro-social design, since the loneliness epidemic is a precursor of some mental health issues; 2) pro-nature regenerative living systems design to improve green/blue/grey infrastructure and urban biome, such as urban heating, flood mitigation, biodiversity gain, carbon emissions reduction, and health creation. A variety of measures may include rain gardens; building integrated vegetation (roofs/walls); water; a variety of vegetation in streets and small local spaces; and connections to larger conserved or re-wilded public spaces.

The global economic burden for all mental health conditions is estimated to be US$6 trillion by 2030. Sustainable Development Goal SDG3 Health & Wellbeing is central to delivering the other 16 SDGs by 2030, and improving mental health and wellbeing is seen as key to reducing the global burden of NCDs. This paper explores how salutogenic urban design can be integrated with broader ecosystem service improvements through ecourbanism, offering a roadmap for healthier, more resilient cities.

Learning Objectives

• Understand the interconnected impact of urban design, biodiversity, and mental and physical health, particularly in relation to non-communicable diseases (NCDs) and microbiome diversity.
• valuate the principles of Salutogenic design and Ecourbanism as integrated strategies to enhance ecosystem services, reduce healthcare costs, and improve urban resilience and well-being.
• Analyze how urban planning interventions, such as green/blue infrastructure and pro-social, regenerative design, can support Sustainable Development Goal 3 (Health & Wellbeing) and contribute to long-term economic and environmental sustainability.

Homestead Hafod Farm: A therapeutic model for community-based supported housing for those with a diagnosis of psychosis

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Homestead is a new model for holistic, therapeutic supported housing for people with a diagnosis of psychosis. Developed by architects and clinicians – including Heather Macey and Tim Makower of Makower Architects and clinical psychologist Dr Andrew Howe of the Maudsley NHS Foundation Trust – the project is shaped by both professional expertise and lived experience of mental healthcare environments.

Founded as a community interest company (CIC), Homestead reimagines supported housing through three core pillars: creative engagement; working with nature; and community participation. These elements are embedded in both the physical design and daily rhythms of Homestead life, offering a dignified alternative to traditional institutional care.

Our first pilot, Homestead Hafod Farm in North Wales, transforms a three-hectare rural site into an integrated community combining supported accommodation, therapy gardens, shared kitchens, art spaces, and social enterprise. Up to 15 residents and 25 live-in staff, makers, and guests live and work together – forming a community rather than a treatment facility.

Homestead is grounded in the belief that community-based care offers more sustainable and empowering outcomes than long-term inpatient treatment. The project challenges the prevailing model by prioritising autonomy, daily routine, social connection, and therapeutic choice.

Creative arts therapies and nature-based interventions are central – not as add-ons but as essential to health and recovery. Residents engage in local craft and cultural practices, horticulture, animal care, and creative expression tailored to local identity and needs. These interventions support emotional wellbeing, social functioning, and independence – all critical for reducing emergency interventions and hospitalisation. Homestead also places strong emphasis on community integration. Through partnerships with local makers, artists, and organisations, each site is shaped by its setting. Residents are not only supported but are included, visible, and active participants in local life.

This model seeks to break the cycle of crisis and institutionalisation by creating therapeutic spaces that feel like home, and are grounded in co-production, dignity and trust. Homestead is designed to be scalable and nationally relevant – a prototype for systemic change in the way we approach care, place and psychosis.

Learning Objectives

• Random Control Trial Process and other research based learnings
• Knowledge Sharing
• Critically assess the challenges and opportunities of embedding research, evaluation, and health economics into the early stages of design-led mental health projects.

Past models, future cities: Reimagining post-industrial urban quarters for healthy ageing

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In 19th-century industrial cities like Lodz, hospitals were built as part of an emerging capitalist system to care for the health of factory workers. These institutions were not isolated but were part of a broader urban ecosystem alongside workers’ housing, daycare shelters, outpatient clinics, and the factories themselves. Factories did not only produce goods – they shaped entire micro-cities, where living, working, healing, and social life were deeply intertwined.

Today, in a post-industrial context, technological and environmental shifts have left behind a scattered urban legacy – hospitals, green spaces, housing blocks, and former production halls are now divided between various owners: the city, the hospital, and private developers.

Our project attempts to “stitch” these fragments back into a coherent urban fabric, integrating residential, healthcare, and social functions. Within the grounds of a former textile factory, we are planning senior assisted living (approximately 250 units), rehabilitation facilities, and a municipal senior health centre – all in direct proximity to the still-functioning Jonscher Hospital. This case study explores a large-scale urban area designed to support long, healthy lives. The historic factory halls will house senior living apartments, with the ground floors hosting shared community spaces: a gym; cafe; spa zone; communal kitchen; workshop rooms; a small auditorium; and spaces for intergenerational activities. Nearby family housing will be complemented by shared gardens, green courtyards, playgrounds, and a small river. The hospital, located on a hill overlooking the site, is once again becoming an integral part of the community.

The core idea is to learn from the planning logic of industrial cities – but with contemporary knowledge, tools and values. We build on the heritage and spatial DNA of the city, restoring memory, identity and social connection. Instead of designing a new “hospital town” from scratch, we re-activate an existing, post-industrial ecosystem, where the hospital is once again a central piece of community life. This time, however, it is also surrounded by loft-style housing for seniors – young in spirit, living in spaces once designed for machines, now reimagined for people.

Learning Objectives

• Understand how historical industrial urban patterns can inform contemporary models of integrated care and community development.
• Explore design strategies for re-integrating hospitals into the everyday life of local communities.
• Examine collaborative planning approaches that bridge public, private, and civic sectors in the adaptive reuse of urban heritage.

Rebuilding health from the inside out: Community-centred design and funding to support frontline care

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As cities evolve and healthcare demands intensify, the wellbeing of frontline healthcare workers, particularly nurses and consultants, is emerging as a critical public health issue with far-reaching consequences for the communities they serve. This research explores the systemic strain placed on healthcare workers and makes a case for community-centred design and innovation to restore sustainable work-life balance, and grow the local economy.

Based on three years of applied research across seven countries, and active partnerships with hospitals, home nursing providers, and aged care institutions, this practice-led work reveals both the direct and cascading impacts of workforce challenges. From staff shortages and absenteeism to disruptions in community-based care and declining public health resilience, the consequences extend far beyond the hospital setting.

This case study identifies root causes behind many of today’s workforce challenges and illustrates how data-driven digital transformation (co-designed with frontline staff, healthcare executives, policymakers, community stakeholders, and city-aligned funding bodies) can drive the meaningful support our health systems urgently need.

These findings also reflect broader government policy shifts: from hospital to community care; from analogue to digital systems; and from reactive treatment to preventive support. Yet, while policy direction evolves, funding models have not kept pace.

Today’s healthcare funding landscape is under strain. Top-down treasury budgets are constrained. Bottom-up hospital funding is limited – many hospitals are running multi-million-pound deficits and forced to prioritise acute care over digital transformation. Meanwhile, private capital models, particularly traditional venture capital with 7–10 year return cycles and high return-on-investment expectations, are often misaligned with public healthcare goals. These funding structures can introduce new risks, pushing innovation towards short-term metrics rather than long-term community outcomes.

As a solution, this paper explores sustainable funding models like public innovation funding, where the likes of cities, insurance- and pension-focused funding models invest directly in digital health companies serving their communities. This model aligns with public health priorities, supports frontline care delivery, and helps build new sectors of long-term, high-impact employment rooted in local needs. By investing in digital tools and services that stabilise staffing, reduce administration burden, and empower healthcare workers, cities can improve health system resilience while driving economic and social value.

There is a timely opportunity for local governments and regions to adopt new investment frameworks that directly link health system sustainability to community wellbeing and growth, ensuring that innovation in healthcare administration is matched with innovation in how we fund it.

Learning Objectives

• Understand the root causes and cascading impacts of workforce strain in public healthcare systems - from the frontline to our communities
• Design frontline-led digital solutions that strengthen local care systems
• Align healthcare innovation with city-based funding for sustainable growth

the feminiNE1: A case study analysis of gender inclusivity in Newcastle’s planning policy and practice

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Despite decades of evidence documenting the exclusion and marginalisation of women in urban environments, progress towards more inclusive, gender-equitable planning remains slow. This paper investigates the relationship between gender representation in planning authorities and the inclusivity of urban policies, using Newcastle upon Tyne, a rare case of a female-dominated city planning department, as a critical case study. This work explores how gender identity shapes urban experience and how structural planning processes either enable or inhibit inclusive outcomes. The research aims to generate actionable policy guidance for gender mainstreaming in the context of Newcastle’s forthcoming Local Plan 2045.

This research was conducted from a transdisciplinary approach, drawing from gender theory, sociology, political science, and urban studies. A three-phase methodology was employed, beginning with a thorough literature review and extensive analysis of current local policy and design codes. This initial investigation informed the structure of a participatory gender walk and workshop attended by academics, architects and planning professionals in Newcastle. These findings were disseminated and further interrogated through expert interviews conducted with local stakeholders, including senior planning professionals from Newcastle City Council and a prominent architect. Data from each phase was iteratively interpreted into a gender-mainstreaming policy, incorporating place specificity while also ensuring transferability beyond Newcastle and the North East.

Findings suggest that despite demographic shifts in Newcastle’s planning leadership creating space for new perspectives, structural planning processes continue to reproduce gendered biases. The participatory research methods employed in the gender walk and workshop highlighted persistent barriers for women in public spaces, including issues of safety, mobility and accessibility. Subsequent expert interviews underscored a disconnect between individual values and institutional practice, where progressive intentions are often constrained by rigid planning systems and policy legacies. However, the research also identified clear opportunities for intervention, particularly in embedding gender mainstreaming principles early in the policy design process.

The research concludes that while gender diversity within planning leadership is an important and necessary step towards progress, it is insufficient without accompanying structural reform. The study presents a context-sensitive gender mainstreaming framework for Newcastle with elements of broader applicability across the UK, contributing both practical guidance for policymakers and theoretical insight for the regeneration of our urban realm. By centring lived experience and feminist urban knowledge, the research advocates for embedding gender equity in planning practice, supporting healthier, more inclusive urban environments for all.

Learning Objectives

• Understand how gender inclusivity is addressed within the strategic policies of Newcastle’s Local Plan.
• Examine how gender identity influences urban experiences in Newcastle and evaluate the potential of gender mainstreaming to improve inclusivity.
• Analyse the impact of female representation in Newcastle’s planning leadership on the gender inclusivity of the urban environment.

Evidence-based and engagement-led asset optimisation strategies for healthy, connected communities

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Healthy cities are a function of interconnected systems where governance, services, infrastructure, and communities must align to achieve sustainable wellbeing. A well-connected network with continuous feedback loops supports evidence-based forward-thinking decision-making , well-informed communities, as well as generating social capital, where trust and confidence help collective action.

This paper presents three place-based projects that exemplify how evidence-based and engagement-led asset optimisation strategies can support local authorities in managing challenges and fostering community resilience. The three projects – 1) the Croydon Asset Mapping Tool; 2) Newhaven Town Council’s Estate Strategy; and 3) public engagement support for East Lothian Council’s placemaking strategy – demonstrate scalable methods to identify and address spatial, financial, and service provision gaps in public infrastructure.

These projects respond to common urban challenges that councils face in planning space and service provisions: financial constraints; underperforming assets; shifting demographics; and the impact of strained relations between local authorities and the communities they serve. Through a mixed-methods approach – combining contextual desktop research, demographic analysis, and inclusive public engagement (e.g., workshops, interviews, town halls) – each project aimed to create meaningful feedback loops that inform both placemaking decisions and community empowerment. These also look at how communities and stakeholder engagements conducted in a holistic way can influence the relationships between the governing bodies and communities – helping to identify the true needs and priorities of the community and enabling governing bodies to provide support in a more targeted, efficient, and effective manner.

In Croydon, a digital asset mapping toolkit was co-developed to visualise service and spatial gaps across the borough, layered with demographic and contextual datasets. This helped the council prioritise investment and identify areas for immediate and future intervention. In Newhaven, engagement and scenario planning enabled the development of a strategic estate plan aligned with funding constraints, building conditions, and community needs. In East Lothian, early-stage engagement helped uncover reasons for asset underperformance, including communication breakdowns and under-leveraged community interest in asset ownership and management. A key insight was the need for intermediary roles, such as community liaison officers, to rebuild trust, co-ordinate volunteer networks, and unlock collective action.

Findings across all three projects highlight that asset optimisation is not only a technical and financial exercise – it is, most importantly, a social process. When approached holistically, it has the potential to promote social cohesion, accountability and build resilient urban systems, ensuring efficient long-term investments serving the evolving needs or changing populations.

Learning Objectives

• Feedback loops in placemaking projects empower communities and support collective action that directly influences community resilience
• The relationship between local authorities and communities they serve is critical to enabling or inhibiting efforts made by the council in providing services and infrastructure. Stakeholder confidence and community trust and help develop
• Evidence-based early engagements in a placemaking project enable governing bodies to provide support and make investments in a more targeted, efficient, and effective manner that helps the communities and authorities in the long term.

Learning environments: Designed for difference, built for belonging

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The Adaptive Classroom is a practice-based response to the growing crisis in Special Educational Needs and Disabilities (SEND) provision in the UK. Developed collaboratively by professionals across trauma-informed education, design, and restorative practice, the project pilots a radical redesign of primary school classrooms. It supports children affected by adversity with a holistic approach that incorporates ergonomic, modular furniture and trauma-informed environments, alongside embedded restorative teaching techniques.

Targeting a Year 4 cohort in the Isle of Man, a group impacted by the Covid-19 pandemic, this 12-month pilot is engaging a primary school in co-designing a classroom space and curriculum aligned with six trauma-informed principles. Following installation during school holidays, a comprehensive programme of hybrid training and coaching is delivered for staff, students, and families to promote consistency across school and home environments. Bringing together trauma-informed design and restorative practice, the pilot combines neuroscience, psychology, and design to create spaces that support healing, connection and empowerment. The work is rooted in lived experience and academic research, focusing on the trauma-informed design principles of choice, trust, safety, cultural sensitivity, collaboration and empowerment.

The methodology includes baseline data collection (both qualitative and quantitative) to understand behavioural challenges, emotional regulation, and environmental stressors. Throughout the programme, key performance indicators are tracked and reviewed collaboratively, with adaptive modifications made to training and classroom use. Evaluation focuses on impact on student engagement, behaviour, wellbeing, and teacher confidence.

By aligning physical design with trauma-informed and restorative principles, the Adaptive Classroom transforms the learning environment into a place of safety, belonging and possibility.

This paper will provide insights into lessons learned, the co-design process, practical implementation, and measurable outcomes to support replication and scaling across other education settings. It offers a timely, sustainable and human-centred solution aligned with national priorities for health prevention, early intervention, and inclusive community investment.

Learning Objectives

• To demonstrate how trauma-informed and restorative practices can be integrated through classroom design to support vulnerable learners.
• To share the co-design and implementation process of The Adaptive Classroom pilot project.
• To present data-informed outcomes and practical insights for replication in other school and community settings.

The first causal impact evaluation of a child-friendly cities Initiative: The Tirana School Streets Study

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Around the world, cities are reimagining how the built environment can support children’s health. A growing movement of child-friendly urban design is transforming car-dominated streets near schools into spaces that support walking, play and community connection. But while interest in these “school streets” is rising, causal evidence of their impact on health and wellbeing remains virtually non-existent.

This panel presents the research design and early results from the first causal impact evaluation of a school streets intervention of the Tirana School Streets programme. Since 2020, the Municipality of Tirana and the Albanian NGO Qendra Marrëdhënie have piloted school street transformations at 12 public schools. These projects reclaim street space for pedestrians by removing car parking, widening sidewalks, lowering speed limits, and adding greenery, seating, and shade. The result: calmer, more social environments where children arrive at school more safely and caregivers linger and connect.

Anecdotal and observational data suggest improvements in traffic safety, pollution, and social interaction – but until now, no rigorous research has confirmed these effects. In 2025-2026, Qendra Marrëdhënie will partner with Epoka University and NYU’s Global TIES for Children to evaluate the programme’s expansion to 38 new school sites through a quasi-experimental design.

Panellists will share early findings from a 2025 pilot study, present the evaluation’s theory of change, and describe the research design. The study will examine key public health outcomes: commuting behaviour (active versus passive transport); caregiver and child stress and mood at drop-off; perceptions of safety in the school’s surrounding environment; and teachers’ reports on student engagement.

This session will explore how changes to the urban environment shape children’s daily experiences and mental wellbeing, how to measure these effects rigorously, and what cities and policymakers need to know to support healthier public space. It is an invitation to centre childhood in the way we design streets – and to ground this approach in evidence.

Learning Objectives

• Understand the health and psychosocial rationale behind child-friendly street design near schools.
• Learn how to design and implement a causal impact evaluation of urban design interventions in real-world settings.
• Identify key indicators and methods for measuring the public health impacts of changes to the built environment.

Making connection visible: A theory-of-change approach to wellbeing in urban development

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Background and aims: This project explores how social connectedness can be designed and embedded as a core element of health and wellbeing in new communities, using Ebbsfleet Garden City – part of the NHS Healthy New Towns programme – as a testbed. As urban developments scale rapidly, the challenge is not only the delivery of physical infrastructure but also the cultivation of social infrastructure that underpins long-term community resilience. The primary aim was to co-create a practical and scalable theory of change – a framework that aligns existing activity, identifies gaps, communicates opportunities for involvement, and provides direction for community and institutional stakeholders alike.

Methods: We undertook a seven-month, iterative collaboration between Ebbsfleet Development Corporation (EDC), local residents, and experts in design for human connection from Imperial College London. The work unfolded in two phases: 1) development of a theory of change to clarify how social connection drives community health and belonging; and 2) co-design and refinement of seven illustrative interventions that demonstrate how this framework can be operationalised. Methods included community workshops, immersive neighbourhood visits, stakeholder interviews, and hands-on co-design sessions.

Findings: The resulting theory of change provides a coherent and flexible framework for guiding action on community connectedness. It has already begun to serve multiple functions: making sense of existing initiatives; articulating shared goals; supporting legacy planning by EDC; and empowering the Community Board to sustain momentum. Built on behavioural insights and design principles, the framework translates abstract aims like “belonging” and “participation” into actionable components. Seven intervention ideas – including the Ebbsfleet Market, Chalk Festival, Community Art Trail, and Elements of Connection – demonstrate how the framework can be applied in diverse and locally tailored ways. While individually modest, these interventions gain impact through their strategic alignment with the theory of change.

Conclusion: This paper presents a replicable approach to embedding health-promoting social infrastructure in new communities. The theory of change is the project's key innovation, providing a structured yet adaptable way to design, evaluate and grow social connectedness over time. Ebbsfleet’s experience highlights the power of co-production and behavioural design to shape community-led, inclusive urban futures. It offers both a strategic lens and practical tools for other developments aiming to turn connection into a foundation for health and resilience.

Learning Objectives

• Understand how a Theory of Change can be co-developed and used as a strategic framework to design, align, and evaluate social infrastructure initiatives in new urban communities.
• Explore the role of behavioural science and participatory design in translating abstract wellbeing goals—such as belonging and connectedness—into actionable and locally meaningful interventions.
• Gain insight into practical, scalable methods for embedding social connectedness in urban planning, with lessons from Ebbsfleet Garden City that are transferable to other health-focused developments.

Designing the Invisible: How built environment strategy shapes community health and policy outcomes

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Background: The built environment is often treated as a backdrop to health outcomes rather than a driver of them. Yet spatial decisions – many made long before the first brick is laid – profoundly shape community health, equity, and resilience. These invisible levers include zoning, executive planning, capital investment, and design strategy – domains that remain siloed from public health policy despite their shared impact.

Purpose: This paper introduces a practice-based framework developed through real-world consulting engagements across the US and UK. It demonstrates how embedding design strategy at the executive level – from C-suite decision-making to municipal governance – unlocks healthier, more equitable outcomes across communities. The aim is to bring visibility to the invisible drivers of health: space, systems, and the stories we build into them.

Methods: This paper introduces a practice-based framework developed through strategic advisory work and peer-to-peer research across the US and UK. Through emerging engagements with mission-aligned non-profits and city leaders, the author synthesizes early-stage spatial strategies, stakeholder activation tools, and executive-level planning models that frame design as a driver of health. The work also incorporates reflections from the Rice University symposium on 'Designing for Health Equity using Digital Tools'.

Results: The proposed approach has resonated strongly in early-stage conversations with organisations seeking to embed health equity upstream, prior to architectural design. Pilot dialogues have revealed a critical opportunity: when C-suite leaders and municipal stakeholders are equipped with spatial strategy tools early, they can reimagine their assets through the lens of behavioural health, walkability, and community equity. These insights form the foundation for future case development, offering a roadmap for how design strategy can shift not just buildings, but belief systems.

Implications: Design must be repositioned not as a downstream service but as a strategic input at the policy, investment, and planning level. By “designing the invisible,” we empower civic and corporate leaders to recognise the built environment as a proactive tool for health equity, not a reactive cost. As governments pivot towards preventive care, community-first infrastructure, and digital integration, this approach offers a replicable model for impact-driven urban policy – one that is elegant, equitable, and economically sound.

Learning Objectives

• Background: The built environment is often treated as a backdrop to health outcomes rather than a driver of them. Yet spatial decisions—many made long before the first brick is laid—profoundly shape community health, equity, and resilience. These invisible
• Background: The built environment is often treated as a backdrop to health outcomes rather than a driver of them. Yet spatial decisions—many made long before the first brick is laid—profoundly shape community health, equity, and resilience. These invisible
• Background: The built environment is often treated as a backdrop to health outcomes rather than a driver of them. Yet spatial decisions—many made long before the first brick is laid—profoundly shape community health, equity, and resilience. These invisible

Designing the Invisible: A live framework for health-first strategy in urban and organisational projects

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Designing the Invisible is an interactive workshop that invites civic leaders, design professionals, and public health practitioners into a collaborative session to reimagine how we shape healthier cities – not just through buildings but through strategy.

Led by architect and strategist Barbara Benesh, the session introduces Designing the Invisible – a live, systems-thinking framework designed to surface the unseen drivers of health embedded in capital planning, executive decision-making, and the built environment.

Rather than reacting to illness, this approach centres wellbeing at the earliest stages of planning, prior to site selection, masterplanning, or design. Participants will engage in facilitated exercises using fictionalised case prompts drawn from real-world advisory work with non-profits and municipalities, mapping the “invisible infrastructure” that shapes outcomes in equity, access, and service delivery.

Whether you are a policymaker, health system leader, urban planner, or investor, this session offers tools to apply a health-first lens to your projects and policies – bridging the gap between intention and implementation.

Learning Objectives

• Understanding how upstream strategy and spatial decision-making shape public health outcomes.
• Apply a systems-thinking lens to identify invisible drivers of inequity and opportunity within a project or region.
• Prototype a health-first strategic response using a live case model and takeaway framework.

Haven

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When the City of Philadelphia sought collaborators this past autumn, Stantec immediately saw the value of creating a project vision that would be something ground-breaking and inspirational. We assembled our design team, composed of subject matter experts in behavioural and mental health design, landscape design and urban design, healthcare masterplanning, and architecture. We spent two weeks in an intensive design charette, researching contextual precedents and the specific populations that the City sought to bring to the site – breaking apart the constraints and focusing on the human scale needs that stood at the centre of the request.

By digging into the site to derive its value and meaning while, at the same time, dissecting the problem statement and understanding how a trauma-informed design approach might affect the programmatic objectives, our holistic approach was an attempt to share a cohesive vision for an equitable and respectable method of public investment to treat the chronically unhoused.

Haven’s approach brings together housing and health, with wrap-around services for formerly unhoused individuals in a transitional housing programme. This conceptual masterplan is in response to the Mayor of Philadelphia’s vision to create a “wellness village” along the Delaware River waterfront.

Building on evidence-based studies of therapeutic landscapes and incorporating empathetic practices of resident personas, we used a trauma-informed design approach for this new community. Our plan addresses four main resident neighbourhood groups: veterans, men, women, and seniors. Each neighbourhood offers a mix of inwardly focused resident amenities, campus-oriented therapy, and support and public spaces.

As our most vulnerable populations within urban centres are increasingly pushed out to the fringe of society in the name of public safety, this alternative approach capitalises on a city-owned parcel for development of a beautiful place to heal individuals suffering from long-term homelessness.

Stantec was not awarded the project, which is in the process of being designed by another design team hired by the City of Philadelphia. Instead, we carefully crafted a vision built on on an evidentiary and empathetic approach, understanding of the specific context that exists, pro-bono. The intent of this vision was not only to display an alternative model for communities and municipalities to emulate but also to strategically highlight a more thoughtful way to design for a vulnerable population.

Learning Objectives

• Trauma-Informed Design
• Transitional Housing
• Healing

Harti Hauora Tamariki; Delivering holistic care to improve child wellbeing through cross-sector action in Aotearoa New Zealand

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Background: In Aotearoa New Zealand, there are large and enduring health inequities between Māori (Indigenous) and non-Māori tamariki (children). These inequities result from systems failures, differential access to the determinants of health and unresponsive, poor quality, and siloed health service delivery. The Harti Hauora Tamariki (Harti) programme was a whānau (family) Māori centric multi-level programme aimed to support wellbeing, health prevention, and address health determinants using a holistic approach.

Methods: The Harti intervention included culturally safe engagement, holistic electronic needs assessment (including housing) and navigation to community wellbeing services. A randomised controlled trial (RCT) measured the impact of Harti at a hospital paediatric ward. Primary measures were hospital readmission risk at 30-days, six and 12 months post-hospital discharge. Analysis is also underway to examine five-year outcomes.

Results: In total, 965 children were recruited; 485 (50.3 per cent) in the intervention group; 480 (49.7 per cent) in the control group, with over half of participants Māori. No significant differences in readmission risk were found for any timepoints in the first 12 months post-discharge. Significant differences were found in the documentation of unmet need, referrals to and receipt of wellbeing services (including oral health checks and enrolment, and smoking cessation referrals), and satisfaction with care. The holistic needs assessment, delivered by community navigators, also improved referrals to housing support services, and therefore potentially improved health and equity gain. Qualitative interviews highlighted that the Harti approach prioritised relationship building, enabling better patient and family connections to healthcare services and assisting with better access to community services. Following the RCT, Harti has evolved into the Whiri Model of Care and has been implemented in emergency and community services, and further tested within research (e.g., cancer).

Conclusions: Harti had positive individual, whānau and systems-level impacts. Harti also enables health equity gain for Indigenous people and those with the greatest need, maximising the value delivered from scarce resources for improving wellbeing. We will discuss the Harti model of care, Whiri evolution into multiple settings (including community and cancer care coordination), cross-sector partnering, and describe how lessons learnt from these processes can upscale and be adapted to support further capacity building to advance health improvement and improve health equity. Bridging siloes between health and community services has the potential to greatly improve outcomes for children, their families, the wider community and society.

Learning Objectives

• Attendees will be able to define what a whanau centred holistic approach looks like
• Describe ways to enhance engagement with Indigenous populations
• Describe ways to address determinants of health

Nature-based social prescribing for promoting health and wellbeing in urban settings: A participatory workshop to develop an international agenda for public policy action

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Nature-based solutions for the promotion of health and wellbeing are receiving increasing interest in urban contexts. In this workshop, we are focused on the role of inter-agency collaborations that bring together urban planning, green space, healthcare and non-healthcare stakeholders to support the mental health challenges of vulnerable and marginalised populations. One example is “nature-based social prescribing” – an approach where people are referred to nature-based activities, such as gardening, walking in parks, or conservation work, to support their physical and mental wellbeing. This is part of a broader “social prescribing” model, which connects individuals to non-medical interventions to improve health and reduce reliance on traditional healthcare services.

As a provocation for discussion, we outline emerging new messages from RECETAS, a European Union-funded multinational cities research and innovation programme, which has tested nature-based social prescribing (NBSP) interventions to address community-wide levels of loneliness. RECETAS draws on randomised controlled trials (RCTs), pre-post studies, cost effectiveness studies, and international case studies in Europe, South America and Australasia. This work draws attention to the need for shared understandings in cross-sectoral collaboration, participant voice, and contextualised evidence.

Through a process that draws on the Delphi and Sutherland consensus-building methods, participants in this workshop are invited to discuss and rate priorities for policy, practice and research based on perceptions of contemporary gaps and opportunities in the field.

We envisage that the results of the workshop will support an international agenda-setting publication. All consenting conference workshop participants will be acknowledged for their contribution to this publication.

Workshop outline:
• Introduction to NBSP and the RECETAS project;
• Presentation of key messages for NBSP for policy, practice and research in the context of healthy city design;
• Delphi/Sutherland interactive consensus and prioritising exercises; and
• Group discussion, reflections and next steps.

Learning Objectives

• Understand the role of inter-agency collaboration in implementing nature-based solutions to support mental health in urban settings.
• Gain awareness of emerging evidence from international research, to inform the development of nature-based social prescribing interventions.
• Contribute to the advancement of an agenda for multisectoral and multilevel action for NBSP in an international context.

Impacts of a co-designed sustainable park on physical activity and other wellbeing behaviours in a deprived UK urban area: A seven-year mixed-methods natural experimental study

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Background: There is a dearth of robust natural experimental studies examining the impact of urban green space interventions on physical activity. Very few studies have examined interventions involving sustainable park design solutions or interventions in areas facing socio-economic and environmental disadvantage. Further, most natural experimental studies rarely go beyond two years follow-up.

Purpose: This study aimed to 1) assess the short- and long-term impacts of a new co-designed, sustainable “sponge park” in a deprived, high flood-risk area of Manchester (UK) on park use, physical activity, and other wellbeing behaviours; and 2) develop a theory of change to explain the mechanisms underpinning these intervention effects.

Methods: Two comparison sites were matched to two intervention sites using eight environmental correlates of physical activity. All sites were in the UK’s 10-per-cent most deprived areas. The primary outcome (observed walking) and secondary outcomes (vigorous physical activity, socialising, taking notice) were assessed using the MOHAWk behaviour observation tool. Observations were conducted at baseline in 2018, before the intervention was implemented in 2020, with follow-up assessments at three months (2020) and 15 months (2021) post-intervention. A 63-month post-intervention follow-up is planned for August 2025. Negative binomial regression models were used to estimate the effects of the intervention compared with the comparison group, controlling for key co-variates. Intercept surveys were also used to assess self-reported outdoor space usage at baseline and 12-months post-intervention. Qualitative interviews with local residents are currently being conducted to develop a theory of change based on realist methodology.

Results: Compared with the comparison sites, the total number of people observed walking at the intervention park increased at three-months (incidence rate ratio (IRR) 2.18) and 15-months post-intervention (IRR 3.44). Similar increases were observed in vigorous physical activity, socialising, and taking notice at the intervention sites compared with the comparison sites. Self-reported increases in outdoor space usage from baseline to follow-up were twice as large in the intervention sites compared with the comparison sites. The long-term 63-month follow-up results will also be presented, along with qualitative findings that will outline the underlying mechanisms driving these effects.

Conclusions/Implications: Creating sustainable parks is a promising intervention to promote walking and other wellbeing behaviours, especially in deprived areas. More robust mixed-methods natural experimental studies like this are needed to inform policymakers on how urban green space interventions can promote physical activity and wellbeing in different contexts.

Learning Objectives

• 1. Understand the application of natural experiment study designs to assess the impacts of real-world environmental interventions on physical activity and wellbeing behaviours.
• 2. Learn how to develop a theory of change that explains the underlying mechanisms driving the effects of urban green space interventions on health and wellbeing.
• 3. Understand the policy and practical implications of evaluating urban green space interventions, with a focus on reducing health inequalities in deprived areas.

Multi-level longitudinal analysis of physical functioning change by sociodemographics and neighbourhood disadvantage among mid-to-older adults

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Background: By 2050, an estimated 22 per cent of the global population will be aged over 60 years, mostly living in urban areas. In this context, physical functioning, an individual’s ability to undertake daily activities, is critical to enabling healthy ageing and independent living in later life. Many empirical studies have found that individuals with lower socioeconomic positions and residents of the most disadvantaged areas reported poorer health outcomes. However, limited longitudinal research has explored the influence of individual and neighbourhood-level disadvantages on changes in physical functioning in later life.

This study aims to examine the associations between sociodemographic characteristics and neighbourhood disadvantages and changes in physical functioning over three years in mid- to older-aged adults.

Methods: Data were collected from 3288 participants, aged 45-74 years, living across 200 neighbourhoods of Brisbane, Australia, using Wave 4 (2013) and Wave 5 (2016) of the How Areas in Brisbane Influence healTh and activiTy (HABITAT) study. Multi-level linear regression analyses were conducted, incorporating interaction terms between individual and neighbourhood disadvantage to examine whether the effects of different sociodemographic characteristics on changes in physical functioning varied across neighbourhood disadvantage quintiles.

Results: After adjusting for baseline physical functioning scores and sociodemographics, residing in more disadvantaged neighbourhoods was associated with greater decline in physical functioning. The associations between individual-level markers of disadvantage and greater decline in change in physical functioning were moderated by neighbourhood disadvantage, demonstrating the impact of double disadvantage. Those aged over 70 years, in casual work or renting privately, also reported greater decline in physical functioning irrespective of neighbourhood disadvantage.

Conclusion: This study identified the social gradient in physical functioning among mid- to older-aged adults. The findings underscore the importance of concurrently examining individual and area-level disadvantages to better understand how their interaction contributes to double disadvantage, accelerating physical functioning decline among older adults.

Learning Objectives

• Neighbourhood disadvantage and health disparities
• Perceived physical functioning among older adults
• Multilevel longitudinal analyses