Mr Chen Qining is currently the Board Member, President of State & City Planning Consultants Pte Ltd (China). He has more than 30 years of urban and regional planning experience. He had worked in Suzhou Industrial Park Administrative Committee. During 1994 to 2004, he was involved in the planning and development of the 70sqkm SIP. Prior to that, he worked Jiangsu Province Planning Design Institute. His expertise includes strategic consulting, concept plan, master planning, detailed planning and operational planning etc.
This outbreak since late 2019 has been a public health emergency. Before this, China has experienced the SARS in 2003, the bird flu in 2004, the hand-foot-mouth disease in 2007, and the H1N1 flu in 2009, through which It has gradually accumulated experience in dealing with public health emergencies. Infectious diseases are becoming increasingly threatening to human beings in modern society, and since 2003 China has introduced a series of laws and regulations, defined the management structure, as well as established the early warning and emergency response mechanism.
Although some criticized the lag of reporting and releasing of disease information in the early stage of the outbreak, the Chinese government then took decisive measures soon, such as the construction of the mobile cabin hospitals and the Huoshenshan hospital, the increase in the production of masks, and the implementation of the lockdown of cities to contain the outbreak. In general it has been well controlled and the outcome has been optimistic.
This outbreak reminds us that we should make rational planning for public health and emergency medical facilities in advance, and include them into the Urban Comprehensive Disaster Prevention Plan. It should also be further included into the new round of National Spatial Planning, in which enough land space should be reserved.
This outbreak is also a reminder that we should pay attention to urban public safety planning, including the prevention of natural disaster, accident calamity, and public security. These issues are easy to be ignored in ordinary times, when there is no accident, we do not realize the importance of them; however once there is the disaster, we will then face a huge problem. Therefore, it is the role of urban planning to predict the future risks and nip them in the bud.
This outbreak will inspire the Chinese government and all sectors of society to attach great importance to ‘healthy city’, and will lead to a construction boom of healthy cities, towns and villages. ‘Healthy city’ is a concept advocated by the World Health Organization (WHO) in 1984. The idea was firstly implemented in North America and Europe with a series of healthy city project being initiated. These projects put people first, emphasized on building healthy communities and work environments based on people’s lifestyles; and then expanded to macro influential factors such as healthy regional economic and social development, and global climate environment. You will notice that ‘healthy city’ is progressive concept, firstly it is about environmental hygiene, then medical care and personal behavior, and finally it concerns the social factors that affect health.
In 1994, WHO defined a healthy city ‘is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential’. It can be seen that the implication of a healthy city could be very broad. From the perspective of people’s health, it covers health maintenance, mind nourishment and character cultivation, which is related to a comprehensive health idea of people’s physiology, psychology and morality. From the perspective of promoting the practice of healthy city, it is not only the matter for medical and health departments, but also a matter faced by all government departments, social organizations and people in the whole society.
The concept of ‘healthy city’ was introduced into China in 1994 , when ‘patriotic health campaign’ was then transformed to the idea of ‘healthy city’, and this approach was firstly promoted in Beijing, Shanghai, Suzhou etc. After the SARS outbreak in 2003, healthy city construction was becoming popular in China. In 2006, the second international convention of the Alliance for Healthy Cities was held in Suzhou, and the city received the Good Practice Award in health city. Suzhou was the first city recommended by the National Patriotic Health Campaign Committee to WHO to carry out the construction of a healthy city. So far, the city has received 32 awards from WHO and Alliance for Healthy Cities.
According to the big data analysis provided Suzhou Center for Disease Control and Prevention, chronic diseases account for 96% of total deaths in Suzhou. Therefore, Suzhou adopted the ‘531’ series action plan, to establish 5 collaborative disease treatment centers (chest pain etc.); to form 3 screening mechanisms (tumor etc.); and to build a comprehensive public health management service platform. Suzhou has also released the Plan Outline Healthy Suzhou 2030, which makes it clear that the focus of health service in Suzhou will shift from ‘disease curing’ to ‘health promoting’, and explore the path of healthy development from multiple dimensions including disease treating, disease preventing, supervising and participating. Last year, average life expectancy in Suzhou reached 83.5 years and the city was awarded the title of Healthy China City of the year in China.
Suzhou is a microcosm of China’s many health cities, with both achievements and remaining room for improvement. According to the 2019 Annual Report on Urban Development of China, among 288 cities in prefecture-level or above, only 35 are in a state of relatively healthy, accounting for only 12%, and more than 80% of the city is in a state of ‘sub-health’. I believe that after COVID-19, governments will see the value of building a healthy city, and the number of healthy cities will also be greatly increased.
In 2014, our company SCP have jointly conducted research on healthy city and held an international symposium on healthy city together with Soochow University and XJTLU. Researchers, designers and practitioners from all over the world, including United States, Japan, Singapore, South Korea, Australia and Hong Kong had gathered in Suzhou, and discussed various aspects of healthy city, including: index system of healthy city, medical and health service system, healthy public facility, built environment, transport and infrastructure, health industry as well as elderly care service system.
Community Complex for the Elderly – Kampung admiralty, Singapore
Then, what is the international benchmark for a healthy city? BBC has named the world’s top five healthy cities, and they are Tokyo in Japan, Singapore, Copenhagen in Denmark, Perth in Australia and Monaco. Again, Singapore and Copenhagen were included in the list of world’s top ten healthy cities made by the American CNN. What the two cities have in common is worth studying: they both emphasize on urban planning, health care system and public transportation; set up cycle lanes and health trails system; encourage sports and garden city construction etc. Their aim is to help people develop a better way of life, let them spend the budget on the prevention instead of the curing of disease. We therefore believe that reducing the number of patients is the best health care system. We also predict that the study of healthy city will be a hot topic in the near future, and the concept of health should be integrated into urban planning – better planning, healthier city.
Singapore Master Plan (2019)
The outbreak of the epidemic has made us realize the importance of the comprehensive health industry in urban development and planning. Health industry covers broad fields: in the primary industry, it involves agricultural products cultivation, food, safety etc; in the secondary industry, it involves pharmaceutical and medical device industries etc; and in the tertiary industry, it involves medical and health care, sports, elderly care, insurance, R & D, and informatization etc. Some places are building health care cities/towns, seeking to integrate the breeding, processing, marketing and health care service together, and aim to achieve interconnected development of the primary, secondary and tertiary industries.
The value of China’s health service industry had grown from 2.4 trillion yuan to 8 trillion yuan between 2011 to 2020, with an annual growth rate of 14.3%. According to the Plan Outline of Healthy China 2030, the value of China’s health service industry is expected to reach 16 trillion yuan, which is a very big increase. It is also predicted that there will be great development in the manufacturing industry of Chinese biological medicine, new varieties of chemical medicine, high-quality traditional Chinese medicine and high-performance medical devices.
From the perspective of medical treatment, more social forces will enter the medical field and more foreign investment will be attracted to set up hospitals in China. With the promotion of 5G, big data, cloud computing, Internet of Things and a series of high technologies, the medical and health field of human society will experience tremendous changes. Wearable devices, smart health electronic products and health care mobile application service will come into our lives.
The combination of China’s health industry with artificial intelligence and big data has already made some achievements. For example, during the outbreak of COVID-19, the ‘health code’ in Alipay had been adopted and promoted to 100 cities in the first week and quickly became the standard tool in urban epidemic prevention, which is a good application of individual big data in disease control.
Health industry can be integrated with elderly care, tourism, the Internet and the fitness industries, to form new health-related business model. A variety of sports fitness clubs and amateur sports events, as well as fashion and leisure sport programs with consumption leading characteristics, such as snow and ice, mountain, water, motorcycle, aviation, equestrian and extreme sports will continue to appear.
In terms of urban and rural planning, there will be many new built forms, such as medical mall, health care complex and health care city, which will put more emphasis on mixed development. Meanwhile, there will also be many health-related industry parks, such as biomedical park, medical apparatus and instruments park, health emergency industrial base and so on.
Health facilities include a wide range of facilities for disease prevention, treatment and rehabilitation. The construction and layout of health facilities mainly include the arrangement of hospitals and clinics. The China’s health care system has four main characteristics: 1) the total amount of resources is insufficient; 2) the resource distribution structure is unreasonable; 3) lack of coordination in the service system; 4) public hospitals are expanding too fast. An indicator of the amount of resource is the number of hospital beds. Despite its continuous increase, the number of beds per thousand in China only reaches 6 in 2020, which has an evident gap comparing with 10+ in developed countries. Unreasonable resource structure is reflected in the weak community level health institutions, and as a result, people often choose class-A hospitals when they are sick. This structure should be improved to greatly strengthen the construction of community health care facilities.
Urban planning should also consider not only the conventional medical facilities at all levels, but also emergency medical facilities, such as the pre-arranged planning for mobile cabin hospitals and the Huoshenshan hospital.
As China is entering an aging society, geriatric hospitals, nursing homes for the elderly, and rehabilitation institutions also need to be arranged in advance. It is better to combine them with the hospitals. When designing community centers and neighborhood centers, in addition to the medical clinics, we also need to consider health care services for the elderly, providing daily care, chronic disease management, rehabilitation, traditional Chinese medicine health care services for them, and even extending nursing services to residents’ homes.
Health facilities should also include sports, fitness, leisure equipment and public open space to promote people’s physical and mental health. The city should be able to provide more small parks, running tracks and basketball courts, which belong to disease prevention facilities.
Singapore’s community planning is very distinctive, with its public housing system world famous. Punggol New Town, for example, conforms to the characteristics of the WHO healthy city. It has mixed development of industry and residence, mixed multi-ethnic living which leads to social stability; commercial, medical, education, sports and welfare facilities available within 5 minutes walking distance; good quality waterway and greenery; and high coverage of TOD bus service.
Punggol Waterway Terrace, Singapore
Today, the focus on community level organizations and community public service facilities is emphasized by many researchers and practitioners in the planning field. Since the outbreak of COVID-19, this topic is also discussed a lot by Chinese planning professionals. Singapore emphasizes the two-layer structure of new towns and neighborhoods, neighborhoods are like healthy cells, when the cells are healthy, the body is healthy. Suzhou Industrial Park has learned from the experience of this ‘neighborhood unit’ and ‘neighborhood center’ concept since 1994, and has achieved very good results.
Transit Priority Channel, Bencoolen Street, Singapore
In fact, the idea has been around since the British Garden City Movement in the 19th century. The British planning system places a lot of emphasis on the basic unit. In the 18th and 19th centuries, epidemics of infectious diseases such as malaria and cholera in British cities promoted the integration of urban planning and public health systems. In 1848, the British Public Health Act was enacted, which became the first comprehensive public health act in human history to promote urban development. In order to solve the ‘urban disease’ brought by industrialization, the British planning pioneers kept exploring, and in 1898, the Garden City theory was proposed, which laid an important foundation for the birth of modern urban planning in the early 20th century.
Chronic noncommunicable diseases have expanded since the 1960s, and the outbreak of infectious diseases in the 21st century have brought new challenges to healthy cities. It seems that these planning ideas are still working in the current context. For instance, 1) neighborhoods and workplaces should be close to each other in order to reduce long-distance mobility, lower the flow of commuter traffic, as well as reduce traffic congestion and vehicle emissions; 2) abundant community-level service facilities can bring more convenient daily services to residents, including medical care and healthy leisure services, which will help to increase the neighborhood cohesion – this is also the future development direction of healthy cities.
Nowadays, many places are talking about the “Future Community”, which is driven by new technologies and the Internet of Everything. This is our future hybrid living space, a new way of life, and a form of healthy cell in our healthy city. In short, the outbreak of disease has shown us the value of the community.
Urban planning is a kind of science, an art and a policy movement. Planners need a very rich knowledge structure. They should not only care about the built form, but also pay attention to economic and social development, and at the same time, they should not forget urban safety issue.
According to an urban historian, a city is a safe, busy and sacred place, which is the triple attributes of a city. Usually we focus on the attribute of ‘busy’, working for industrial development and urban expansion – planners are always very busy. This outbreak reminds planners to pay attention to safety issue. It covers a wide range of fields, involving nature science and engineering. Each field is deep and specialized, such as lifeline engineering, health care safety, infrastructure planning and design etc. Urban planning also involves a lot of sacred elements. In the past, it may be temples, churches, squares and palaces. Today, it could be cultural buildings, opera houses, civic activity centers where people pursue their spirit.
In such a complex system, urban planning is an industry requiring collaboration, which inspires us that the requirement for professional quality is the ability to learn, especially deep learning ability. Planners should shape themselves becoming expert in one field while possessing all-round knowledge and ability, namely the “T-shaped Talent”. The horizontal can be achieved through collaboration, while the vertical is where our value actually lies.
The length of the vertical line is the degree of expertise that determines our height. All the planning and design agencies are professional service institutions, which rely on their expertise. The number of horizontal lines determines our breadth, a lot of enterprises are now emphasizing the integration of resources and collaboration of work. An excellent urban planning work is the result of the collaboration of numerous high-value talents.
Therefore, the most important thing for urban practitioners is to find their own positioning, continue to dig deep into their own professional area, be able to leverage their comparative advantage with continuous innovation, and become a specialist in their field. At the same time, they should also have an open mind, so as to actively cooperate with people around.