Health Secure Cities

6 min read

Urban Planning in a Pandemic

For examples in world history of grand changes to urban planning, look no further than a health crisis. It is often how major civil works projects that should’ve happened long before finally get done. The Bubonic Plague that killed a third of Europe in the 14th century spurred urban decentralization. The cholera outbreaks of the 19th century led to the construction of sewage systems in many global cities. And the various public health problems that arose during America’s industrial era drove sweeping Progressive Reforms, such as the planning of large parks to encourage clean air and less crowding. Will the Coronavirus pandemic lead to changes like this? In the U.S. it already inspired a six-month partial shutdown of society, so long-term shifts seem likely, especially in dense cities where the virus could spread more quickly. Primary among them is the move out of cities altogether, as technologies like remote conferencing and faster broadband make suburban and rural living more attractive. As of deadline for this article, people were flooding out of New York, San Francisco, Los Angeles and other big U.S. cities.

The big infrastructure “shift” then, might be for these cities to retrofit themselves in ways that make them more healthy and resilient to pandemics, compelling people to stay. Below are three broad-level ways cities can do this.

When a pandemic hits, it means that urban dwellers will—as they’ve learned these past six months—have to spend lots of time quarantined in their homes. So it’s important that these homes are “healthy” – well-ventilated, sanitized and able to prevent disease. Tax Credit Advisor columnist David Smith and a team at the Affordable Housing Institute are developing a concept called Health Secure Housing (HSH) that promotes a vision where almost every aspect of a building’s design is geared toward positive health outcomes, especially related to Coronavirus. Building entries have voluntary check-in stations; on-site staff offer preventive care; elevators are refurbished for better ventilation; communications between landlords, workers and tenants are done remotely and electronically to the greatest extent possible; and much more.

“Those who live in affordable housing will be incontrovertibly demonstrated to be particularly vulnerable, through the combination of pre-existing risk profiles and then by definition living in close quarters with many others,” writes Smith. “These hard-won insights will coalesce into a national health reinvestment strategy that focuses on making sure those most susceptible to this disease are able to live in Health Secure Housing.”

While Smith sees HSH as an idea that could be rolled into federal housing policy, via tax credits and bond cap allocations, an even more landmark shift would be if it became common private sector policy. There’s already a move among some builders towards health-oriented design practices – namely via Fitwel certification. HSH would be another move in that direction.

It’s not just a concept that needs be applied to housing, either. If the U.S. economy is to rebound and our collective spirit to return, we eventually must reopen civic institutions that define our way of life – schools, stadiums, theaters, indoor malls and more. Because they cluster people even more tightly, those facilities will have a stronger need for health design best practices.

Coronavirus hit urbanized states like New York, New Jersey and Massachusetts much harder than less urbanized ones. There is no scientific consensus on why, but explanations abound, ranging from their global connectivity, to their mishandling of nursing homes, to their population density. Another explanation is that high percentages of the population in these states take transit.

Some scientific literature has questioned the connection between transit use and Coronavirus spread, but the stigma remains, and transit ridership has plummeted. There is a certain logic to this, as people might naturally avoid crowded, indoor, underground trains with poor ventilation and lots of potential for germ spread.

Some agencies, such as the New York Metropolitan Transportation Authority, have done an admirable job of having rotating cleaning schedules. But this will become harder to maintain financially as transit continues suffering from a “death spiral” of lower ridership and receipts, which was occurring before the pandemic.

Another approach could be for cities to encourage rideshare services that are solo or carry only a few passengers. Nascent companies like Uber already have policies in place to disinfect vehicles. This alternative transport option, which has long struggled for regulatory approval in many cities, might finally get it on the basis of promoting public health.

Another wrinkle in the post-COVID-19 transport landscape is that there will be fewer trips overall. Businesses have adjusted during the pandemic by ramping up their remote work operations, which has reduced the need for commuting.

Public Spaces
The most lasting consequence of Coronavirus—simply because it’s the easiest to pull off—may be with public spaces.

There already had been a growing call in America’s cities to reduce the space dedicated to the automobile and use it for other purposes. Urbanists have been pining, for example, to replace free on-street parking in cities like New York and San Francisco with bike lanes, parklets, etc.

But al fresco dining is the truly essential use for the moment. Because of social distancing orders, many restaurants cannot operate at full capacity. Letting them move their dining outdoors and onto parking spaces is how they can continue to serve customers. My hope is that cities recognize during these pilot tests that outdoor dining bolsters community life and makes the changes permanent.


There can always be downsides to governments taking such aggressive actions on behalf of public health. Post-World War II urban renewal was justified as a means to clear slums and improve sanitation but was mostly just a scheme to raze minority neighborhoods for roads. One concern The Guardian had for our current crisis is that by trying to track the virus’ spread, governments are setting up a mass surveillance state that could later be used for dubious purposes.

That’s not something that will make more people want to live in cities. But the wider prospect of safe urban housing, transport and public spaces will, and changes to it could be coming.