Healthy City Design 2026
The Lowry, Salford
Marsha Ramroop

Healthy cities cannot be built by unhealthy sectors.

We measure the city in enormous detail. We barely measure the behaviour of the sector designing it. This page will show you, in about four minutes, where your organisation is currently intervening and what to change first.

Marsha Ramroop · Founder Director, Unheard Voice Consultancy · Author of Building Inclusion (Routledge, 2025)

The problem

What we measure, and what we miss

Both columns shape human health. Only one of them gets counted.

We measure the city

  • Air quality and emissions
  • Access to green and blue space
  • Housing quality and overcrowding
  • Active travel and connectivity
  • Whole life carbon

We do not measure the sector

  • Who is in the room when it is designed
  • Whether they can safely disagree
  • Who progresses, and who quietly leaves
  • What the supply chain is paid to care about
  • Whose lived experience shaped the brief

The second column is the unheard voice. It is not softer than the first. It is upstream of it.

The ladder

Where you intervene decides what changes

Donella Meadows ranked twelve places to intervene in a system, from the weakest to the strongest. The bar width below is the leverage. Most inclusion spending in the built environment sits in the narrow bars at the bottom. Select any rung to see what it looks like in practice.

Narrow bar = weak leverageWide bar = strong leverage

Four minutes

Where is your organisation intervening?

Six questions about how your organisation actually behaves, not what it says. Answer honestly, including the answers you would rather not give. Nothing is sent anywhere and nothing is stored.

0 of 6 answered

The intervention

Cultural Intelligence is behavioural infrastructure

CQ is a measurable, improvable capability to function and relate effectively across difference, developed and validated by the Cultural Intelligence Center. Infrastructure is the thing everything else depends on. You notice it only when it fails.

The evidence

Six organisations. One pattern.

Case studies drawn from Building Inclusion (Routledge, 2025). These are cases, not a controlled trial. What they demonstrate is a pattern: each one attached inclusion to a mechanism the organisation already had to obey.

Why sincere effort stalls

The hidden benefits of business as usual

David Peter Stroh's insight is that the status quo is not held in place by malice. It is held in place by benefits, and those benefits go unnamed. Tick anything your organisation would genuinely lose if it changed how decisions get made.

0

Nothing ticked yet. Take your time with this one. It is more useful when it is uncomfortable.

What this means

Three things to take away

One

Cultural Intelligence is structural urban infrastructure, not a soft skill.

It belongs in the capital planning conversation, not only in the people team's annual report.

Two

Inclusion produces outcomes only when procurement, workforce and community systems connect.

Siloed effort produces siloed results. Every organisation on this page joined the systems up.

Three

The business case and the social case are the same case.

Safer sites, better design decisions, retained talent, stronger planning outcomes, resilient local economies. One mechanism, many returns.

There are no quick fixes, no magic wands, no silver bullets.

Just conscious, inclusive actions, repeated until they stop being an initiative and become the way this sector works. Heathrow took three years. Lewisham took ten. Start anyway.

Build the sector, and the city follows.