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Improving Global Health With Smarter City Planning


A series of papers in The Lancet highlights how city planning and urban design can prevent chronic diseases and create healthier and more sustainable cities.

By 2050, 75% of the world’s population is expected to live in cities, making city planning key for addressing disease prevention and global health challenges, according to a series published in The Lancet. City planning that encourages walking, cycling, and public transportation can directly and indirectly affect non-communicable diseases, such as cardiovascular disease and diabetes, traffic injuries, and other adverse health and environmental outcomes.

The series was led by the University of Melbourne in Australia and the University of California, San Diego. The series’ authors identified key regional planning and local urban design interventions needed to create cities that promote health. The 3 interventions part of regional planning are destination accessibility, distribution of employment, demand management. The 5 interventions part of local urban design are design, density, distance to public transport, diversity, and desirability.

“With the world’s population estimated to reach 10 billion people by 2050, and three quarters of this population living in cities, city planning must be part of a comprehensive solution to tackling adverse health outcomes,” series author Professor Billie Giles-Corti, University of Melbourne, Australia, said in a statement. “City planning was key to cutting infectious disease outbreaks in the 19th century through improved sanitation, housing and separating residential and industrial areas. Today, there is a real opportunity for city planning to reduce non-communicable diseases and road trauma and to promote health and wellbeing more broadly.”

Giles-Corti added that the researchers had concluded that focusing on walking and cycling alone was not enough. Cities needed policies that included input from multiple sectors: land use, transport, housing, economic development, urban design, health and community services, and public safety.

In one paper of the series, researchers used a health impact assessment framework to estimate the population health effects arising from alternative land-use and transport policy initiatives in Melbourne, London, Boston, Sao Paulo, Copenhagen, and Dehli. As part of the model, land-use density was increased by 30%, which reduced the average distance to public transportation by 30%, and the diversity of land-use was also increased by 30%. Assuming a 10% shift from private cars to either cycling or walking, the researchers predicted health gains in all cities.

“Many countries concerned by the costs associated with the mounting burden of lifestyle-related chronic disease have put in place plans and public policy initiatives that encourage increased levels of physical activity,” the authors wrote. Although the successful implementation of these plans varies, the study’s findings “suggest that government policies need to actively pursue integrated urban and transport planning and design interventions—particularly those focused towards achieving more compact cities—that support and encourage model shifts away from private motor vehicles towards new urban mobility.”

In a commentary, New York City Mayor Bill de Blasio wrote on the importance of parks and green space in urban areas. New York City has nearly 30,000 acres of beaches, community gardens, playing fields, hiking trails and more. A new initiative in New York is adopting strategies to ensure everyone can use these green spaces.

“Today, the City of New York is using the power of green spaces to strengthen the overall health of our thriving metropolis, especially in low-income neighborhoods that are grappling with health disparities,” de Blasio wrote.

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