REPLENISH - REimagining PLaces and ENgineering Infrastructure Systems for Health

基础设施系统支持我们的城市系统，为市民、社会和城市服务，已经发展了几个世纪。随着人口的增长、技术的发展和环境的变化，它们被各种方式取代、扩展和补充。随着人们对更好的服务的期望不可避免地上升，这就提出了维护（保持旧部件的运行）和整合（新旧部件的整合）的挑战。公司专注于“城市新陈代谢”——资源、商品和人员在城市的流动。当支撑这种“城市新陈代谢”的基础设施系统不受干扰、不受过度需求或缺乏负担能力的阻碍时，它们就会运转良好，市民也会感到高兴。这是期望。然而，有几个因素综合起来会损害这些系统的有效性，并对公民的身心健康和福祉（H&WB）造成实质性损害：—许多基础设施系统的运行主要不是为了它们所服务的公民的利益。如果（例如许多公用事业）服务是由私营公司提供的，它们的主要责任是对股东负责，利润是压倒一切的必要条件。监管是一种为共同利益而行动的机制，但只有在无可辩驳的证据下才能被援引。-我们的基础设施系统是高度相互依赖的-一个系统的失败或需要进行重大干预往往会对许多其他系统产生严重的不利后果。-快速增长的需求往往超过供应，对交通系统的影响最为明显。交通拥堵、延误、出行时间的不确定性以及为“击败竞争对手”而规划路线都会导致焦虑和压力(“通勤愤怒”，参见。“路怒症”，在极端情况下)和精神健康受损。-基础设施系统因使用年限、重复使用和环境因素而恶化。维护、翻新和更换跟不上整个系统的恶化，导致故障和紧急维修，并经常造成重大破坏。街道工程对城市新陈代谢的破坏是一个典型的例子，这是由于道路下多个埋管和电缆的物理相互依赖而产生的。-目前移动系统的严重副作用包括发动机废气排放和车辆刹车和轮胎的空气微粒。-较富裕的公民有时可以通过使用他们的一些财富来避免这些问题，而较贫穷的公民则不能。这导致了贫富差距。此外，这些“城市新陈代谢”问题的解决方案为体育锻炼提供了可能。包括心脏病、中风、癌症、糖尿病和慢性肺病在内的非传染性疾病造成的死亡人数占全世界死亡人数的近70%。彻底改变城市环境质量和我们在城市里的出行方式，将明显改善这种状况。因此，我们目前的基础设施系统是非传染性疾病和精神健康受损的主要上游决定因素之一，对英国经济造成了巨大的直接成本（如NHS）和间接成本（如生产力损失）。补充认为，如果我们的基础设施系统及其相关的城市景观设计以积极的H&WB结果为主要设计标准，将产生巨大的社会和经济效益。因此，通过采用系统思维和系统工程（或“做”），我们建议：-创建证据基础，以证明对公民健康和生活的损害程度以及变革的好处；-重新思考和重新设计我们的工程基础设施系统和城市景观；-创建替代商业模式，以证明进行此类变革的投资价值，并修改治理形式，以控制其有效性；-通过与设计委员会，Sustrans和其他用户合作伙伴合作的示范项目来证明这些概念。

The infrastructure systems that support our urban systems and serve citizens, society and cities, have developed over centuries. They have been variously superseded, extended and supplemented as populations have grown, technology has developed and contexts have changed. This presents challenges of maintenance (keeping the older parts going) and integration (of the new with the old) as expectations of ever better service inexorably rise. REPLENISH is focusing on the 'urban metabolism' - the flows of resources, goods and people into, around and out of cities. When the infrastructure systems underpinning this 'urban metabolism' work uninterrupted and unencumbered by excessive demand or lack of affordability, they work well and citizens are happy. This is the expectation. However there several factors combine to compromise the efficacy of these systems and materially damage citizen mental and physical health and wellbeing (H&WB): - Many infrastructure systems are not run primarily for the benefit of the citizenry they serve. Where (e.g. many utility) services are provided by private companies, their primary responsibility is to their shareholders and profit is an overriding imperative. Regulation is a mechanism for acting for the common good, but can only be invoked using incontrovertible evidence. - Our infrastructure systems are highly interdependent - a failure or need for major intervention in one will often have significant adverse consequences on many others.- Rapidly-growing demand often outstrips supply, with effects most keenly felt in mobility systems. Congestion, delays, uncertainty of travel times and plotting of routes to 'beat the competition' lead to angst and stress ('commuter rage', cf. 'road rage', in the extreme) and compromised mental health.- Infrastructure systems deteriorate with age, repeated use and due to environmental factors. Maintenance, refurbishment and replacement fails to keep pace with system-wide deterioration, causing failures and emergency repairs, and often major disruption. Disruption to the urban metabolism due to streetworks, arising from the physical interdependency of multiple buried pipes and cables beneath roads, is a prime example.- Serious side effects of current mobility systems include engine exhaust emission and airborne particulates from vehicle breaks and tyres.- Wealthier citizens can sometimes avoid such problems by using some of their wealth, whereas poorer citizens cannot. This results in H&WB inequalities.Moreover, the solution to some of these 'urban metabolism' problems offer potential for physical exercise. Non-communicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide. Radical changes to the quality of the urban environment and the way we move around cities would manifestly improve this situation. Our infrastructure systems, as currently constituted, are therefore one of the major upstream determinants of NCDs and compromised mental H&WB, and contribute hugely to direct costs (e.g. to the NHS) and indirect costs (e.g. loss of productivity) to the UK's economy. REPLENISH contends that if our infrastructure systems and their associated cityscapes were designed with positive H&WB outcomes as the primary design criterion, huge social and economic benefits would result. REPLENISH therefore proposes, by adopting systems thinking and systems engineering (or 'doing'), to: - create the evidence base to prove the extent of the damage to citizen H&WB and the benefits of change,- rethink and redesign our engineered infrastructure systems and cityscapes,- create alternative business models that would prove the value of investment in making such change, and amended forms of governance that control their efficacy,- prove the concepts via demonstrator projects in association with the Design Council, Sustrans and other user partners.