Opinion – Claudio Bernardes: Healthy cities for healthy people

In a world that is moving very quickly towards the existence of a predominantly urban population, the WHO (World Health Organization) declares that city planning is recognized as a critical part of a comprehensive solution to deal with adverse health outcomes.

Although we are going through a long and painful pandemic process, the relevance of non-communicable diseases for the health of the world population is increasingly evident. By 2030, according to scientists, they will be responsible for 77% of the global disease burden. Cardiovascular or heart disease are the most common types, accounting for 44% of all deaths caused by noncommunicable diseases.

Work published by researchers at the University Medical Center in Mainz, Germany, explores how urbanization exacerbates the risks of such diseases, thereby threatening the population of cities. Can urban planning protect health?

The Mainz study synthesizes the existing evidence about the impact on health of various urban environmental risks related to air pollution (respiratory and cardiovascular diseases), with noise from means of transport, which contribute to the risk of metabolic diseases by increasing the levels of stress hormones, heart rate and blood pressure; and with light pollution at night associated with changes in circadian rhythms, which are linked to conditions such as obesity and heart disease. The work also points out how human health and climate change are related.

Car-based mobility cities favor traffic congestion, air pollution and noise. The result is more stress, trauma, and physical inactivity, which result in poorer overall health and more deaths. It is concluded that we need better projects for our cities. The study shows, for example, that 20% of all deaths could be avoided if cities were designed to meet recommendations related to physical activity, air pollution, noise, heat and green spaces.

The researchers identified four urban models that can be described as healthy. The first is the compact city, with high density, optimized transport and wide green spaces.

The second model is the city structured in superblocks delimited by arterial roads, in which pedestrians and cyclists have priority and residential traffic is only allowed with a speed limit. In Barcelona, ​​Spain, urban planning carried out in this way is estimated to prevent nearly 700 premature deaths each year.

The third is linked to the 15-minute city, which has recently regained popularity as a form of urban structuring due to the pandemic. That idea, to which Anne Hidalgo, mayor of Paris, tied her campaign for re-election in 2020, is that all residents can easily meet their essential daily needs in 15 minutes by walking or cycling.

Finally, the car-free city model successfully implemented in the Vauban district of Freiburg, Germany, is structured around the reduction of unnecessary private traffic and easy access to active public transport.

Pollution, green spaces and housing quality are interlinked issues. Thinking about them as a contribution to structuring urban areas can help to understand how, together, they impact on health problems and socioeconomic status, which influence the extent of their effects.

Ultimately, considering modes of transport, energy sources or housing, work and leisure options, there is an urgent need to consistently assess all urban factors that affect our well-being. This would position urban planners as de facto health professionals, with the concomitant responsibility to plan cities and protect human health.