Incorporating Health into Urban Planning: Lessons from Building Healthy Cities and the World Urban Forum

As countries worldwide continue to experience rapid urbanization, there is an increased need to address health risks due to lifestyle factors in urban environments. These include non-communicable diseases, respiratory illnesses, over and undernutrition, and infectious diseases, among others. According to the United Nations[i], 54.5 percent of the world’s population lived in urban environments in 2016. That number is expected to increase to 60 percent by 2030. Now, more than ever, cities must address the underlying causes of health risks in urban environments.

Addressing health in urban settings is a priority area for JSI. The USAID-funded Building Healthy Cities (BHC) project, implemented by JSI and partners*, aims to refocus city policies, planning, and services with a health equity lens while improving data-driven decision-making for “Smart Cities” in India, Indonesia, and Vietnam. The goal is to identify cost-efficient yet high impact ways to improve urban health across sectors; ensure health is appropriately accounted for within urban planning; reduce transaction costs of data produced for policy decisions; and empower citizens to demand better health-related services. The anticipated results of the project’s work include changes to urban planning that improve access to health services, decrease risk factors for chronic diseases, lower the burden of infectious diseases, and widen access to data related to social determinants of health.

As part of JSI’s efforts to engage urban stakeholders in sectors outside health, the project hosted a training event, titled “Building Smart, Healthy Cities – Tools for Embedding Health Considerations into Urban Planning,” in February at the ninth session of the World Urban Forum (WUF) in Kuala Lumpur, Malaysia. Using tools developed by BHC, the training stimulated participants to examine how health can be embedded in urban planning. The participants acquired the requisite knowledge and skills needed to prepare development plans for their own cities that align with the WUF’s New Urban Agenda, and support several key sustainable development goals under the principle of “Health in All Policies.”

The participants learned about social determinants of health—things outside the control of just one person but that impact people’s daily living conditions and ultimately one’s health outcomes. Examples showed how health outcomes can be improved in urban settings in Asia by addressing social determinants of health through policy and interventions at the city and other levels. Representatives from two BHC partner Smart Cities—Indore, India, and Makassar, Indonesia—presented on the promising work taking place in their cities. In Indore, this includes constructing public toilets; improving infrastructure and education tools in public schools; upgrading water supply and waste management; and road safety projects. In Makassar, activities include equipping home care ambulances with telemedicine capabilities; developing a green corridor through the city; digitally integrating health service provider management data; and using a “War Room” dashboard to monitor real-time data from various sources to better address issues of public safety and disease, among others.

Above, training participants discuss social determinants of health and design a systems map of key sectors and stakeholders. Photo credit: Kim Farnham Egan, JSI.

Participants then broke into small groups to conduct a systems mapping exercise around social determinants of health in a case city. The exercise led to discussions about the populations that are vulnerable to health shocks in each chosen city, examining what makes them vulnerable and whether their voices are typically heard by those with the power to initiate change. The groups also discussed the sectors in a city that could influence social determinants of health. These include transportation, the private sector, local government, and NGOs. They also talked about the key stakeholders that could be engaged in each sector to lead and support improvement efforts, such as government officials, resident welfare associations, or academic institutions. Finally, the groups presented their systems map and shared key points from each case city discussion.

The participants came from 14 countries across 5 continents, with backgrounds in a variety of sectors including health, academia, governance, urban planning, and conservation. The diverse experiences and knowledge among participants resulted in an engaging discussion and underscored the fact that health really does have a place in all sectors.

Stay tuned for more updates from BHC. Resources and tools will be made available as the project continues to address social determinants of health. The project is also discussing reprising this training in BHC countries.

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*Building Healthy Cities is a three-year cooperative agreement funded by the United States Agency for International Development and implemented by JSI Research & Training Institute, Inc. (JSI) with partners Urban Institute, International Organization for Migration, and PricewaterhouseCoopers Pvt Ltd.

[i] United Nations, Department of Economic and Social Affairs, Population Division (2016). The World’s Cities in 2016 – Data Booklet (ST/ESA/ SER.A/392). Available at: http://www.un.org/en/development/desa/population/publications/pdf/urbanization/the_worlds_cities_in_2016_data_booklet.pdf