Do No Harm: Dilemmas in Planning for Health

Planners have long imagined themselves as physicians attending to the good health of cities and the communities living in them. Do No Harm unpacks the complex connections between environmental health, public health, and city planning. The course title, a nod to both the Hippocratic Oath and the creed of social reformer Florence Nightingale, represents a challenge to students preparing to manage the discrete, conflicting interests of that most complex of organisms–the metropolis. 

This class uses housing as a starting point for a sectional slice of inquiry that spans from the underground to the air that surrounds us. We will discuss how the design, policy, geography, ownership model, and maintenance of housing influence various public and environmental health metrics, and what levers are available to planners to influence those outcomes. We will explore and evaluate tools of assessment and intervention and identify points of leverage. Within this framework, students are expected to bring their own interests, disciplines, and experience to bear on a semester where our focus will range from affordable and simple tools at the housing-health nexus (smoke detectors, mosquito nets) to more complicated questions of ethics, objectives, and priorities. 

Together we’ll consider the nexus between health and planning as an ongoing process of experimentation, monitoring, learning, and adaptation, with the aim of constantly improving the conditions that promote health for all populations, but with a particular focus on improvements that alleviate the inequities currently experienced by segregated and disinvested communities around the world.

The class will be divided into two streams–input and action. In the input part of the class students will study famous and infamous stories about how our decisions can harm or heal communities, such as Haussmannian hygienist efforts in France, the rise of air-conditioning in Global South cities, or slum clearance in the United States. In the action component groups of students will develop an approach to addressing a real problem in a real place, using housing as a lever for better health. These may be speculative or tailored for a client who works at this nexus between planning and health (the Parisian Roofscapes). These outputs may take the form of written reports, graphic visualizations, or creative endeavors which students will refine and pitch at midterm and final presentations.  

We’ll ask: What are the key health issues that should concern those in planning and related fields? Can physical design and planning alone improve health? In a world of finite resources, how do we weigh competing priorities and evaluate the costs and benefits of our interventions? Do we need values systems to guide or restrain technocratic evidence-based approaches? Where are the limits of our responsibility for health outcomes in our jurisdictions? 

This course will equip you with the understanding, vocabulary, and tools you need to make health a part of your future practice, whether you become a housing advocate, a land use planner, a developer, an urban designer, a transportation planner, or some other role entirely. For those who come from the world of public health and environmental policy, you will gain new insight into the powers and politics that enable and constrain planners, architects, and other practitioners in the city.

The first day of classes, Tuesday, September 3rd, is held as a MONDAY schedule at the GSD. As this course meets on Tuesday, the first meeting of this course will be on Tuesday, September 10th. It will meet regularly thereafter.