Urban Health and the Built Environment

On a grey February evening, the lure of complimentary wine and cheese, and a great track record of talks was enough to find me at the University of Westminster’s Fyvie Hall. There, James Wates, CEO and Chairman of the Princes’ Trust Built Environment Leadership Group and Vice Chair of the Queen Elizabeth’s Foundation for Disabled People was presenting ‘Why Professionalism is as important to the built environment as it is to medicine‘.

Image Credit: A Bow-Bertrand

Made it. Image Credit: A Bow-Bertrand

You may be wondering how there can be crossovers or comparisons drawn between the construction industry and the field of medicine. But both fundamentally prioritise quality of care and safeguarding of human welfare. Indeed, Wates drew on our immediate situation, highlighting that it was essential for us to have cover and warmth in order for the talk to proceed. So too, in order to survive, we need buildings in the form of schools and hospitals, shelter in the form of a roof on our homes and functional infrastructure to provide sustainable supplies of potable water.

Wates then cited the comparable need for teamwork between the two sectors using John Godfrey Saxe’s 1878 analogy (by way of Indian parable) of five blindfolded builders touching an elephant (one touched the trunk and thought he was dealing with a hosepipe; another a leg and thought it was a tree, another the tail and surmised it was a rope, yet another the body of the beast and thought it was a wall, and finally another touched the tusk and thought it was a sewer). Only through communication, cooperation and prioritisation of what Wates called ‘professionalism’ could the safety and suitability of the finished product (which he related to the medical ‘patient’ or bodily construct) be ensured.

Image Credit: A Bow-Bertrand

Making Introductions. Image Credit: A Bow-Bertrand

Where mistakes are made on a construction project, they are, according to Wates, frequently irreversible as is the case in much of medicine in which: ‘good patient care turns into misery and despair; for the built environment projects that turn bad can damage so much. The advantage the built environment professional has is scale; we do big things that can last for generations’. To me, it is problematic to suggest that professionalism is of comparable importance to the building industry as to medicine. Or, rather not that it isn’t important but to question whether they are even synonymous.

Indeed, medicine, unlike construction, is a profession in the vocational sense. So to consider professionalism as a quality of it is to overlook the very composite quality of this field. The two are not comparable, and can only be contrasted to a certain extent. Certainly, I agree with Wates’ comment that ‘the built environment and medicine have a lot in common. Each have a number of different specialisms which seek to address particular issues. When it works it all goes well, when it doesn’t then there are major problems and we end up losing focus on what we are trying to achieve’.

However, in spite of the caveats, there is real interest in this field in terms of medicine and global health, most particularly in how the built environment can impact user and client wellbeing. We have all read reports of office  workers who sit near to a window who sleep better at night and those who report greater work satisfaction if there is sufficient communal space within their workplace. This is one facet addressed by and in the area of urban health, but which demands a discourse of management rather than ‘professionalism’.


Image Credit: A. Bow-Bertrand

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