One key theme of this Midwinter leadership meeting has been the disruption of traditional definitions of space and sectors. E-commerce companies are buying manufacturers, retailers are becoming logistics companies, industrial spaces and offices are being blended with housing and other uses. These have profound implications for cities and space.
Today, Sir Malcolm Grant, Chairman of the UK’s National Health Service – such a source of British identity and pride that it was honored in the opening ceremony of the 2012 London Olympics – presented a compelling case for the role of real estate in promoting health. And he didn’t mean building hospitals or clinics. In fact – he said we needed to “rethink the hospital,” since critical care facilities are not the appropriate places to address the major contributors to poor health today. Namely, the way people live.
Whereas communicable diseases once were the major causes of death (and, sadly, still are in many developing countries), the primary causes of death in the developed world are now lifestyle-related. Said Sir Grant, “we’re moving from the plague of infection to the plague of human behavior.” And that plague is one ill-addressed by the health care system, no matter how efficient and high quality. In fact, the UK’s National Health Service ranks #1 compared to many other countries on many quality and delivery factors, but is nearly on par with the US (which is to say – not good) when it comes to producing healthy lives. That’s because the health system only accounts for 10% of health outcomes. The rest is determined before birth (via genetics) and then how we live.
Whether it’s super-sized portions and bad nutrition, lack of physical activity, or poor air quality, people have overtaken germs as the cause of our downfall. And, sadly, skyrocketing spending on health care is crowding out expenditure on other things (education, environmental protection, parks and recreation facilities, and infrastructure – including transit) that are positively correlated with healthy lives.
Getting people moving is essential to reducing obesity, and associated ailments such as diabetes. That speaks to building layouts, density, and transport infrastructure. As populations age, spaces that enhance social support networks to treat dementia and designs that keep them safe from falls and other accidents are critical.
Former ULI Chair Todd Mansfield observed that this is very exciting for the real estate community, because it provides an “extraordinary opportunity for us in the built environment to promote health” by building “walkable, mixed use, more dense environments that allow greater mobility and a sense of community.” Maybe that’s what Sir Grant meant when he said, “Health is the new wealth”?