Health and sustainable development

Case studies of healthy, sustainable cities

WHO/CCAC urban health initiative

In many developing cities, population growth is far outstripping the capacity of municipal governments to plan and build infrastructure. Economic development, environment and health sectors are not well aligned on pollution issues and actions, and implementing integrated strategies is not easy. The Urban Health Initiative aims to catalyze more effective urban action on air pollution and SLCPs – saving lives by linking health, environment and development decision-makers to forge policies that reduce short-lived climate pollutants.

In an initial six month “scoping” phase, a worldwide mapping of city initiatives that focus on climate, SLCPs and air quality is being undertaken to identify opportunities for the CCAC initiative to make a difference. This ‘scoping phase’ includes outreach and consultations with urban leaders from developed and developing cities around the globe.

Following the scoping phase, pilot cities will be selected for further in-depth work, building on synergies with other CCAC initiatives and complementing other national and international initiatives to reduce urban air pollution. Capacity-building will be a key component of this phase, for instance, health sector actors may be trained to estimate local mortality from air pollution – and thereby track air pollution reductions achieved from actions in other sectors, e.g. shifts to cleaner transport systems.

Objectives

The initiative’s mission is to help empower cities to take effective action on air quality, in collaboration with health, environment and development sectors. The CCAC initiative is led by WHO, UNEP, the World Bank, governments of Norway and the United States, as well as urban and civil society stakeholders, such as ICLEI (International Council for Local Environmental Initiatives) and ICIMOD (the International Centre for Integrated Mountain Development). Working through our respective organizations and agencies, we aim to harness the energies of existing sustainability initiatives, focusing on synergies among health, air quality and environment, and development leaders. Traditional practitioners will play a particularly important role in reaching high-risk and vulnerable populations.

The initiative will link with other related CCAC initiatives such as those promoting cleaner heavy-duty diesel vehicles, better management of municipal solid waste, and cleaner brick production and domestic cookstoves to improve people’s health in near-term and for future generations. Lessons learned in urban areas will be used to support action in rural areas.

Healthy and equitable urban planning - Curitiba, Brazil

Curitiba’s bus system is a model for rapid transit.
WHO

Curitiba, Brazil, is an example of how governments and planners worked together to design low-emission, health-promoting communities, integrating urban planning, green spaces and waste management strategies. Despite a five-fold population increase in the past 50 years, air pollution in Curitiba is close to WHO guideline levels for PM and comparatively better than in many other rapidly growing cities

The success of Curitiba is due to a number of factors, including a long-term plan for development designed in 1966. Curitiba has become more than 4 times denser, expanded the amount of green space per resident, and created a comprehensive urban transport system that is used regularly by an estimated 72% of the population. More than 1.5 million trees have been planted, over 50% of paper, metal, glass and plastic is recycled, and there is an extensive network of pedestrian walkways. In terms of health, life expectancy in Curitiba at 76.3 years is two years longer than the national average, and the city also has relatively low infant mortality.

Part of Curitiba’s success is the result of initiatives directly aimed at low-income residents, which promote health, environment and equity simultaneously, such as:

  • provision of social housing in mixed-income neighbourhoods;
  • a program where garbage can be exchanged for bus tickets and/or vegetables, improving both nutrition and sanitation;
  • ensuring broad access to public transport, anchored by a bus rapid transit system of exclusive busways;
  • preserving green spaces in areas vulnerable to flooding, also reducing human vulnerability;
  • free medical and dental care to low-income residents.

Curitiba owes part of its success to strong governance and institutions. A cogent long-term vision, sustained political commitment, and a politically insulated regional planning organization to implement the vision have all been crucial steps in the city’s long-term sustainable urban pathway.

Building climate resilience – Da Nang, Vietnam

Da Nang Skyline
Jess Sloss/Flickr Commons

Climate change is a significant and emerging threat to public health, posing the greatest risks to vulnerable populations, particularly the urban poor. Due to its low-lying coastal location by the mouth of the Han River, the city of Da Nang in central Vietnam is particularly vulnerable to rainfall variability and typhoons. This vulnerability is expected to increase with climate change-related sea level rise, increased frequency of typhoons, and increased variability in rainfall.

Intra-urban inequities in Da Nang produce cause low income communities to be more vulnerable to these environmental threats, in addition to the social impacts of unstable employment and insufficient access to health care, education, housing and other services.

To face those challenges, the government of Da Nang has developed a series of policy interventions to enhance climate resilience, including early flood warning systems, an integrated coastal management plan, and improved urban planning. These projects have been developed by encouraging inter-agency cooperation and the raising of awareness at all levels of municipal governance.

Sustainable urban transport - Freiburg, Germany

Outdoor air pollutioncauses some 3.7 million global deaths each year. Another 1.25 million people die from traffic injuries while 3.2 million deaths are due to a lack of physical activity.

Although this burden is concentrated in developing countries, air pollution levels in developed countries of the European region can still be above the WHO guideline limits, and it is estimated that in OECD countries, the transport sector is responsible for up to 50% of air pollution-related health damage.

The city of Freiburg in south-west Germany has become a world leader in integrating sustainable transport and land-use in urban planning. Elements of this transformation include:

  • prioritising public transport infrastructure development ahead of residential expansion;
  • effective implementation of improvements in public transport;
  • promotion of bicycling and walking for short trips;
  • restrictions on car use.

As a result of these policies, and despite significant economic and population growth, the level of motorization in Freiburg has levelled off and per capita CO2 emissions from transport have decreased. Furthermore, the number of trips by bicycle in the city has tripled, transit ridership has doubled, and the share of daily trips by car has decreased from 38% to 32%.

’Freiburg’s combined 68% share of trips by public transport, bicycling and walking is higher than in most other cities of similar size: 2 to 10 times higher than in North American cities and 10% to 30% higher than in other German cities. Share of trips in Freiburg in 2007 by mode was: 27% bicycling; 23% walking; 18% public transport, and 32% car trips. The high reliance upon low-emissions modes is well reflected in Freiburg’s air pollution levels, which meet WHO guidelines for small particulate concentrations.

Slum housing upgrade – Indonesia

Cyclists in the alley of a neighbourhood in Indonesia which has undergone the urban reclamation and upgrading programme.
Jeff Kenworthy

Housing upgrade projects can promote both health and sustainability. For instance, in densely population Indonesian working-class neighbourhoods called kampongs, alleys previously obstructed with road traffic were reclaimed for pedestrians. Furthermore, the alleys were “greened” with urban pocket gardens. This project was part of a larger programme for water, sewage, and housing improvements in the neighbourhoods. Such upgrades reduce air pollution exposures and injury risks due to heavy road traffic, while improving health particularly for children and promoting physical activity for urban dwellers.