NICOLAS NOTIN, project manager for urban health and the Greater Paris Area at the Agence régionale de santé (regional health agency), in Île-de-France
ANTHONY BÉCHU, architect and director of the Béchu + Associés agency
MAXIME VALENTIN, head of sustainable development and innovation for the Lyon Confluence project
Nicolas Nicotin, setting aside the current pandemic, can we hope to live a long, healthy life in Paris?
N.N.: Within Paris city limits, overall, the health indicators are good. There are fewer chronic diseases and cardiovascular diseases than in most regions in France. However, there is great social and territorial disparity in health in the region, between the 8th arrondissement in Paris, and some northern municipalities: there is 7- or 8-year gap in the life expectancy among men! Setting aside the current pandemic, the major problem remains air pollution. Although the concentration of pollutants (nitrogen dioxide, fine particles and ozone) has stabilised, and even slightly decreased, it remains high near infrastructure such as national and departmental roads. It is a factor which causes or worsens respiratory diseases (asthma, bronchitis) and strokes. Noise pollution comes up nine times out of ten, among the issues raised by residents, but it is not currently being addressed using reinforced engineering methods.
On which urban problems has the pandemic shed light?
N.N.: One subject that came back to the forefront with Covid-19 is the inequality between health sectors in different departments, which stems from socioeconomic inequalities. The crisis affected the most disadvantaged populations, those most exposed due to their work and housing conditions. The vulnerability of Seine-Saint-Denis in the face of the virus comes from factors such as overcrowded housing (up to five hundred people live in a shelter designed to house two hundred), education and work that cannot be performed remotely. Moreover, the municipalities hardest hit by Covid-19 struggle to access quality fresh products. Young people affected by excess mortality generally suffered from comorbidities such as diabetes or obesity. But if you compare Neuilly-sur-Seine and Garges-lès-Gonesse, you’ll notice that the ratio of these diseases is 1 to 6. Finally, vulnerable areas are the ones suffering the most from environmental nuisances (pollution and noise) and have more difficulties accessing health care.
Could these problems be resolved by urbanism?
N.N.: There is an urban divide between Paris, which is encircled by the ring-road, and the suburbs, which causes a segregation. Currently, in Île-de-France, about thirty municipalities have started working on the matter of urbanism that would foster health, with a systemic long-term vision on housing, urban development and transport. They came to us to discuss general health matters – how to reduce environmental nuisances, live a healthy lifestyle, have access to health as well as medical and social services. This forces us to work together and face our respective responsibilities.
Anthony Béchu, how can we repair this divide between Paris and the suburb?
A.B.: The capital walled itself in without reaching out to the villages and small towns in the surrounding area. We now need to reconnect them and turn the ring-road into a real urban boulevard. We need to put some green space back in between these satellite towns and the big city, give them back their function as food providers, and recreate kitchen gardens in the middle of Paris. Local farmers must be included in city life. It’s only logical, when we know that 80% of food worldwide is consumed in urban areas. Everyone agrees to reintegrate nature into the city and restore the ecosystems. But this will not happen smoothly. The issue of shopping centres, for example, is an urgent one to resolve. What will we do with these buildings in the shape of shoe boxes? One of our teams is working on the matter.
Your daughter, Clémence Béchu, calls you a “space doctor”. What does that mean?
A.B.: My job is to optimise people’s lives in the spaces where they spend the majority of their time: we spend nearly 80% of our time inside buildings! The streets, plazas or courts where homes and offices are located, the way in which we will include vegetation and let in the light, the materials used, air filtration, ceiling heights to control the heat, colours, etc., all of these things have an impact on well-being.
We could create much more pleasant private spaces by creating more passages between common areas and personal areas: an open door between the lounge and the bedroom is sufficient to escape, to walk a different pathway through the apartment; it saves you from having to go through the hallway which generally leads to the bedrooms and bathroom. It has a psychological benefit. An additional room should be added, either a space to welcome guests or to telework, using subventions or tax exemptions.
Finally, we can no longer think about apartments without balconies or terraces, without access to the exterior and nature. Even next to the ring-road or a highway. In fact, at the Spallis site, to the south of Saint-Denis, north of the Pleyel intersection, we created a noise barrier on the ring-road side, and courtyards on the city side, with balconies and other openings looking out onto them.
How can we combine respect for biodiversity and new housing?
A.B.: Brownfield lands and abandoned buildings still remain to be reinvented. The polluted lands adjacent to the city need housing in synergy with nature, with vegetation climbing up the walls and roofs. There is also a lot of work to be done to remove some of the asphalt, and to regenerate the soil and make it permeable once more. Soil pollution must be cleaned up so that farmers come back to the city and children can see the blue sky again. That is the work we initiated in 2015 in the ecocity of Shenyang. It was so polluted by mercury that we could have taken our temperature just by putting a fish under our arm!
Nature is an engineer that we need only imitate to reduce our environmental footprint to a minimum. That is the principle of biomimicry. We raised the D2 tower at La Défense, on a very small piece of land surrounded with buildings, by drawing inspiration from trees and funnel basket fish traps, which enabled us to save 30% of material: the tower rests on a concrete central pillar, like a trunk, from which stem branches, or in other words, the different floors. The outside structure – the tree’s leaves, where magpies have made their nests, rise up to shape the archways under which grows a garden in the clouds. The vegetation settled there, and mushrooms and slugs made a home at a height of 171 metres. From the 6th floor up, there is no more pollution in the soil of the balconies and terraces.
Now, we also have to think about buildings’ flexibility. We created a workshop just for that. How can we design a building that could turn into something else? We need to give back permanence to that which becomes obsolete with time. Any thought process will need to include this flexibility.
How do you foster the life of a neighbourhood?
A.B.: We give roots back to places and people who have lost them. If you take people somewhere without providing strong identity roots, they become adrift.
We need to create places where people feel at home; people need to find their own culture again inside their own neighbourhood and be connected to the history of the place at the same time. This is fundamental. Thus, one of the major problems Africa will face in the future will come from the migration towards the cities, which expanded according to the American models. The villages, tribes and associated social and societal organisation model where these future residents come from are actually calling for a different kind of urbanism: it is imperative, if farmers are going to have a place in cities and if cities are going to feed us. The reference point for cities is the culture of the people living there. In India, Louis Kahn used bricks and local materials, and when the residents arrived, they thought to themselves, “This is mine; I am home.”
Next, a certain social diversity must be ensured to enhance vitality. A neighbourhood must be a town within a city. Along these lines, in collaboration with Alain-Charles Perrot, we designed the “International gastronomy and wine city of Dijon” on the site of the old Hôtel-Dieu: an inhabited park, a 3.5-hectare eco-neighbourhood which includes a hotel school, cultural areas, a living gastronomy museum, seminar rooms, various types of housing units, senior housing and coliving spaces, as well as public areas such as markets.
An urban development and architecture project is like a menu to be enjoyed. Everything there to be seen, heard and felt has to create a harmony which makes us feel good.
So you are contributing to the creation of the “city of proximities” advocated by Anne Hidalgo?
A.B.: As architects and urban planners, we’ve always worked on creating the city of proximities! I was born to a father and grandfather who always thought about the use and function of things more than their shape, and about what a building was going to leave behind it. To build a neighbourhood in the same way we build a building, we work with the urban space and with the residents of that space in mind. In our offices, we put ourselves in the shoes of others through roleplaying games, in the humblest possible way, to zero in on the needs we would have. We also talk with the mayor, the municipalities and the residents. Without these discussions, our work would lose some of its meaning, as discussions also enrich our designs.
Maxime Valentin, how have you, little by little, put health at the heart of the Lyon Confluence project, a project to renovate a central neighbourhood?
M. V.: The issue of health was brought up indirectly as SPL Lyon Confluence initiated the Lyon Confluence project twenty years ago. It is a 150-hectare neighbourhood at the south point of the Presqu’Île, at the heart of Lyon, where the Saône and the Rhône rivers meet. As developers, we started thinking about the well-being we wanted to ensure for the residents, starting with air quality.
We worked in-depth to restore the green and blue urban frameworks and make the neighbourhood greener by planting vegetation in open ground around most of the buildings. Very few underground spaces were built. We only created one car park underground, which is shared, to free up the courts, make them green and reduce heat islands; in Summer, the temperature there is cooler than that on concrete streets by 2 to 3 degrees Celsius. The buildings with openings on different sides are naturally ventilated.
Which health services have you put in place to guarantee this quality of life?
M.V.: Five years ago, in response to DIVD (Démonstrateurs industriels de la ville durable, or sustainable city industrial demonstrator), a call for projects launched by the government, we created Eureka, a consortium designed to develop ideas on health and well-being, among other subjects. When we created this, we realized that we were not working with the health sector. The professionals we sought out, namely the AST (action – health – work), general practitioners, pharmacists, and neighbourhood nurses, were very favourable to the creation of a project; we just needed to define it. There were already health facilities nearby. However, through our exchanges, we realized that the matter of prevention was neither addressed nor structured.
A 1,000 m2 building created by Linkcity was going to host the project. One of the floors is dedicated to prevention. The top floors are reserved for general practitioners and nurses. A team of three operators, called Alliance Santé, was brought together specifically for the project: Office Santé (a health centre operator), radiologists (which were lacking in this arrondissement), and the AST – occupational health.
This synergy between general practitioners, occupational health and radiology gives depth to our response on the matter of quality of life by ensuring both health care and prevention services in the neighbourhood. Occupational health services refer patients to the doctors on the top floors of the healthcare facility, or make the appointments with them directly, and these doctors refer patients to radiology services when they need preventative screening tests (for breast cancer, for example). We save time and trips. And we save a lot of energy.