In conversation with Cheong Koon Hean
Cheong Koon Hean looking at a building model

Professor Cheong Koon Hean has played an active role in the urban transformation of Singapore over the years // Credit: Norfaezah Abdullah, Duke-NUS


It’s projected that by 2050 an estimated 68 per cent of the world’s population will live in urban areas, a significant increase from 55 per cent today. According to the World Health Organisation (WHO), this urbanisation surge will have profound impacts on public health, highlighting the need for health-focussed urban planning. In a densely populated, small island-city like Singapore, the challenges of a growing population are further compounded by a rapidly ageing population and the threats posed by climate change.  

In this issue, MEDICUS speaks with visionary urban planner Cheong Koon Hean to discuss how urban environments affect health, and explore strategies for tackling these emerging issues to create more liveable and sustainable cities.

An infographic on Prof Cheong Koon Hean

 

MEDICUSThank you for joining us today. The WHO emphasises the importance of integrating health considerations into urban planning. To begin, can you elaborate on how specific elements of the built environment can influence our health?

Cheong Koon Hean:
The built environment is a very important component that impacts health—from your physical fitness level to your mental wellbeing. For example, if you have access to green spaces, such as open fields and recreational spaces, it encourages you to move about, which not only improves your physical fitness but also helps reduce your stress levels.

Research has shown that people who stay in neighbourhoods with parks and green areas tend to have lower rates of obesity and chronic diseases. That’s why features like playgrounds and exercise stations have been built, particularly within HDB estates, to encourage people to stay active. And in the new generation design of HDB flats, you even have running tracks which form part of sky gardens and these are located on top of the blocks. In addition, cycling and pedestrian networks have also been intentionally weaved into the city to encourage people to use greener modes of transport instead of taking the car. Singapore’s park connector network is a good example of an urban innovation that has encouraged walking and cycling. It provides walking trails that enable people to connect to different parks and greenery and expands our sense of ‘space’ in land constrained Singapore.

Another important element is whether there’s good air flow through the town, because having good quality air is important in keeping us healthy. This is also why we make use of computer simulations where we create digital twins of a city to test the quality of our plan. 

So the way we design makes a lot of difference. Just as essential as food, having a roof over our head anchors us to a place, fulfilling a basic human need. This is why Singapore’s public housing not only provides affordable homes, but also a good quality living environment. Collectively, good urban planning, architecture and transport systems not only contributes to the health of individuals and their communities, but also enhances their quality of life.
A bridge in Marang Trail

One of the many walking trails dotted around Singapore, the Marang Trail, which is part of Singapore’s HortPark Southern Ridges // Credit: iStock.com / johannes86



MEDICUS: Clearly, a lot of thought has gone into how our living spaces are designed. But there were still major events that happened which took us by surprise, COVID-19 being a recent example. Looking back, what were some of the lessons we learnt from that episode?

Cheong Koon Hean: COVID-19 reminds us of the importance of developing liveable and healthy cities. Fortunately, Singapore has always planned and build with this intent in mind. While we didn’t design specifically with the pandemic in mind, we already designed intuitively in a way that makes for healthier towns that are highly liveable.

Interestingly, HDB towns are planned like bubbles at the town level. Each town is separate from other towns and comprehensively planned to be self-sufficient with all amenities for living, working, playing and learning. So you actually don’t need to head downtown via crowded public transport to do your shopping and that played a major role in our attempts during the pandemic to reduce the spread of COVID-19. 

Every town is also organised as a collection of neighbourhoods, each equipped with schools, parks, social amenities and shops which are generally within walking distance of our homes. So each neighbourhood is in effect also a self-sufficient bubble, which minimised the need for residents to travel to amenities elsewhere. 

Personally, I truly appreciate the many parks that are sprinkled throughout Singapore. These provided much needed relief during COVID-19 once we were allowed to leave our homes.


MEDICUS: You spoke about the concept of healthier towns earlier. What in your opinion then, constitutes a healthy town or city?

Cheong Koon Hean
: A healthy city is one that creates a ‘health-supportive’ environment. It should enable us to have good quality air and water, proper sanitation, easy movement around the city and is safe. So we design transport systems that are very convenient and accessible. The city infrastructure must cater to all ages to both the able bodied and the less abled. Then we also have green spaces where people can pursue recreational activities there which promotes good health and mental wellness. The presence of plants in the built environment and nature filled places in the city can also reduce stress, improve comfort and enhance our mood.

We also have to make sure that there is access to health care and there are enough amenities —not just hospitals and active elderly centres for the aged, but also nurseries, childcare centres and schools that are convenient and within walking distance. The design has to work in a way that keeps a whole spectrum of individuals healthy.

A photo of Cheong Koon Hean speaking

Prof Cheong Koon Hean has also published ‘Seeking A Better Urban Future’, which is a collection of lectures she delivered as the S R Nathan Fellow established by the Institute of Policy Studies // Credit: Norfaezah Abdullah, Duke-NUS


MEDICUS: With Singapore set to become a rapidly aged society, with one in four citizens who will be 65 and older by 2030, how would that affect the way our towns are designed?

Cheong Koon Hean: We shouldn’t design cities just for the aged. Instead, we should focus on designing cities for all ages of which the elderly is an important component. The design of a city and in particular of a HDB town, has to be comprehensive, which means it must cover all ages. We have to design with the life cycle of a person in mind. So there are two things we have to consider: building a healthy city, but one that is also an age-friendly city.

Take Kampung Admiralty that was completed in 2017 for example. This was a first-of-its-kind development in Singapore that integrates housing for the elderly with a wide range of amenities including a medical centre, shops, hawker centre and a child care facility. In this all-in-one complex, we built a fantastic roof garden for community gardening and exercise stations, but that’s also where we put the playgrounds. By doing that we get our children to mix with the older folks. 

An image of a roof top garden

Roof gardens have been built to promote community gardening // Credit: iStock.com / Lim Weixiang - Zeitgeist

So not only do we design the hardware to put these two groups together, but the software is also designed to promote interaction. So we have the people who run the elderly care activity centre and the senior activity centre do some cross programming with the operators of the childcare centre to encourage interaction between the two groups.

This integrated development concept was very successful and is now being replicated in subsequent towns that are designed. That’s why I say it is not just about designing for the elderly, but also designing for the young. Can you marry the two? And if you can achieve that, then you have a much healthier relationship and synergies across the different age groups.


MEDICUS:
With an increasingly diverse population, how then can city planners leverage emerging technologies to address the needs of the population?

Cheong Koon Hean: We’ve used technology in many ways to shape and design our city.  I’ll give you some examples of what we’ve done to transform our HDB estates into smart towns. One way is through smart planning. I mentioned the use of digital twins earlier. Besides enabling us to simulate the air flow through a town, this method also helps us model for noise, so that we can refine our layouts to minimise noise transmission.

We have also introduced a smart estate initiative where we use technology to help make services more efficient and reliable. For example, we put sensors in lifts to monitor lift breakdowns. Taking this one step further, we hope to predict break downs before they happen or what we call predictive maintenance. For instance, if we observe vibrations in the lift movement, or changes in the heat emanated, they could be warning signs of a potential problem. So we will check the lift to pre-empt a break down. 

We can even make use of technology to monitor our elderly who live in the flats alone. Through sensors and the use of AI which help us detect changes in their movement patterns which might signal a fall or a loss of consciousness, the smart technology can be programmed to send an alert to the phone of their caregivers so someone can check on the individual. 

I’m a strong believer of technology but at the end of the day, we have to remember that technology is only an enabler. You don’t start with the tech when you build a city. We need to remember that our end goal is to build a good city for human beings, and that technology is only a tool that helps us achieve those goals. 

A drone flying above the city

Prof Cheong explains that drones have also been used to inspect the façade of flats to check for cracks. The footage captured by the drone is analysed by a software, which would alert engineers of cracks that require follow-up inspection, saving time and manpower in maintaining thousands of blocks across the island. // Credit: iStock.com / Naypong


MEDICUS
Let’s talk about the impact of climate change on Singapore. What are some of the challenges that we will face from this emerging threat?

Cheong Koon Hean
: As a dense and built-up city, Singapore is affected by the urban heat island effect. That happens when our pavements, buildings, and other hard surfaces absorb and retain heat. This causes the temperature in the city to rise.  And the hotter we get, the more we have to turn on the air-conditioning which produces more carbon emissions and traps more heat in the atmosphere - so it’s a vicious cycle.

And particularly for island city states like Singapore, because we are surrounded by water, we are not exempt from the effects of the rising sea levels due to climate change either. 


MEDICUS: Considering the multifaceted nature of these challenges, what key strategies can we implement to effectively address them?

Cheong Koon Hean: Well, there are two broad strategies that we can implement: one is climate mitigation and the other is adaptation.

Climate mitigation is about finding ways to reduce carbon emissions so that we can slow or even reverse climate change if possible. And that’s why the way we design buildings is very important. For instance, if the design incorporates natural ventilation from the start, then you reduce the amount of air conditioning used. The use of renewable energy will also help us to reduce carbon emissions.

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Adaptation is about preparing an existing city to deal with impending climate change impacts. For example, to tackle more intense storms that could lead to flooding, we have to update our drainage carrying capacity and also make use of nature-based solutions such as parks, to hold back rain water and slow water discharge into our canals.

You may have heard of the East Coast reclamation plan. The land that is reclaimed will become a coastal protection measure for Singapore against rising sea level. It is built higher, so that it becomes almost like a dam, protecting the whole of East Coast from flooding. But it will also be used for other things like housing and recreation, so it serves more than one function. Clever planners and designers always go for a two-in-one design because we are land scarce.

Both strategies are like two sides of the same coin in the fight against climate change and crucial for a sustainable future.



MEDICUS: 
Looking towards the future, what long-term transformations can we expect in the city as a result of these strategies?

Cheong Koon Hean: City planners and builders play a big role in in getting it right. Besides having more greenery and planning green infrastructure, we should also plan and design a city using a circular economy approach. This means that we should try to recycle most resources so it’s a closed loop.

For example, several government agencies are strengthening the water-energy-waste nexus through the Tuas Nexus, where they locate an incineration plant together with a water reclamation plant. 

When the rubbish is incinerated, it generates heat, and that heat is used to generate electricity which runs the water reclamation plant. But after the water is reclaimed, the sludge that is left over is burnt in the incineration plant, which in turn generates electricity again to recycle the water. So this is a self-sustaining loop which reduces the use of energy. 

Another example is the transformation of the old Sungei Kadut Industrial Estate, one of Singapore’s oldest industrial estates, into a new agri-tech estate.  By co-locating synergistic industries together, a sustainable circular economy can be created. For example, waste materials produced by one company can be processed within the estate and fed to another company as a resource material. 


MEDICUS: What do you think cities in the future will look like?

Cheong Koon Hean: I think it will be a tale of two cities. You can either build a highly sustainable, livable and healthy city, or we will have cities that are totally unsustainable and with many suffering from the impacts of floods, heat stress, pollution, and even starvation. 

That is why it’s important for government leaders and industry experts to come together to not only discuss the challenges they face, but also to share integrated urban solutions.


This interview was conducted and edited by Dr Chua Li Min, Science writer.

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