Indicators

Health-related indicators can be used to measure progress of sustainable development policies related to cities, food and agriculture, energy, water and sanitation – particularly policies with health and equity co-benefits like reducing greenhouse gas emissions and increasing resilience to environmental change. Health indicators reflect progress on social equity, environment, and development of sustainable cities. Core indicators include:

• urban air quality in terms of particulate pollution, with respect to WHO air quality guidelines;
• slum housing improvements that benefit health, as assessed by well-defined measures for safe, resilient, and climate-adapted structures with access to clean energy and basic utilities;
• healthy, efficient transport, in terms of safety and use of sustainable modes, including walking, cycling, and public transport;
• urban violence, in terms of intentional homicides.

Governance indicators assess how cities account for health in urban planning and building codes, and in monitoring of air and water quality and sanitation risks. Furthermore, indicators of urban services essential to public health and sustainable cities can include: access to health care services, green spaces, fresh food markets, and waste management.

Developing sustainable and healthy cities will require a significant improvement in the lives of slum dwellers. However, this has been hampered by the lack of available data with few countries reporting on all five parameters used to define slum households’ access to:

• durable housing structure;
• sufficient living area;
• safe, affordable water;
• improved sanitation; and
• security of tenure.

With the exception of the indicator for slum improvements, most indicators proposed here are already collected by UN agencies, national governments, or by cities themselves.

Guidance and tools

There exists different guidance and tools that provide information on how to create healthy urban environments:

Integrating health in urban and territorial planning: a sourcebook

It is a tool designed to guide decision-makers towards developing cities planned and built with a focus on human and environmental health, showing how an integrated approach to health can influence decisions on sectors such as housing, transport, energy, and water and sanitation.

Compendium of WHO and other UN guidance on health and the environment

It is a comprehensive collection of available WHO and other United Nations (UN) guidance for improving health by creating healthier environments. It provides an overview and easy access of 500 actions, and a framework for thinking about health and environment interventions. It covers a broad range of areas such as air pollution, water, sanitation and hygiene, climate change, chemicals, radiation, or food systems. More information: https://www.who.int/tools/compendium-on-health-and-environment

Hidden cities: unmasking and overcoming health inequities in urban settings

Certain city dwellers suffer disproportionately from poor health and these inequities can be traced back to differences in their social and living conditions. This report provides information and tools to help governments and local leaders reduce health inequities in their cities. The objective of the report is not to compare rural and urban health inequities.

WHO ambient air quality database

It covers more than 4300 cities and settlements in 108 countries. More and more locations are measuring air pollution levels and recognizing the associated health impacts. More information: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/ambient-air-pollution

AirQ+: software tool for health risk assessment of air pollution

This is a health risk assessment and modelling tool that calculates the health effects of long-term exposure to both ambient and household (indoor) air pollution. Air Q+ will allow you to estimate the reduction in life expectancy, and health effects as air pollution levels change. More information: https://www.who.int/europe/tools-and-toolkits/airq---software-tool-for-health-risk-assessment-of-air-pollution

Guidelines on sanitation and health

These guidelines provide comprehensive advice on maximizing the health impact of sanitation interventions. The guidelines summarize the evidence on the links between sanitation and health, provide evidence-informed recommendations, and offer guidance for international, national and local sanitation policies and programme actions. The guidelines also articulate and support the role of health authorities in sanitation policy and programming to help ensure that health risks are identified and managed effectively.

Guidelines for drinking-water quality

These Guidelines aim to protect public health associated with drinking-water quality. In some regions, it has been shown that investments in water supply and sanitation can yield a net economic benefit, because the reductions in adverse health effects and health care costs outweigh the costs of undertaking the interventions.