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Healthy Higher Density Living Issues Paper - 2017
Healthy Higher Density Living Issues Paper - 2017
Higher
Density
Living
Issues Paper
MELISSA O’NEILL.
Centre for Population Health,
Western Sydney Local Health District
LUCY FOKKEMA
City of Parramatta
Healthy Higher Density Issues Paper
As part of an ongoing strategic partnership, the Centre for Population
Health, Western Sydney Local Health District (WSLHD) and City of
Parramatta Council (Council) have jointly developed this issues paper,
outlining recent insights into the lived experience and attitudes of people
living in higher density in City of Parramatta local government area (LGA).
December 2017
1 https://www.greater.sydney/content/three-cities
2U dell T, Daley M, Johnson B, Tolley, R, Does density
matter? The role of density in creating walkable
neighbourhoods, Melbourne: National Heart
Foundation of Australia, 2014, accessed online
<https://www.heartfoundation.org.au/images/
uploads/publications/Heart_Foundation__Does_
density_matter_FINAL2014.pdf>
These trends will intensify. Parramatta’s population is Current evidence identifies that higher density
forecast to grow from over 245,000 people in 2017 to neighbourhoods can improve health for residents
397,000 people in 2036 (62% increase). A large share by increasing opportunities for physical activity,
of these people will be housed in higher density, social interaction and access to daily living needs.2
particularly in urban renewal areas. However, poorly designed and located apartments
can have a negative impact on residents’ health.
Our community has consistently told us that
managing the impacts of growth is one of their Purpose of this issues paper
major priorities. Increased public transport and
The purpose of this issues paper is to provide a concise
pedestrian accessibility, improved facilities and
overview of the health impacts of living in higher
increased access to green space and recreation
density in City of Parramatta, and to consider a range of
opportunities are required to support development.
options for minimising negative health impacts.
Definitions
Term Definition
Medium The following dwelling types were classified as medium density: apartment/flat
density (up to 3 storeys); duplex/semi-detached/villa; flat above shop.
The following dwelling type was classified as low density and screened out of the
Low density
survey: ‘separate house’.
“Living in Includes participants living in both medium and high density dwellings. Higher
higher density” density neighbourhoods can consist mainly of medium density dwellings.
Issues paper 5
How did we develop
this issues paper?
This issues paper draws on:
Literature review. A review of current academic WHO WILL USE THIS
literature was undertaken to provide a context for this
issues paper.
ISSUES PAPER?
Healthy Higher Density Living Survey. The pilot survey
This issues paper will assist
consisted of 27 questions, incorporating a range of social planners, land use
validated questions from a number of similar studies.
The survey was administered to 425 City of Parramatta planners, policymakers and
residents living in higher density in October to
November 2016, via the Our City Your Say online panel. other decision makers to have
Interviews with Council and WSLHD staff. Stakeholder an understanding of the issues
interviews were undertaken with staff from a number
of teams within Western Sydney Local Health District and evidence base regarding
and City of Parramatta Council. These informal
consultations revealed a number of key themes
higher density living in City of
regarding the health impacts and risks of higher Parramatta.
density living for residents in City of Parramatta.
Issues paper 7
Experiences of
higher density living
in Parramatta
The Healthy Higher Density Living Survey aimed to gain insight into the experiences of
residents living in higher density in City of Parramatta. In total, 425 residents responded
to the survey, and some of the key insights included:
Almost half of respondents identified that they would like some or more interaction
with people in their neighbourhoods. Respondents who lived in apartment buildings
up to three storeys were most likely to feel they had enough social interaction.
Respondents were more likely to run into people they knew close to their buildings,
near the entrance or in communal facilities.
3 https://www.heartfoundation.org.au/images/uploads/publications/Heart_Foundation__Does_density_matter_FINAL2014.pdf
4 Giles-Corti B, Ryan R, Forster S. (2012). Increasing density in Australia: maximising the health benefits and minimising the harm. Report to the
National Heart Foundation of Australia, Melbourne.
5 https://www.cancercouncil.com.au/wp-content/uploads/2011/08/Passive-smoking-SHS-Apartments-Achieving-smoke-free-Apartment-
living-on-line-kit-Final-as-at-30-8-11-30-August-2011.pdf
6 Heenan R. (2017). Healthy High Density for Kids. The effects of high-density housing on children’s health and development: a literature review
to inform policy development in Western Sydney.
10 Healthy Higher Density Living
Cardiovascular mortality
• Due to exposure to environmental stressors
such as, air pollution and traffic. Higher density
housing located on roads with heavy traffic may
increase the risk of cardiovascular disease.
Road traffic mortality
• Due to neighbourhood features that increase
the risk of pedestrian injuries, particularly for
children. These features include: high traffic
speeds and volumes, increased curb parking,
the absence of a park or play area near home
and the presence of crossings where there are
no traffic lights present.
Cancer mortality
• Due to an increased exposure to environmental
stressors e.g. air pollution. In addition to the
potential negative impacts of living in higher
density on lifestyle risk factors including physical
activity, smoking and fruit and vegetable intake.
Mortality
• A number of studies have found over-crowding
is positively associated with mortality. The
evidence between crowding and mortality was
consistent, regardless of whether crowding was
measured by persons per room or the number of
housing units per structure. However, there was
no association for population density.
However, higher density neighbourhoods that are
well located, planned and designed can deliver a
wide range of positive health benefits.
Issues paper 11
Characteristics of
healthy higher density
neighbourhoods
To plan and deliver healthy higher density neighbourhoods, policy makers
need to address three different domains simultaneously: the building, the
socioeconomic and cultural make up of residents, and the quality and amenity of
the neighbourhood as a whole.3
Figure 1: The domains which require simultaneous consideration to ensure healthy higher density neighbourhoods.
The building including its location, • The social environment can be improved by:
construction, design, management • Designing developments to encourage opportunities
and maintenance. for selective rather than enforced interactions as this
ensures positive interactions that protect the mental
• Healthy higher density buildings are located health of residents.
with easy access to public transport, shops,
• Co-locating families on the same level, as this creates
social infrastructure, services and a hierarchy
a sense of community.
of public open space and away from roads
with heavy traffic.4 • Achieving higher densities through lower rise
development as it is optimal for families and
• Building design features include: older adults.
• Noise insulation • Adequate provision of social and affordable housing to
reduce housing stress and enable households to meet
• Breeze ways that optimise ventilation
basic living costs.4
• Designing balconies, windows and draw points
for air conditioners so they do not overlook The quality and amenity of the
roads with traffic neighbourhood.
• Use of Crime Prevention through Environmental Design
• Factors that encourage active modes of transport
features to enhance territoriality and promote natural
and promote healthy higher density living by
surveillance
impacting on residents’ quality of life include:
• Providing opportunities for selective interactions
• The appearance and aesthetic appeal of the
between residents including children
neighbourhood.
• Co-locating families on the same levels, for example
• Diversity of land uses which create opportunities for
by locating three bedroom apartments on the same
interactions and contribute to a sense of community.
levels, where feasible
• Access to public transport services.
• Ensuring housing is large enough to accommodate
families will prevent overcrowding.4 • Access to services and recreational destinations
including; shops, schools, places of worship, healthcare
• Healthy higher density buildings often have
facilities, social and community facilities and public
a suitable level of governance to create a
open space.4
functional living environment which reduces fear
and influences real and perceived safety.4 • Overall, the needs of children, young people and
older people require special consideration to ensure
The socioeconomic and cultural additional negative health impacts are not experienced
by these population groups.4
make up of residents and the local
neighbourhood.4
• Low socioeconomic status is associated with
poor quality housing and poor general health and
mental health outcomes. The presence of crime,
vandalism and disorderly behaviour clusters
is amplified in high density areas.4
Issues paper 13
What are the health impacts
of high density in Parramatta?
A number of health-related questions were included Of concern is:
in the Healthy Higher Density Survey (2016).7 Results
indicate that the health status and behaviours of • 65% of respondents felt stressed some of the
time in the past four weeks. A further 16% of
respondents were mixed.
respondents reported they felt stressed either
The good news: most or all of the time. In comparison, in 2015, 9% of
the WSLHD population reported high and very high
• 69% of respondents rated their health during the levels of psychological distress.10
past 4 weeks as either excellent or very good
• Only 6% of respondents consumed the
• Only 4% of respondents reported they smoke. In recommended five serves of vegetables a day
comparison to the WSLHD population, 14.3% of the and 31% consumed the recommended two serves
WSLHD population aged 16 years were smoking in of fruit per day. In comparison, in 2016, 4% of the
2016.8 population aged 16 years and over consumed the
recommended servings of vegetables and 43%
• The top destinations people walk to in a of the WSLHD population aged 16 years and over
usual week are: consumed the recommended servings of fruit per
• The shops (69%) day.11
• Around the neighbourhood (65%) • 47% of respondents identified they would like
some or more interaction with people in their
• To public transport (63%)
neighbourhoods.
• To a park/oval/bushland (53%)
These results indicate that the majority of respondents
• 32% of respondents reported they walked to work, have excellent or very good self-rated health. Self-
which is significantly higher than the community as rated health is a strong and independent predicator
a whole where 4% walk to work.9 of subsequent illness and premature death.
• Only 1% of respondents reported they do not walk However, the results which identify behavioural risk
anywhere in a usual week. factors for chronic conditions are mixed. The good
news is, smoking rates are low and weekly incidental
walking levels are high. However, fruit and vegetable
consumption is very low and perceived levels of stress
are high.
7 Fokkema L, Wearne K, O’Neill M. (2017) Healthy Higher Density Living: Summary Survey Report. Available from:? .Please note, the results are
from a convenience sample and therefore may be biased.
8 http://www.healthstats.nsw.gov.au/Indicator/beh_smo_age/beh_smo_lhn_trend?filter1ValueId=18395&LocationType=Local Health
District&name=Smoking&code=smo
9 https://opendata.transport.nsw.gov.au/dataset/journey-work-jtw-2011/resource/85258a6b-e7d1-46e1-bb2e-570f59e00db0
10http://www.healthstats.nsw.gov.au/Indicator/men_distr_age/men_distr_lhn_trend?filter1ValueId=18395&LocationType=Local Health
District&name=Mental health&code=men bod_dementhos
11 http://www.healthstats.nsw.gov.au/Indicator/beh_veg_statage/beh_veg_lhn_trend?filter1ValueId=18395&LocationType=Local Health
District&name=Nutrition&code=beh_veg mab_feed mum_folate beh_feed
14 Healthy Higher Density Living
To maximise the health outcomes for residents it is essential that the health
impacts of higher density housing are considered through councils planning
controls and internal policies. As indicated by the evidence, effective planning
of higher density housing can improve the health outcomes of residents.
Specific considerations which will positively impact the behavioural risk factors
assessed in this survey include:
• Ensuring fresh healthy food (fruit and vegetables) is affordable and accessible in higher
density neighbourhoods
• Ensuring access to; public transport, active transport opportunities, a variety of local
services, social infrastructure and recreational destinations, and a hierarchy of quality
green open space.
• Locating higher density developments away from busy roads, and ensuring
environmental stressors such as crowding, noise, poor indoor air quality and lighting
are considered during the design of buildings.
Issues paper 15
What impact has higher density
growth and development had
on Council and WSLHD service
provision?
In 2016, Western Sydney Local Health District (WSLHD) and Council conducted interviews with teams whose
operations have been affected by increased population density. The interviews have been summarised to
highlight the unique ways that higher density has had an impact on service provision for Council and WSLHD.
Council perspective
Impact Examples
WSLHD perspective
Impact Examples
• Limited parking for visitors or allocated parking for essential services around
Limited parking and within developments.
• Limited pick up and drop off zones for community buses
Inability to
• Difficulties conducting/completing home visits
conduct home visit
o Due to crowding creating a lack of privacy for the client
consultations
Issues paper 17
What approaches could
Council and WSLHD consider
to minimise the negative
impacts of high density living
on people’s health?
Considering the pace and intensity of development across City of Parramatta, it is essential that Council,
WSLHD and their partners continue to advocate for healthy higher density neighbourhoods which improve
individual and community wellbeing. Minimising the negative impact of higher density living on residents
requires collaboration between key stakeholders across a number of potential approaches.
The recommended approaches are summarised below.
Continuing to • Continue to research the impacts of higher density living on 0 – 5 year olds.
research the health • Scope research to understand the health and wellbeing impacts of higher density on
impacts of higher residents in lower density.
density living
• Investigate opportunities to research the long-term health impacts of living in higher
density on residents.
Promote the use of • Make the extensive research into the health impacts of high density living readily
existing tools that available for relevant departments
promote positive • Promote the existing tools that support positive health outcomes in higher density
health outcomes in neighbourhoods by planners and developers, e.g. Healthy Urban Development
higher density Checklist, Heart Foundation’s Healthy Active by Design, Social and Health Impact
Assessments, Apartment Design Guides, etc.
• Working to finalise the Draft Social Infrastructure • Undertaking research into the health impacts of
Strategy, which outlines City of Parramatta higher density living on 0-5 year olds. WSLHD is
Council’s long term direction for social leading research into the health impacts of higher
infrastructure provision to support our growing density living on 0-5 year olds, including guidance
communities and improve the quality of life, and on healthy higher density living for children in City
health of our residents. of Parramatta.
READING LIST
Local research: Literature
• Fokkema L, Wearne K, O’Neill M. (2017) Healthy • Giles-Corti B, Ryan R, Forster S. (2012).
Higher Density Living: Summary Survey Report. Increasing density in Australia: maximising
the health benefits and minimising the harm.
• Heenan R. (2017). Healthy High Density for Report to the National Heart Foundation of
Kids. The effects of high-density housing on Australia, Melbourne. Available from: www.
children’s health and development: a literature heartfoundation.org.au/images/uploads/
review to inform policy development in publications/Increasing-density-in-Australia-
Western Sydney. Evidence-Review-2012-trevor.pdf
• The Committee for Sydney. (2016). Making • NSW Commission for Children and
Great Places, Density Done Well discussion Young People. (2009). Built4kids: A good
paper. Available from: www.urbangrowth.nsw. practice guide to creating child-friendly
gov.au/assets/Living-Cities/CfS-Discussion- built environments. Available from:
Paper-Making-Great-Places-Density-Done- http://cdn2.hubspot.net/hubfs/522228/
Well.pdf documents/NSWCCYP2009-Built4Kids.
pdf?t=1503784038100
• Heart Foundation. (2017). Healthy
Issues paper 19