Noncommunicable diseases and mental health

NMH Newsletter

Issue 1, January 2011

WHO Centre for Health Development, Kobe, Japan

Global Forum on Urbanization and Health

The WHO Global Forum on Urbanization and Health brought together government leaders and city mayors with experts from around the world to address the links between cities and health. The Forum was hosted by the WHO Centre for Health Development (WHO Kobe Centre) in Kobe, Japan on 15-17 November 2010.

"Building on the opportunities presented by concentrated urban living, city leaders can have a dramatic and positive impact on the health of their societies," said WHO Director- General Dr Margaret Chan. "Providing safe public transport, investing in public utilities, and reducing air pollution by banning smoking in public can lead to a marked improvement in urban public health."

Urbanization is a major challenge for public health, with more than half of the world's population now living in urban areas. However, city living also provides great potential for better work, education, social, cultural and other opportunities. With the number of urban residents growing by nearly 60 million people per year, urban planning to reflect broader policies incorporating health is now more vital than ever.

Ministers and city leaders from cities as distant as Windhoek, Bangkok, Addis Ababa and Shanghai exchanged policy ideas and best practice. Leaders and representatives from over 90 countries from around the world learnt from the example of these cities to see how they can shape policy to enhance rather than damage the health of their populations.

There have been several recent and important commitments from leaders to improve urban living: in Southeast Asia, Health Ministers adopted the declaration of action on urbanization and health 7 September. In the Americas, Health Ministers held a Roundtable on 29 September to discuss the issues and in the Western Pacific, Health Ministers on 15 October declared actions be taken to promote healthy settings in cities and islands.

Hidden cities

New report shows how poverty and ill-health are linked in urban areas

A new report published on 17 November 2010 by WHO and the United Nations Human Settlements Programme (UN-HABITAT) showed for the first time how ill-health is linked to poverty in cities, and not just among the poorest urban populations. It calls for policymakers to take action targeting health inequities.

The report, Hidden cities: unmasking and overcoming health inequities in urban settings, will enable city leaders and urban planners to identify deprived populations and target measures to improve their health.

The report is based on a new analysis that looks beyond city averages or beyond the usual information from cities and towns to identify hidden pockets of ill-health and social deprivation. Past efforts have largely focused on data averages, and on differences between cities. The new approach combines available demographic data with novel analysis to unmask urban averages. These findings allow city leaders and policy makers to look at trends, even within neighbourhoods and understand differences within as well as between cities.

"Averages hide large pockets of disadvantage and poor health, concealing the reality of people’s lives," said WHO Director-General Dr Margaret Chan. "This new analysis uncovers gaps in health and healthcare access across urban populations, and shows city leaders where their efforts should focus."

This new report reveals inequities by looking at subgroups of city dwellers according to their socioeconomic status, neighbourhood or other population characteristics.

"All too often policy makers and planners fail to understand that with the urbanization of poverty, many slum dwellers suffer from an additional urban penalty: they have a higher rate of child mortality, die younger and suffer from more diseases than their more affluent neighbours," said Joan Clos, Executive Director of UN-HABITAT. "To better understand the causes of poor health, the report focuses on several factors including population dynamics, urban governance, the natural and built environment, the social and economic environment, and access to services and health emergency management."

The report notes that unless urgent action is taken to address urban health inequities, countries will not achieve the health-related Millennium Development Goals. Targets are set for countries as a whole but cities are crucial parts of the equation, as now half of the world’s population lives in cities. Success in reaching MDG targets will depend in large part on achievements among urban populations.