Health as the 'Pulse' of the New Urban Agenda

The Habitat III New Urban Agenda can be an important inter-governmental framework for integrating health, air quality and climate considerations into cities planning and governance. Sustainable urbanization is a critical prerequisite for improved health and to limit global average temperature rise to 1.5° C. The New Urban Agenda has the opportunity to bring together what WHO Director General Dr Margaret Chan has described as healthy people and a healthy planet as two sides of the same coin.

Health can act as a powerful “accelerator” of progress on the New Urban Agenda. However, reference to health is largely missing from current deliberations.

This event “Health as the ‘Pulse’ of the New Urban Agenda” is co-organized by the governments of Norway and of Ghana, in cooperation with the WHO, UN-Habitat and the Climate and Clean Air Coalition, held at the UN headquarters in New York City on Tuesday 26th April, 2016 from 1:15-2:45 pm.

Experts in this meeting will consider how health issues, tools and actions can be incorporated to address multiple urban challenges, including air pollution, climate change and equity, as well their linkages to urban planning and governance. Member States and other stakeholders will articulate the contribution that the health sector can make to the New Urban Agenda – ensuring that cities, and the people living in them, reach their full economic and social potential. 

HEALTH AT THE NEXUS OF THE NEW URBAN AGENDA

Urbanization has granted us unprecedented mobility and economic opportunity, as well as greater access to health, education and other services. Yet rapid, uncontrolled growth of cities is having profoundly negative health, environment and climate impacts – which urgently need to be addressed to fulfil the true potential of urban communities, while ensuring that global temperature rise is contained.

In terms of health, expanding urban slums, degraded water quality, lack of sewage as well as waste hazards, all have “multiplier” effects on the transmission of vector borne diseases such as dengue and Zika, on childhood diseases like diarrhoea, and on longstanding disease challenges such as helminths and related anaemia.

At the same time, mounting traffic, poorly designed cities and lack of access to clean energy lead to soaring levels of urban air pollution, sedentary lifestyles, and traffic injury which coupled with low access to healthy foods, feed the global pandemic of non-communicable diseases. About one quarter of all heart disease, and over one-third of all chronic respiratory illness, lung cancer and stroke, is due to air pollution, indoors and outside. While most of the 7 million deaths annually from air pollution are concentrated in low income regions, even in European cities, air pollution levels remain severe. A WHO-cosponsored study of 25 cities found air pollution levels 1.5-4 times above WHO guideline goals, leading to the loss of 2-22 months of life, on average, for each city resident.

In lower income cities and population, maternal and child health are intertwined with access to decent housing, water and sanitation services, and clean energy for cooking, lighting and heating. Pedestrians, often children and teens, are among the main victims of urban traffic injury and air pollution affects poor neighbourhoods even more severely. Development of safe mass transit systems, as well as public green spaces for “active transport” are neglected, while expanding highways create new barriers to physical activity. As fast food franchises edge out fresh food markets, healthy food options may be diminished. Urban design factors thus reinforce persistent health inequities – eroding the promise of an inclusive New Urban Agenda.

Many of these same urban planning and investment choices also dramatically increase emissions of greenhouse gases such as CO2 as well as short-lived climate pollutants such as black carbon (emitted by diesel traffic and generators, biomass and municipal waste), and methane, a product of poor municipal solid waste management and peri-urban livestock production. Conversely, solutions that improve health also reduce climate impacts of cities, which represent two-thirds of the world’s raw energy consumption.

HEALTH AS A KEY FACTOR IN URBAN DESIGN AND DEVELOPMENT

CHALLENGES

Sustainable urbanization is therefore a critical prerequisite for improved health and to limit global average temperature rise to 1.5° C. The New Urban Agenda has the opportunity to bring together what WHO Director General Dr Margaret Chan has described as healthy people and a healthy planet as two sides of the same coin.

Urban leaders that incorporate health factors into their urban design and investment decisions for transport, housing and energy can generate immediate health benefits for their urban constituents. They will also reduce emissions of short-lived climate pollutants such as methane, black carbon and HFCs – as well as longer-lived emissions of CO2. What happens in cities can thus make the difference between success or failure in climate targets, near-term – while generating climate mitigation benefits and related health benefits for decades to come.

Urban leaders can capitalize on health arguments to advance a New Urban Agenda for vibrant, people-centered, inclusive and low-carbon cities that promote health and wellbeing to bolster climate and economic goals as multiple “win-wins” – increasing support for bold new decisions. They can also benefit from the support and, credibility and local knowledge that health systems can bring when recommending sustainable local policies as a measure for disease prevention and health promotion, as well as using health indicators to track progress.

A HEALTH ACTION AGENDA FOR HABITAT IIl

This event will explore how urban health actors can advise on urban policies in sectors like transport, housing, waste or energy, so as to prevent disease and promote health, avoiding not only health risks but also large, associated healthcare costs. It will consider how urban policies that consider health can help accelerate urban transformation as well as giving voice to citizens, particularly the weakest social sectors, including children, elderly, persons with disabilities, urban migrants, and those living in informal settlements. Tools in the urban health and design arsenal will be explored including:

• Health-based guidance for air and water quality, as well as for transport and housing design.

• Health impact assessment and health-based cost-benefit assessment of new transport infrastructures – so that costs of traffic injury, air pollution and physical inactivity are considered from the start of planning processes.

• Health-based progress indicators – how tracking of air and water quality, injuries, obesity, and physical activity indicators represent a universal “pulse” against which a city’s health can be measured.

An action agenda for Health in Habitat III will be articulated – to consider the way forward for the contribution that the health sector can make to the New Urban Agenda – ensuring that the people-centred and liveable cities for the future are healthier, more equitable, and reach their full economic and social potential.