I’ve waited patiently the last two months to see if some city government or health official somewhere might respond to Nature Magazine’s breakthrough article on urban stressors affecting mental illness.
Regrettably, there is no gravy, corruption, hacking or sex scandal to make this a story. It’s just the same- old, same-old professional specialists and government departments stuck in departmental silos and ivory towers — missing a golden opportunity to save billions of dollars in misspent public and private spending while avoiding unnecessary and preventable private suffering of millions.
This opportunity has now been dropped on health-conscious city planners, who can literally let their planning minds run wild with the implications of the Nature article and naturalized environments linked to a whole new approach to urban food production.
In June, Nature, commonly ranked as the best or second-best science journal in the world, published research findings of neurological and schizophrenia expert Andreas Meyer-Lindenberg.
Disturbed to discover that schizophrenia is twice as common among city-raised as country-raised individuals, Meyer-Lindenberg hopes to encourage brain specialists, psychiatrists and social scientists to cooperate as researchers. The new kids on the brain block can then try to weigh in with urban planners responsible for policy on green space and overcrowding, factors that loom large as possible explanations for city-countryside differences.
Meyer-Lindenberg’s findings on brain functioning evoke pioneering campaigns by “biophilic” (nature-loving) educators and building designers, who believe people need lifelike surroundings akin to those in which people evolved over 99 percent of human history. His use of the latest techniques in brain imaging updates ancient folk wisdom expressed in such fables as the “country mouse and city mouse.”
Specifically, Meyer-Lindenberg took brain images of volunteers subjected to stressful scolding. The images showed that two emotion-processing areas of the brain — the amygdala and the cingulate cortex — don’t protect city dwellers with the inner calm or roll-with-the-punches habits that withstand typical urban and workplace hassles.
Why does this change the conversation about city planning and urban food production?
THE SMOKING GUN
First, his experiments provide the kind of “smoking gun” evidence that’s often needed to move public policy on health issues.
It’s well-recognized, for example, that “hard” and “science-based” evidence on “second-hand smoke” was game-changer enabling public health campaigners to limit smoking in public spaces and workplaces during the 1980s and ‘90s.
Two factors account for that remarkably speedy turnaround, now widely accepted as plain common sense and good manners.
First, the new “science” on lung cancer specified precise physical pathways and biological processes that had a cause-effect relationship — one big and non-debatable step up from a “statistical association” between people who lived with or hung out with smokers and later contracted cancer, even though they never smoked themselves.
Second, the science on second-hand smoke destigmatised lung cancer, since “innocent” people who never smoked could not be blamed for lack of personal “willpower” and similar powers deemed “virtues” in a moralizing society. Only after individuals were cleared was the way clear for the environment beyond personal control to become the focus of policy.
Since the non-smokers’ rights victories, “smoking gun” evidence has become the gold standard for public health campaigns.
Meyer-Lindenberg brings the same kind of cause-effect physical and scientific evidence on physical mechanisms and biological pathways to the much-stigmatized field of mental health. It’s the amygdala, stupid!
Let’s get physical. We’re now clear to deal with the environment that can optimize the brain’s functioning. The doors have been opened to discussing new public opportunities to nourish and protect mental, psychological and spiritual well-being, thereby saving billions of dollars of public money now spent treating the damage from relatively preventable diseases.
NEW HEALTH INFRASTRUCTURE
Going further back in time than the 1980s and ‘90s, there’s a possibility that a new conversation of mental health and city form could duplicate the transformation of urban planning a century ago.
When scientists found that typhoid, cholera and other killer diseases that plagued 19th century cities were caused by pathogens in human excrement and garbage, the entire physical infrastructure for managing water and waste in cities had to be transformed. Water filtration plants, sewage pipes, garbage pickup and the like became the norm throughout the Global North – all universal services provided as a right to all residents.
We need the same scale of transformation of the “soft infrastructure” of cities today, whereby universal provision of green space and other land-use tools that boost personal well-being and social cohesion while preventing mental illnesses.
MIND OVER MATTER WORKS
It’s clear that there’s as much public good to be done and as much public money to be saved solving the mental health problems of tomorrow’s cities as was accomplished by sewage, water and public health reformers of yesteryear. Putting mind over matter is not such a bad guideline for city infrastructure of tomorrow.
The World Health Organization (WHO) estimates that 100 million people presently suffer from mental ill health disorders, surely a low-ball estimate given Meyer-Lindenberg’s guesstimate that approximately one per cent of the population suffers from schizophrenia alone.
According to the U.S. Center for Disease Control and Prevention, about one American adult in ten suffers from chronic depression, which costs individuals as well as tax-funded medical and social support systems something like $317 billion a year, or $1000 per person per year. Estimates from the 2008 report for Chronic Diseases in Canada indicate the full medical and non-medical costs of mental illness in Canada add up to $51 billion a year.
If city land-use policies could reduce the toll of mental illness by modest amounts, savings in money and suffering would be substantial. If smart health-inspired land-use policies simultaneously yielded other health or economic improvements, the final (marginal) costs of improvement would be barely noticeable.
Look out for the second part of this two-part series next week!