Urban Health Initiative

Enabling cities to include health in policy-making

The Urban Health Initiative is an implementation framework which aims to reduce the deaths and diseases caused by air pollution and lack of clean energy access in cities. It aims to equip health and other sectors with the data, tools and capacity to demonstrate to the public and decision-makers the full range of benefits that can be achieved from creating healthy urban environments.

The Initiative works with governments and partners to change the trajectory of a city’s health impacts by:

• equipping decision-makers, public health experts and other stakeholders with health-based tools to identify and assess the impacts of unsustainable urban policies;
• fostering the multidisciplinary work across sectors and institutions;
• supporting the mapping of health and economic impacts in transport, land-use, energy, housing and waste management scenarios;
• helping health and development sectors estimate the health costs and benefits of alternative policy choices and business-as-usual scenarios;
• improving communication to nudge the health sector, urban leaders and the public to rally around healthier development choices.

• providing better access to relevant evidence on the linkages between air and climate pollutants and health;
• enabling and encouraging health actors to support sector policies that prevent diseases and pollution;
• strengthening the capacity to analyse, evaluate and communicate health co-benefit opportunities from policies and interventions; and
• helping bridge sectoral decision-making silos, and enhancing intersectoral cooperation.

Urban planning – a health issue

Health is an urban planning issue. The urban environment can promote health or contribute to health risks, including air pollution, traffic injuries, noise stressors, barriers to physical activity and sanitation risks. Policies and investments supporting cleaner transport, energy-efficient housing, power generation, industry and better municipal waste management are therefore essential to creating healthy cities. 

The Urban Health Initiative goes beyond improving access to health care and promoting healthy behaviours, and focuses on how to build cities that enable and encourage good health.

A model process for integrating health into policy-making

1. Map stakeholders and policies impacting urban environments

• Map existing policies and plans with impacts on health e.g. air pollution, land-use, transport and waste management.
• Identify expected health impacts and gaps in ability to collect comprehensive data that support policy action. 
• Map all relevant stakeholders. Consider needs, perceptions and socioeconomic realities of impacted communities.

2. Building capacity for effective engagement

• Train health actors at policy, programme and service delivery levels to engage in cross-sector policy-making processes.
• Conduct relevant health analyses and communicate effectively with the public on links between policies and plans being considered and their relations to health and well-being.

3. Tools for assessing health and economic impacts used locally

• Adapt and apply available tools to assess the health and economic impacts of policies.
  

4. Alternative scenarios and policy options tested

• Test alternative scenarios based on policy options locally to estimate the potential health and economic impacts.
• Identify preferred policy scenarios and interventions.
• Measure health impacts, co‑benefits, and the costs of inaction and intervention. Conduct cost–effectiveness and cost–benefit analyses. 
• Develop city-level action plans, strategies, roadmaps.

5. Urban leaders engaged to communicate cost of inaction 

• Engage urban leaders and champions to communicate the costs of inaction, including through the citywide #BreatheLife communications campaigns, media training, outreach, workshops and social marketing – intensifying demand for action.
• Provide health and economic arguments to spur policy-makers to act.
• Enable health care workers to advise patients, workers and communities on the need for interventions.

6. Policy tracking and monitoring outcomes

• Develop a monitoring framework/tracking mechanism to measure policy change impacts and the results from city initiatives to address policy impacts, urban risks and exposures, and their associated health outcomes.