New Towns (NTs) are residential settlements characterized by a notable disconnect between urban planning theory and actual implementation. To address this gap in the context of old New Towns (old-NTs) in East Asia, this study empirically aims to examine the transformation of healthcare facilities by land-use zone using the case of Senboku New Town (Senboku-NT), a prominent old-NT in Japan. Employing an explanatory sequential mixed-methods design, the analysis reveals substantial growth in healthcare facilities within low-rise residential, medium-rise residential, and community center zones. These transformations reflect adaptive responses to demographic aging and the decline of traditional retail activity. The findings indicate that the original neighborhood-unit model, particularly Principle-5 (local retail facilities), requires revision to explicitly incorporate eldercare services within community centers tailored to aging populations. Additionally, the study identifies a new planning principle: establishing general hospitals on vacant lots within medium-rise residential zones. This aligns with NHS England's integrated health hubs concept, offering a practical approach for transforming aging communities into Healthy New Towns. In contrast to the predominantly top-down NHS approach, the Senboku-NT case underscores the role of bottom-up processes in reshaping neighborhood-unit principles to accommodate demographic changes. By demonstrating these urban transformations empirically, this study clarifies how the functionalist neighborhood-unit model is functioning in the Senboku-NT context, illustrating existing theoretical and practical gaps. The insights offer practical urban management strategies derived from this specific case study, which may be transferable to other old-NTs managing similar demographic transitions, particularly in Japan and East Asia. • Analyzed the urban transformation of healthcare facilities according to zone types. • Explanatory sequential design of mixed method as a case of Senboku New Town. • Healthcare facilities increased from 2003 to 2023 according to aging population. • Community center zones need to have more local shops and eldercare facilities. • The trigger for the transformation was the relocation of the general hospital.
Haruka Kato (Wed,) studied this question.