Urbanization is one of the leading global trends of the 21st century that has a significant impact on health. Over 55% of the world’s population live in urban areas, a proportion that is expected to increase to 68% by 2050. As most future urban growth will take place in developing cities, the world today has a unique opportunity to guide urbanization and other major urban development trends in a way that protects and promotes health.
That is also because the health and well-being of their citizens is perhaps a city’s most important asset. Yet most of the 4.2 billion people living in cities – half of humanity – still suffer from inadequate housing and transport, poor sanitation and waste management, and air quality failing WHO guidelines. Other forms of pollution, such as noise, water and soil contamination, urban heat islands, and a dearth of space for walking, cycling and active living also combine to make cities epicentres of the noncommunicable diseases epidemic and drivers of climate change.
Consequently, today’s cities and those of tomorrow are facing a triple health burden: infectious diseases like HIV/AIDS, tuberculosis, pneumonia, dengue, and diarrhoea; noncommunicable diseases like heart disease, stroke, asthma and other respiratory illnesses, cancers, diabetes and depression; and violence and injuries, including road traffic injuries.
While cities can bring many challenges, they can also bring opportunities for better health, cleaner environment and climate action. Strong urban policies must match those challenges since health is essential for fostering good urban livelihoods, building a productive workforce, creating resilient and vibrant communities, enabling mobility, promoting social interaction, and protecting vulnerable populations.
Cities should also make use of the opportunity presented by having a single authority under a city mayor who is empowered to take cross-sectoral decisions, for example on urban planning, transportation systems, purchasing, supply of energy, water and sanitation, and waste management. Strategic urban planning will be the key to creating supportive and enabling environments for health, making sure that health and equity considerations are integrated throughout the planning process, investments, and policy decisions at the local level.