Sydney is often considered a significant city. With its natural beauty, iconic Pacific presence, and unique demographics, Sydney could lead the world in urban health development. The reality is, we lag behind many cities in Australia and the world when it comes to including health indicators in urban planning, economic development and design policies.
We are turning this around.
The HUE Collaboratory will be looking at how urban policy and governance in Sydney can lead to better health outcomes for local and global populations. We are supporting local health districts to translate health and environment research into policy and action. And we are working with public health academics, clinicians, social scientists, public health leaders and executives, and built and natural environment specialists to bring Sydney to the forefront of healthy urban environments.
Activity
There are 5 focus areas where we intend to deliver the greatest impact.
1. Country and Health
Indigenous health is intrinsically linked to the health of the land. ‘Country’ is equivalent to Indigenous identity. But colonisation has dramatically affected the relationship that Aboriginal people have to Country, particularly in major cities and urban areas. And this has dramatically affected Aboriginal health and wellbeing. We are working closely with Aboriginal communities to bring lasting change to our health. And re-imagining how we can embed everyday practices, like walking on and caring for Country, into urban design ecologies.
The notion of Country is central to all our work. Our research will blend Aboriginal storytelling with robust research that privileges the voices, lives and experiences of the Aboriginal community. We include these complex cultural perspectives into the healing pathways of urban planning frameworks, especially at a strategic level.
2. Spatial analytics and cities
We are accessing large datasets to understand how spatial structures determine health and people’s access to services. This is a significant amount of work, which will be shared with local health districts, public health networks and councils. It is intended that these services will use the data to influence health planning, prevention measures, and the design of built environments. The goal is to significantly improve health outcomes and access to services.
3. Place-based health interventions and smart cities
Sensors fitted to asthma inhalers quickly crowdsource poor air quality zones, and send alerts to sufferers which minimises the risk of attacks. The Internet of Urban Things has great potential in supporting individual and community action for health and well-being. There are also many innovative, place-bound translational health programs in existence. We will work alongside clinicians and community agents to experiment with how these existing trials and programs can be optimised for even greater patient outcomes.
4. Targeting unhealthy urban environments
We are identifying issues that affect Sydney’s urban environment, such as food deserts, hotspots of accumulated disadvantage, air pollution and poor quality housing. We aim to identify, change, and assess parameters in the urban environment that create, sustain, and hinder individual and population health. We are focused on identifying ways we can support positive health outcomes through partnerships with state departments, local governments, and elected representatives.
5. Health precincts and health infrastructure users
The creation of health innovation precincts is high on the NSW state agenda. Three of these are in the HUE Collaboratory service area (Campbelltown, Liverpool, and Kensington). This presents an opportunity to understand how the design and organisation of these areas influence the experience communities, patients and staff have of these spaces. We use a diverse toolbox of qualitative and quantitative research to better understand urban design concepts and how these impacts not only healthcare from an infrastructure level but also health outcomes at an individual level. We will identify concepts such as place identity, dwell space and diversity and look to unravel the web of connections that weaves the urban environment and its human participants together.
Team
Our team brings together leaders with a variety of specialities. It includes academics from our three partner universities and researchers from the two local health districts. Our experience spans public health, built environment, urban planning, geography, architecture, health services research, health political science, health economy, epidemiology, policy development and research management.
We will use our networks to partner with likeminded Sydney and NSW councils, government departments, industry, charities and non-profit organisations. And we will combine the strength of these partnerships to support healthier communities through joint programs, planning and integrated care.
Current Research and Innovation
The HUE Collaboratory is a growing network of public health academics, clinicians, social scientists, creatives, architects, urban planners and other built and natural environment specialists. Our mission is to improve the health of Australians living in urban environments. We achieve this by facilitating partnerships between those who shape and have an impact on cities, and by investing in cutting edge research through seed funding schemes.
HUE Collaboratory upholds Maridulu Budyari Gumal principles by investing in projects that connect and exploit research, innovation, collaboration, education and knowledge co-creation, to drive better health outcomes for our communities.
Current HUE Projects
As of January 2021, HUE has awarded four rounds of seed funding. A total of $229,828 has been awarded across 11 projects targeting healthy places and climate change. For more information on any of the projects detailed below, please contact huecollaboratory@thesphere.com.au
Healthy Places
1. Conceptualising unhealthy urban places: The need for a systems approach (Professor Jason Prior, ISF, UTS)
Through the use of a systems approach, this project seeks to develop a collaborative approach to the development of a conceptual model of place-based unhealthiness. This approach enables expertise from different disciplines to be combined with local knowledge to 1) broaden the scope of health issues that can be identified, and 2) develop priority action areas for the effective urban governance of health. By seeking the input of a broad range of stakeholders, previously marginalised issues may be highlighted, and more equitable outcomes may be realised.
2. NSW built environment practitioners’ perspectives on place-making opportunities that deliver health and wellbeing outcomes (Professor Nicky Morrison, WSU)
The built environment can positively impact the health and wellbeing of individuals and communities. Where you live shapes how easy it is to buy healthy food, use active transport, and make social connections. Our research provides critical insights into the track record of a broad range of built environment practitioners delivering healthy place making across NSW. This joined-up approach allows us to pool knowledge for the very first time, delving into the barriers to delivery but also the wealth of experience and opportunities that exist at the localised scale. Leveraging and sharing this untapped knowledge helps us to develop a sustainable capacity-building platform that benefits policy and practice for all. Our aim is to foster on-going collaboration and commitment among practitioners, policymakers, and academics in ways to create long-lasting sustainable communities that put healthy place-making at the forefront - locally, nationally and transnationally for the wider benefit of planetary health.
3. Effectiveness of community-based food hubs and peer support on food accessibility and dietary intake (Dr Freya MacMillan, WSU)
This project will review the existing literature on healthy food interventions that have been delivered in community settings. We will describe the types of interventions that have been used and the study designs utilised to test these interventions, who they have targeted, what dietary behaviour and health outcomes were measured and the impacts that they have had on participants dietary behaviour and health.
Our project will provide rigorous evidence on the effectiveness of community-based healthy food interventions, including their sustainability over the long-term, to inform future policy and practice within Sydney and beyond. Evidence-based strategies are essential in determining the most effective strategies to invest in and a thorough review of the existing literature will help pave the way for the design of future community-based healthy food interventions.
4. What causes significant changes in walking? Investigating macro and micro level drivers of walking in neighbourhoods (Professor Bin Jalaludin, SWSLHD)
This project will identify factors that lead to definitive and significant changes in walking patterns in neighbourhoods. Current research on walkability has generally been cross sectional rather than prospective with a few exceptions (Knuiman et al., 2014). This study will implement a literature review, a hotspot analysis and a before and after analysis complemented by stakeholder interviews to identify what leads significant neighbourhood level changes in active transport including transportation walking. Our hypothesis is that a combination of both macro level factors (such as land use changes, new developments, transport infrastructure, neighbourhood safety) and micro level factors (such as footpaths condition, traffic and road conditions, street connectivity) when present and/or changed lead to significant changes in active transport in a neighbourhood. This study thus has direct policy implications. The findings of this study will assist policy makers and state/local governments to enable evidence-based decisions in both macro (infrastructure) and micro (neighbourhood) levels to effectively improve active transport walkability and walking.
5. Urban Planning and Design for the COVID-19 era: a rapid review for policy and practice (Dr Patrick Harris, CHETRE, UNSW)
Urban settings are at the epicentre of COVID-19 and require public health and social policy measures, known as non-pharmaceutical countermeasures, to restrict transmission. This project is a rapid review of interdisciplinary knowledge already published, which examines the relationship between cities and pandemics of coronaviruses as well as current and historical H1N1 influenza pandemics. The specific focus is urban planning and design, with a particular focus on at risk groups, and supporting governance and policy influences.
6. Hot Hospital Carparks – An Avoidable Risk for Patients and Visitors? (Dr Sebastian Pfautsch, WSU)
The likelihood that a person with high vulnerability to heat will use a hospital carpark is exponentially greater compared to any other carpark. Documenting air, surface and feels like temperatures, the project will establish benchmarks for temperature regimes in asphalt and concrete carparks. Results of the project will be used to inform planners and operators of carparks how to improve resilience of hospitals during increasingly hot summers. Most importantly, this project can develop a beacon function which (a) raises awareness of the issue with planners and operators of hospital carparks and (b) helps improving public health more broadly by encouraging other carpark operators to address the issue of heat.
7. Waterloo housing estate redevelopment: Assessment of residents’ health needs and circumstances (pilot project) (Dr Christopher Standen, UNSW)
This pilot project will develop and trial quantitative and qualitative methods for a long-term, quasi-experimental, longitudinal health study for the proposed redevelopment of the Waterloo public housing estate. The study will not only measure residents’ psychological and physical health throughout the redevelopment process, but also respond to any negative impacts – through (a) referral of residents to appropriate services, and (b) informing health and human services policy, planning and delivery for the affected community.
The study will provide new insights into the health/well-being impacts on public housing residents exposed to large-scale, long-term redevelopment and change in tenure mix – with a focus on Aboriginal and Torres Strait Islander and older adult residents, whom have been identified as potentially more at risk. It will inform best-practice health policy and practice more broadly – in planning/designing health service provision and interventions for Waterloo and other public housing communities undergoing redevelopment. Finally, the findings will inform the planning and design of future public housing redevelopments in NSW and elsewhere, leading to improvements to environmental determinants of health.
8. Urbanisation and health during the first 2000 days of life: Building a foundation for health in Sydney’s urban environment (A/Prof Dena Fam, UTS)
The concept of ‘child-friendly cities’, predominantly focused on those aged 5 through 12, has been used to guide the development of a coherent research and policy framework into how everyday urban environments sets a foundation for health in later life. This approach calls for seeing urban environments through the lives of children and their parents and carers. Despite the emergence of the child-friendly cities concept, there remains a relatively incoherent and nascent body of research and policy on how everyday urban environments provide a foundation for health during the first 2000 days of life, even though the period from conception to age five is a critical period influencing lifelong health (NSW Health, 2019). This project brings together three SPHERE CAGs - HUE CAG, the Maternal, Newborn and Women’s CAG, and the Early Life Determinants of Health (ELDoH) CAG - in partnership with LHDs. The aim is to systematically map existing evidence of how everyday urban environments provide a foundation for health during the first 2000 days of life. With supporting evidence we then aim to scope the parameters of an interactive data tool to provide a platform to drive research, policy and practice that pays greater attention to how urban environments, both natural and built, support the first 2000 days of life and potentially transform the long-term health of Sydney’s population.
9. What stops and promotes cycling of children from lower socio-economic groups; A Blacktown (NSW) Case Study (Dr Brian Lee, UNSW)
Regular exercise and playability are essential for children’s health and wellbeing (Olds et al., 2015). The Australian Government recommends at least 60-minutes of physical activity for children aged 5-17. However, Australian teenagers are among the most inactive in the world (Guthold et al., 2019). About 80% of children lack exercise and 1 in 4 children aged 5 to 14 are either overweight or obese (AIHW, 2020). Riding a bicycle could be a solution to move Australian children on the track to better health. There is evidence showing that both cycling activity and willing to cycling surged in Australian cities during the COVID-19 lockdown (Mark, 2020; Lock, 2020). Policy and planning efforts of the Australian Government aim to increase cycling activity (Austroads, 2010; Australian Government, 2016). However, planners find it challenging to promote cycling by children in particular, because of lack of knowledge about what stops and promotes cycling by children (Krysiak, 2018). This challenge is amplified for the children of low socio-economic families. Lower socio-economic groups participate less in physical activity (Kavanagh et al, 2007). Some studies report that low-income communities have poorer cycling infrastructure (WHO, 2006). This project aims to identify the barriers and promoters of children’s cycling and examine its possible correlation with the family’s socio-economic status. The findings will contribute to improving cycling policies and incentive programs to increase cycling among children.
Climate Change
1. Climate Change & Vulnerability Assessment of South Eastern and South Western Sydney – Scoping Study (Associate Professor Fiona Haigh, HERDU, UNSW)
Climate change impacts on human health are evident in Australia and are predicted to become more frequent and intense. While the effects of these climate changes impact all of us, already disadvantaged populations are more vulnerable through a compounding of disparities in social and economic conditions. Health services play a critical role in responding to changing health needs of the local population, and to the likely effects of climate change on health service resources, workforce and infrastructure. This scoping project has developed a climate change health and vulnerability impact assessment framework to assess potential health impacts on vulnerable populations and inform health service responses.
Publication
Understanding vulnerability in the context of climate change – a Health impact Assessment Framework
Submission to Climate Health WA Inquiry
2. Carbon Accounting in Healthcare: The path to improving patient health, saving money and saving carbon (Dr Kate Charlesworth, SESLHD)
The health sector has a large carbon footprint and, as the world shifts towards zero-carbon economies, health services and activities will be required to decarbonise. A range of initiatives will need to be undertaken: sustainable hospital and precinct design, green infrastructure, reducing the carbon costs of healthcare activities and services, and developing low-carbon models of care. Internationally, research in carbon accounting in healthcare is rapidly progressing. In this project, we are seeking to investigate carbon footprinting in several areas: pathology, telehealth and potentially radiology – which we see as ‘building blocks’ for this area of research in Australia.
In the future, carbon will be as important as money. In healthcare, we will not only have to measure health outcomes and financial costs, but also the carbon costs of all our activities and services. Carbon accounting is a rapidly emerging area of research in healthcare, internationally. In this project, we aim to measure the carbon costs of several key areas in healthcare in Australia, which will provide a useful platform for longer term research in this area.
