In an increasingly urbanised world, inner-city densification is a key strategy for achieving sustainable urban development. However, this process often conflicts with urban health goals, giving rise to the Health-Density paradox: the tension between Sustainable Development Goal (SDG) 11 for sustainable cities and communities, and SDG 3 for good health and wellbeing. This thesis explores how these contradictory objectives can be reconciled through design. Rather than seeking a universal solution, it argues for a context-sensitive approach by reconceptualising both urban density and urban health. Using the neighbourhood of Overvecht Zuid in Utrecht as a case study, the research investigates how urban densification strategies can be tailored to specific contexts in a way that promotes, rather than compromises, urban health.

This study applies a conceptual framework in which urban density is prescriptively defined through Floor Space Index (FSI) and Ground Space Index (GSI), while urban health is unpacked into eight determinants. The eight determinants are People, Lifestyle, Community, Local Economy, Activities, Built Environment, Natural Environment, and Global Ecosystem. The maximisation method structures the design process, enabling transparent urban design decisions throughout the process. The results suggests that targeted increase and decrease in GSI across the site can strengthen different health determinants. Although empirical data on the precise relationship between density measures and health determinants remains very limited.

All in all, this thesis demonstrates that the maximisation method can effectively serve as a design framework to operationalise the Health-Density nexus, offering a path towards urban densification strategies that supports urban health.

Half of the people worldwide currently live in urban areas, which is expected to grow to two-thirds by 2050. Though relatively little is still known about the exact effects of urban living, in particular on our health, some patterns have been recognised: a higher likelihood of developing mental health issues, a high degree of car-dominance and -dependence, and strongly felt effects of climate change. These diverse issues have one overlapping factor, which is urban stress, the main topic of this thesis. People with a low socioeconomic status experience this especially severly, due to their higher likelihood of living in “problem areas” with many urban issues, in addition to other financial worries. This thesis aims to find out what the exact causes of urban stress are, and find out design solutions that can help lower this urban stress. The question at the centre of this thesis is “What spatial design elements can improve the health of residents of vulnerable neighbourhoods with a low socioeconomic status through stress-relief, based on the case study of Overvecht, Utrecht?”. Overvecht is chosen as a case study, as it has all of the aforementioned urban issues, in addition to issues related to socioeconomics. Firstly, through literature review, sources of urban stress (“stressors”) are formulated and bundled in the so-called STRESS framework, which divides the stressors into five categories: Social, Activity, Economy, Nature, and Personal experience. Then, design solutions are presented in the form of the RELAX framework, which has the same categories, but seen from the perspective of stress-relief rather than stressors. Both of these frameworks are then applied in Overvecht, which shows how they work in practice. This same method could be used in other vulnerable neighbourhoods with similar issues related to urban stress. The main take away is that the different design solutions all depend on each other and to properly and effectively lower urban stress, the different perspectives should all be considered and formed into a synergetic vision/design, which reacts to local circumstances and wants and needs of local residents.