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Early Days in Urban Health Reconstruction

7 min read

During 1858’s Great Stink, London’s Thames River was so foul that members of Parliament fled, and Parliament shut down. Overnight, the problems of industrial urbanization that eminent Victorians had been benignly neglecting for 30 years—wanton pollution, slums and their overcrowding, infrastructure overload, and increasingly severe cholera epidemics—became a national crisis. “Forced by sheer stench” as the Times put it, the members voted funding of sewer upgrading in only 18 days, undoubtedly congratulating themselves for solving the problem.

Completing that work took 17 years.

With 2020’s Great Hunkering Down, ‘two weeks to flatten the curve’ having stretched into 20 months for urban uncertainty, the problems of post-industrial urbanization that eminent Americans have been benignly neglecting for 30 years—pharmacologically enabled mental illness, invisibly housed immigrants and their overcrowding, intractable cycles of poverty, legacy development barriers, spatial and racial separation—have become a national crisis. Forced by tweets, elected officials worldwide have glopped money into portmanteau spending bills, congratulating themselves each time.

Completing this work will take at least ten years.

Our fast-lick, swipe-left world is not used to overnight crises that refuse to be solved overnight. Cities’ value propositions depend on health and safety, its reality and its perception, both of which we took for granted until they shattered in a fortnight. Reconstituting urban health and safety and recovering our self-possession will take time, strategy, consistency and maturity. As of this writing, we have barely started any of that.

The broad outlines are clear. Operational workarounds, like hand sanitizers, masks and social distancing—all visible, participative and annoying—will give way to invisible, automated, readily acceptable systems change, such as app-controlled full-building flow rates, dynamic venting and auto-scrubs, like long-lasting self-disinfecting coatings. Innovation being unpredictable, we cannot say what will arrive when. Changes likely will be little to big, cheap to costly, temporary to durable, so let’s start small and work upward:

  1. Work-from-home becomes a permanent feature of rebalanced employer-employee relations. Workers who can adapt to working from home mainly prefer working from home. Though managers hate this, and many are in denial, their leverage is limited. Coaxing the workforce back to the office is highly location-dependent: the taller the headquarters, the tougher it is to recruit returnees. Already we are seeing huge geographical variation in return-to-office outcomes, with big consequences for office buildings, central business districts and job migration patterns.
  2. Ubiquitous in-home broadband upends owner-resident dynamics. With Freecycle and Nextdoor, what began as simple peer-to-peer swap or sell marts have become gossip forums for all things local, including intra-building mores. If truth travels fast, rumor travels faster, and woe betide the target owner or management agent that is neither listening nor responding. 
  3. The job-hopping epidemic is quelled with emotional loyalty tools. Ambitious employees not physically attached to their company are easier to poach, especially when they need not move either to search for or to start their new job. To stanch this talent outflow, companies have to adapt by consciously addressing non-financial benefits: affirmatively managed career paths, encouragement of old-to-young mentorship, intra-company mission marketing to employees, and office-centric social events to build intra-company attachments. Coaxing workers back, and keeping them emotionally connected, are new managerial skills for which hierarchical seniority is sometimes a drawback.
  4. Specialist individuals not emotionally attached to their company opt for perma-gigging. As employees seek meaning, employers seek productivity, and some meet by creating a self-renewing perma-gig: a reliable steady worker who’s only part-time, flextime or balancing among several employers. This works best for any company activity (e.g., bookkeeping, marketing, travel, health insurance management) that’s both periodically necessary and less than a full-time employee’s worth, much less a full-time office workstation’s.
  5. Indoor airflow management goes high-tech. At each new construction or substantial renovation, existing primitive flow controls, like thermostats, go the way of the dodo, displaced by whole-cubic smart systems that continuously analyze, circulate, scrub and refresh, including dynamic subtle reversal of negative-pressure rooms that align with the biorhythms of people moving about their homes, offices and gathering places.
  6. Zoning has its marijuana moment. Jury nullification—acquitting a defendant guilty in law because ‘if the law supposes that, the law is an ass’—has a centuries-long history of anachronistic laws whose harmful effects have become too widespread to ignore. Half a dozen years ago that happened with marijuana, and as work-from-home remains embedded in every city and town, the 19th-century two-dimensional division of cities based on activity type simply becomes nullified, leading to the next upheaval.
  7. NIMBYism is assaulted as racially inequitable spatial segregation. Until COVID, no one had the antidote to NIMBYism. Visualizing zoning’s downstream consequences through a racial lens has made defending exclusionary development restrictions morally impossible, and the endgame of a political siege is always the same: the fortress falls. Ask taxi medallion owners or Daniel Snyder.
  8. Information technology pervasively infuses high-density live, work and play environments. New dynamics between owners and renters, employers and employees are driving this as a pragmatic emotional-comfort perk. Plentiful discreet perceptive gadgetry will be everywhere: IAQ monitoring, biometric scans (infrared thermometers at ingress and egress, carbon dioxide levels in community rooms and hallways), airflow metering and biological analysis of air particulates and sewage outflows, possibly down to the suite or apartment level.
  9. Real-time health-status transparency is a competitive advantage. Perception is what we experience, and experience can be delivered digitally, in real time, with visual cues (colors, pie and bar charts, with animation), on both desktops, mobile phones and in lobbies, elevators, and common areas. Naturally, owners and managers will be both capturing and curating the information beforehand so make sure messaging is keeping up with reality and perception (see Point 2 above!).
  10. Incentivized by insurance, preventive healthcare is woven into living environments and incentivized by insurance. Now that societal, economic and corporate well-being depend on the physical and emotional health of employees, residents, on-site vendors, stake-holders and voters, anyone who owns a large income-producing property ardently desires the people in it to be healthy. Just as fire insurance companies became experts in fire prevention and mitigation, Health Care Organizations and employers become experts in preventive healthcare to boost connectedness and attachment, quality of life and health span.
  11. Hospitals and healthcare organizations are long-term campus-conscious co-development partners. Campus anchor entities (universities, hospitals, high-tech hubs and casinos) are already active long-term master-planning developers of mixed-use communities.  For housing developers, these partners bring land, demand aggregation, risk reduction, long-term capital availability and local voice legitimacy: not joint venture, but real estate symbiosis.
  12. Healthy Home certification has standardized, probably both via objective external metrics and social media’s five-star user ratings. Standards offer component interoperability, administrative safe harbors, litigation shields, brand reinforcements. 
  13. Auto-surveillance and big AI have created customized stereotyping, with frighteningly accurate results. Among Facebook, Amazon and TikTok, intrusive contactless emotional and physical surveillance has already arrived. If we are what we do, the bots decide who we are based on what they observe us doing (“all for your own good, of course”). People don’t like that…but they do like customized content and being able to record their encounters and make them public. Health fears, digital surveillance and social media are crashing into people’s desire for privacy for me, if not for thee. Property developers, owners and managers are about to be caught in the middle.

As Master Yoda said, Begun the privacy war has.

David A. Smith is founder and CEO of the Affordable Housing Institute, a Boston-based global nonprofit consultancy that works around the world (60 countries so far) accelerating affordable housing impact via program design, entity development and financial product innovations. Write him at dsmith@affordablehousinginstitute.org.