Advancing equitable and sustainable urban health – Nature

Report on Advancing Equitable and Sustainable Urban Health in Alignment with Sustainable Development Goals

Introduction: Urbanization and its Impact on the SDGs

• The majority of the global population resides in cities, with future growth projected to be concentrated in low- and middle-income countries.
• Rapid and unmanaged urban expansion presents significant challenges to achieving SDG 11 (Sustainable Cities and Communities).
• This growth can generate adverse health impacts, including non-communicable diseases, infectious diseases, and injuries, thereby hindering progress on SDG 3 (Good Health and Well-being).
• Furthermore, unmanaged urbanization magnifies social and environmental inequities, directly conflicting with the aims of SDG 10 (Reduced Inequalities) and SDG 13 (Climate Action).

Key Determinants of Urban Health

• Urban health outcomes are shaped by a complex interplay of social and physical environments that affect individuals over their life course.
• These factors are embedded within upstream social and economic systems, highlighting the need for an integrated approach that connects urban planning with broader development objectives such as SDG 1 (No Poverty) and SDG 8 (Decent Work and Economic Growth).

Research Priorities for Achieving Sustainable and Equitable Urban Health

1. Enhanced Descriptive Analysis to Address Inequities (SDG 10, SDG 3)

   • Sharper descriptive research is required to expose and quantify health gaps both within and between cities.
   • Systematic tracking of health trends is necessary to provide actionable data that can spur policy action and monitor progress towards reducing health disparities, in line with SDG 10 and SDG 3.

2. Strengthened Causal Studies on Urban Health Factors (SDG 11, SDG 3)

   • More robust causal studies—employing longitudinal data, quasi-experimental designs, and systems modeling—are needed to clarify how specific urban factors impact health.
   • Understanding these causal pathways is essential for designing effective interventions that promote well-being (SDG 3) in diverse urban settings (SDG 11).

3. Rigorous Evaluation of Multisectoral Policies (SDG 3, SDG 10, SDG 11, SDG 13)

   • Rigorous evaluations and simulations of transportation, housing, fiscal, and climate policies are critical.
   • This research must quantify the co-benefits of such policies for health (SDG 3), equity (SDG 10), and environmental sustainability (SDG 13) to guide integrated, multi-sector action toward building sustainable cities (SDG 11).

4. Stakeholder Engagement for Policy-Relevant Evidence (SDG 17)

   • Meaningful engagement with communities and policymakers, from agenda-setting to dissemination, is essential.
   • This collaborative approach ensures that evidence is locally relevant, politically usable, and fosters the multisectoral collaboration required to achieve the SDGs, as emphasized by SDG 17 (Partnerships for the Goals).

Conclusion: A Call for Integrated Action

• Cities are uniquely positioned to serve as hubs for reducing health inequities and contributing to environmental sustainability, thereby advancing multiple SDGs simultaneously.
• Achieving this potential requires strong political will, robust evidence generated from targeted research, and effective multisectoral collaboration.
• By aligning urban development with the Sustainable Development Goals, it is possible to build healthier, more equitable, and more sustainable urban futures for all.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article’s central theme is urban health. It explicitly mentions adverse health impacts in cities, including “non-communicable diseases, infectious diseases and injuries,” which are core concerns of SDG 3. The goal of building “healthier… urban futures” directly aligns with this SDG.
• SDG 10: Reduced Inequalities: The article highlights that unmanaged urban growth can magnify “social and environmental inequities.” It calls for research to “expose within- and between-city health gaps” and to guide action toward achieving “equitable… urban health.” This focus on reducing health disparities and inequities is a key aspect of SDG 10.
• SDG 11: Sustainable Cities and Communities: The article is fundamentally about the challenges and opportunities of urbanization. It discusses “rapid, unmanaged growth” of cities, the impact of “transportation, housing… policies,” and the need to build “more sustainable urban futures.” This directly addresses the aim of SDG 11 to make cities and human settlements inclusive, safe, resilient, and sustainable.
• SDG 13: Climate Action: The article connects urban policy with climate issues by calling for “rigorous evaluations and simulations of the effects of… climate policies” to quantify co-benefits for health and sustainability. This links urban development strategies directly to climate action.
• SDG 17: Partnerships for the Goals: The article concludes by emphasizing the need for “political will, robust evidence, and multisectoral collaboration.” It also calls for “meaningful engagement with communities and policymakers.” This highlights the importance of partnerships among different sectors and stakeholders to achieve sustainable urban health, which is the essence of SDG 17.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3 (Good Health and Well-being):
   • Target 3.3: End the epidemics of communicable diseases. The article’s mention of “infectious diseases” as an adverse health impact of unmanaged urban growth connects to this target.
   • Target 3.4: Reduce by one-third premature mortality from non-communicable diseases. The article explicitly identifies “non-communicable diseases” as a key health impact in cities.
   • Target 3.6: Halve the number of global deaths and injuries from road traffic accidents. The mention of “injuries” and the need to evaluate “transportation” policies directly relates to this target concerning urban mobility safety.
2. Under SDG 10 (Reduced Inequalities):
   • Target 10.2: Empower and promote the social, economic, and political inclusion of all. The article’s focus on reducing “health inequities” and promoting “equitable urban health” aligns with this target’s goal of inclusion and reducing disparities.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome. The call to “expose within- and between-city health gaps” aims to identify and address inequalities in health outcomes, which is central to this target.
3. Under SDG 11 (Sustainable Cities and Communities):
   • Target 11.1: Ensure access for all to adequate, safe and affordable housing. The article identifies “housing” policies as a critical area for evaluation to improve urban health and sustainability.
   • Target 11.2: Provide access to safe, affordable, accessible and sustainable transport systems for all. The call to evaluate “transportation” policies for their effects on health, equity, and sustainability directly links to this target.
   • Target 11.3: Enhance inclusive and sustainable urbanization and capacity for participatory planning. The article’s call for “meaningful engagement with communities and policymakers, from agenda setting to dissemination” supports the participatory approach of this target.
4. Under SDG 13 (Climate Action):
   • Target 13.2: Integrate climate change measures into national policies, strategies and planning. The article’s recommendation to evaluate “climate policies” to quantify “cobenefits for health, equity and sustainability” supports the integration of climate considerations into urban planning.
5. Under SDG 17 (Partnerships for the Goals):
   • Target 17.14: Enhance policy coherence for sustainable development. The need for “multi-sector action” and evaluating policies across transportation, housing, and climate for health co-benefits speaks directly to enhancing policy coherence.
   • Target 17.17: Encourage and promote effective public, public-private and civil society partnerships. The emphasis on “multisectoral collaboration” and “engagement with communities and policymakers” reflects the partnership model promoted by this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Health Gap and Trend Metrics: The article calls for “sharper descriptive work… to expose within- and between-city health gaps and to track trends.” This implies the use of indicators such as:
  • Prevalence and mortality rates for non-communicable and infectious diseases, disaggregated by geographic area (within and between cities) and socio-economic status.
  • Data on injury rates, particularly those related to urban infrastructure like transportation.
  • Metrics of health inequity, such as differences in life expectancy or disease burden across different communities within a city.
• Causal Impact Metrics: The call for “stronger causal studies” implies the need for indicators that can measure how specific “urban factors impact health.” This involves tracking changes in health outcomes following specific urban interventions or policy changes.
• Policy Evaluation Metrics: The proposal for “rigorous evaluations and simulations of the effects of transportation, housing, fiscal and climate policies” suggests the use of indicators to quantify “cobenefits for health, equity and sustainability.” This could include:
  • Changes in air pollution levels following a new transport policy.
  • Rates of physical activity after housing or transportation interventions.
  • Metrics of access to services and green space.
• Engagement and Collaboration Metrics: The priority of “meaningful engagement with communities and policymakers” implies indicators related to governance and participation, such as:
  • The number and effectiveness of multi-sectoral task forces or committees on urban health.
  • Evidence of community input in the planning and implementation of urban policies.
  • The development of locally relevant and politically usable evidence briefs and reports.

SDGs, Targets, and Indicators Analysis

Source: nature.com