Statistics indicate that about 4 billion people around the world live in urban areas, and that this number is on the rise. As people increasingly cram into cities, potential infectious diseases could spread faster due to the increasing density. A city’s amenities, layouts, population counts, and sanitation measures can impact how diseases spread and, in turn, the severity of epidemics. City planners must think about how to minimise the spread of disease and take this problem as seriously as any other aspect of a well-managed city.
Sara Jensen Carr, assistant professor of architecture at Northeastern University, talks about how urban design ideologies developed in the US, the health crises, and situations that shaped its evolution. “In the 1800s, there was a coordinated movement to get all of the waste out of the streets and bring fresh water to houses,” Carr says. “The net effect is that we have straighter streets to accommodate long pipes underneath to move water and waste more safely.” This is why cities that are organized on grids are more than just convenient when compared to crooked, unpaved streets that collected infected water during the cholera outbreaks of the 1800s.
Carr’s book, The Topography of Wellness, chronicles how these epidemics have informed the design of cities and how crime and chronic illnesses, such as obesity, either influence or are influenced by, changes in American urban landscapes. “Tuberculosis influenced a lot of architecture and urban planning up to about the 1960s, especially in modern public housing,” Carr says, referring to how tuberculosis was treated back then. Hospitals designed to treat tuberculosis patients had people lying outside in beds, sunning themselves, as a form of treatment. “The interesting thing about tuberculosis is that air and sunlight were actually very curative,” Carr says.
The mid-20th century also marked the beginning of the urban crisis in American cities, during which racial tensions were high, and wealthy white citizens began moving to the suburbs, taking business with them. The most crucial health crisis that Carr researched for her book is the link between suburbia and obesity. “People in the suburbs have to spend more time in cars commuting. They don’t have time to exercise. They’re not able to walk to the grocery store,” Carr says. “Suburban sprawl is not the cause of the obesity epidemic, but a lot of people agree that it’s certainly a contributor.”
These are some of the consequences Carr hopes designers will consider more seriously in the future. “We need to start addressing the health needs of our communities and account for the unintended fallout of what we’ve done in the past,” she says.
Anisha Naidu