Healthy cities

Health should be the “pulse” of the new urban agenda.
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Air pollution levels are still 25-50 percent above WHO air quality guidelines in many wealthy cities of Europe, and much higher than that in lower-income ones.
The good news is that strategies are available for making cities healthier and more vibrant places to live, work and raise families.

Health needs to be an integral part of Habitat III, the Third UN Conference on Housing and Sustainable Urban Development, and of its outcome.

The New Urban Agenda, the outcome document, will guide policies on cities at a time when urban growth will have a defining role in the future of climate and environment, and on our ways of doing business, on our lifestyles, and on our health.

Twenty years ago, at the time of Habitat II, most of the world’s population was still based in rural towns or villages. Massive urban migration since then has meant that more than half of us now live in cities, with low-income ones growing fastest.

The growth of cities has created unprecedented economic opportunity, as well as greater access to health and social services for many of the world’s poor. But rapid uncontrolled urban growth has also had profoundly negative impacts, which need urgently to be addressed to fulfil the potential of urban communities and contain global temperature rises.

Developing countries are confronting a “double burden” of communicable and non-communicable diseases. Longstanding epidemic-prone illnesses, such as dengue fever, are again threatening cities, while new threats, like the Zika virus – transmitted by the same mosquito vector – are emerging. Transmission is exacerbated by poor water and waste management and broader trends of globalization and changing weather. Slum conditions are breeding grounds for other infectious diseases, like childhood pneumonia, diarrhoea, and tuberculosis.

Meanwhile, soaring levels of urban outdoor air pollution, sedentary lifestyles, unhealthy diets, and road traffic injuries are contributing to the global pandemic of noncommunicable diseases.

According to the latest World Health Organization (WHO) data, as many as one-quarter of deaths from heart disease, and one-third or more of deaths from stroke, lung cancer and chronic respiratory illness result from exposures to outdoor and household air pollution. The greatest exposures to outdoor air pollution are often in and around cities.

Air pollution levels are still 25-50 per cent above WHO air quality guidelines in many wealthy cities of Europe, and much higher than that in lower-income ones.
The same sources of urban air pollution are drivers of other health threats – and inequities. Poor neighbourhoods are often located near the busiest highways and dirtiest industries, for instance. Pedestrians, many of them children and teens, are often most at risk of traffic injury and other environmental health hazards.

Cities also consume two-thirds of primary energy resources, and are a driver of climate change. Sustainable urbanization is thus critical to limiting global average temperature rise to 1.5 °C.

The good news is that strategies are available for making cities healthier and more vibrant places to live, work and raise families. Many cities, both rich and poor, have well-documented successes in transport, housing, air quality and waste management. Safe rapid transit systems and pedestrian and bike routes can reduce long term health risks from air pollution - as well as the very immediate, and catastrophic effects of traffic injury - while supporting healthy physical activity as cities grow and develop.

Urban green spaces for community gardens and urban design policies that foster fresh food markets and other basic services within walking distance of residential neighbourhoods can help improve access to healthier foods.

Healthy planning of compact walkable neighbourhoods is also more equitable, as it ensures access by the poor and carless to jobs, education and basic health services. It can also reduce energy consumption and pollutant emissions.

Linking health to the New Urban Agenda can help make the difference to the future of cities, our health and our environment. WHO is doing its part to advance this kind of vision at Habitat III, advocating for health as a cross-cutting theme and for an urban air quality target that can mobilize action. It is also collaborating with the Climate and Clean Air Coalition (CCAC) to Reduce Short-lived Climate Pollutants, hosted by UN Environment, to foster new examples of urban health initiatives that cut both air pollution and climate emissions, and position the health sector as an advocate of change.

Public awareness is critical. The WHO/CCAC BreatheLife campaign (, announced at the Second Global Climate and Health Conference in July 2016, is helping raise awareness of air pollution and climate among the urban public, using digital media in innovative ways and urging urban leaders to “breathe life” into their cities by committing to reduce air pollution to WHO guideline levels.

Thanks to WHO’s global Air Quality and Health platform, detailed data are available on air pollution trends and health impacts for 3000 cities. Research institutions and other UN agencies, including UN Environment, are collaborating to improve data generation and assessments.

All of these actions are underpinned by a new World Health Assembly Air Pollution resolution, approved in 2015, followed by an implementation “Road Map” in 2016. Both reflect the growing commitment of the health community to address today's biggest environmental risk to health.

We know that health can be a powerful catalyst to help address complex subjects ranging from poverty to climate change. Focusing our efforts on the New Urban Agenda, we can build on the promises of the 2015 Paris Climate Agreement through comprehensive urban actions. As I said at the Paris conference last December, "healthy people and a healthy planet" are two sides of the same coin. The New Urban Agenda has the opportunity to advance both.

Let’s make this vision a reality, block by city block.