Better urban planning needed to improve health of city-dwellers
Last Wednesday UCL launched their Lancet-commissioned paper exploring the many issues that impact on health in an urban environment. Taking as its starting point the worrying statistic that 60% of the global population that will be living in cities by 2030, the report examines a cross-section of international case studies, from London to Bogota to Toronto.
Leading the international team which authored the report is the Bartlett’s Professor Yvonne Rydin, who says: ‘While cities have the potential to be healthier places for their citizens, this requires active planning. Economic growth cannot be assumed to lift all urban citizens into a zone of better health. Even in scenarios where health in a city has improved, without active maintenance of investments, gains made can be reversed, leading to increased rates of death and disease.’
Examples from the report include community-led sanitation infrastructure programmes in the slums of Mumbai, India; action for urban greening to protect against heat stress in London summers; and transportation initiatives that encourage physical activity in Bogota, Colombia.
Five case studies illustrate key urban health themes, supporting the urgency of innovative urban planning practices and warning that the full complexity of each situation must be addressed. Planners should be working with all urban health stakeholders, including local communities, particularly vulnerable communities.
A key area to address in developing countries was identified as sanitation and waste water management, using the case study of the Slum Sanitation Programme (SSP) in Mumbai, India. This programme received financial backing from the World Bank and state government to ensure provision of one toilet per 50 people by 2025. A usage fee helps maintain the new sanitation facilities, which in some instances have grown into community centres. The idea behind the fee is that a ‘sense of ownership’ results in improved maintenance.
Another example looked at how a city like London could deal with more frequent heatwaves resulting from climate change, particularly with regard to protecting the elderly and vulnerable. Strategies include not only addressing the building physics of thermal comfort and maintaining good indoor air quality, but also encouraging urban ‘greening’ to abate the heat island effect.
The UCL/Lancet report’s recommendations are that city governments should build political alliances for urban health, whilst the state needs to identify the health inequalities in cities, warning that policy makers need to recognise that cities are complex systems and urban health outcomes have multiple causes.
For the urban planner, the report suggests they include health concerns in their plans, regulations, and decisions. A final key point is that experimentation and learning through projects involving local communities is often the best way forward.