The scale of responsiveness of urban planning to its public health is a direct representation of its quality of life. Why? Because it will ultimately affect the public during a period of crisis. Various instances throughout history provide evidence to that statement. So let us start from the origins. 

Urban planning was first observed, in the ruins of ancient cities, scattered through different parts of the world. The various instances of epidemics around the world had a significant impact on urban planning strategies. The cities evolved as a response and also led to various architectural movements.

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Dharavi Masterplan_©Foster + Partners

14th Century

The bubonic plague of the 14th century, also known as the Black Death, marked the end of urban expansion. The disease violently spread through medieval Europe and was widely believed to be divine punishment. The Catholic Church built numerous patient homes and isolated monasteries in the hopes of isolating the infected public. But as the epidemic continued to spread, people realized the importance of public health, clean air, and sewage disposal. It inspired the Renaissance movement, a rebirth of art and architecture that led to a city-wide beautification and order of buildings. 

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Drawings by Leonardo da Vinci about his ideal city_©

Many architects and designers began making theories and concepts for urban planning that would improve public health. One such concept was by Leonardo da Vinci, his vision for an ‘anti-epidemic city’. The plague had invaded Milan, Italy by the end of the 15th century, and Leonardo realized the inefficiency of the streets was one of the core causes of the rapid spread of disease. 

Before the epidemic, people had started migrating to the cities, which resulted in densely populated areas and unhygienic conditions. Hence, da Vinci proposed a three-layered city with each layer serving a distinct function. The open upper layer of the city would serve the public life with a street network for walking and admiring the teeming city life. The middle layer would be for services, commerce, transportation, and industry. And the closed lower layer would be a river network for transportation of goods and wastewater of wheeled traffic. 

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Ideal City Prototype during Renaissance_©

The urban planning of the city hence, ensured good light and ventilation, large urban squares, and laid down standards for the width of streets. Leonardo additionally designed drainage systems and devised a solution for the water supply and sanitation of the city. The ‘anti-epidemic city’ is an ideal model even for today’s times as it realizes the importance of planning and urban health during the process of urbanization. Due to cost and other factors, da Vinci’s city could not be implemented but has pointed out numerous ideas for urban planning.

19th Century

Going further ahead in time, London fell to the clutches of the plague in the 17th century that was followed by the Great Fire in 1666. It resulted in an extensive rebuilding of the city. Though the street layout remained constant, there was a widening of streets, creation of pavements, and; elimination of open sewer systems. The capital took on a new look as new standards for building construction were implied. 

The built environment of the city improved, and so did public health. Science and urban planning also advanced with time and found new applications. Hence, in the mid-19th century, when London suffered an outbreak of cholera, doctor John Snow applied data science to trace its origin. It led to the redesigning of the city’s water system and helped establish the first public health act, the Public Health Act of 1848. It was a sign of the interdependency of urban planning on public health and helped many planners emerge.

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Camille Pissarro’s Boulevard Montmartre_©Wikimedia Commons

Parallelly in Europe, the importance of Haussmann’s model that revolutionized many cities like Paris, Barcelona, and Madrid was seen. The model was theorized to beautify the cities and exterminate unhygienic conditions. The concept included a division of areas according to their functionality and their linkage through a well-designed street network. Although Haussmann’s work in Paris has garnered much criticism, the public administrator successfully achieved improved hygiene, efficiency, and social progress for the city. 

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Extension to Letchworth Garden City_©WestonWilliamson+Partners

Following this was the emergence of the Garden City movement, 1898 by Ebenezer Howard, an urban planner. The idea was to merge the benefits of living in the countryside and the benefits of the city. The concept was one of the first and most valuable responses to the planning of Victorian cities as it talked about the creation of self-contained new towns. The cities were already being over-populated, and in the 1900s, biologist Patrick Geddes took Howard’s idea a step further. 

Geddes proposed the principles of ecological balance and renewal of resources. His theory was to combine geography, culture, and civic education in the process of urban planning. This kind of innovative thinking led Geddes to be known as the father of regional planning. From the model, we can observe the environment as a part of the urban planning process to ultimately improve the quality of life. 

20th Century

In the early 20th century, the world again suffered at the hands of TB and the Spanish Flu. By the 1850s, the Industrial Revolution had transitioned the world to machines and led to rapid urbanization. It led to the people migrating to the cities in search of jobs and the cities becoming over-populous. 

The construction of buildings used steel manufactured from large blast furnaces. It lowered the cost of construction and also saved time. But the bigger picture was the working class of people having cramped living conditions and the increased use of coke resulting in high amounts of air pollution. All these factors eventually led to an epidemic of TB, cholera, and Spanish flu raging through different parts of the world. 

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Le Corbusier’s model of the Radiant City_©

This epidemic gave rise to the new modern architecture, namely the style of Modernism. The infrastructure of the city again evolved as a response. Sufficient light and ventilation, easy to clean materials, and clinical white walls were symbolized as the solutions. Modernist architects like Alvar Alto and Le Corbusier were forerunners of this minimalist style of design that was devoid of ornamentations. 

Another famous concept of the city evolved by Le Corbusier was known as the Radiant City. His utopian city revolved around the idea of vertical architecture and large open spaces on land that would function as traffic corridors and public landscapes. The model was highly criticized and failed due to its overly disciplined and cold design; but its concept mainly focused on improving air, light, and greenery, the lacking elements when the disease spread. Modernism hence evolved as a form of medicine. 

21st Century

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Cities of the future_©HDR | 

Currently, as the world faces another pandemic, urban planning is again set to evolve. The approach by planners is towards long-term sustainable development. This new movement is being termed New Urbanism which revolves around pedestrian-friendly cities through cutting edge technology. Peter Calthorpe and William McDonough are two of the leading figures in sustainable urban planning. They are working on reducing the impact of humans on the rapidly degrading environment. 

Such models and ideas are sustained and improved by many pioneering planners that follow. They strengthen the need for improving public health through the means of sustainable development. And history stands witness to the evolution of cities as a solution to public health.


Liu, Hanmau & Wang, Po. (2021). Research on the evolution of urban design from the perspective of public health under the background of the COVID-19. IJEE, 0 (0), Pages 1-18. Available from:

WHO (World Health Organization)/ L.J. Duhl & A.K. Sanchez. (1999). Healthy Cities and The City Planning Process – A Background Document on Links Between Health and Urban Planning. Denmark. 


Shruti is a student of architecture, driven by the need to constantly explore new avenues. She loves to express herself through poetry and art. And is always inspired by books and movies, may it be fiction or nonfiction. Sustainability and urban design are her architectural avenues of interest.