Better urban design could create healthier cities

A new series published in The Lancet, led by the University of Melbourne and featuring authors from leading global academic institutions, quantifies for the first time the health outcomes that could be gained through changes to urban design and the transport system.

The three-paper series, launched at an event hosted by the United Nations Sustainable Development Society Network in New York, compares six global cities with a variety of livability indexes. Cites examined include Melbourne, London, Boston, Delhi, Sao Paulo and Copenhagen.

With the world’s population estimated to reach 10 billion by 2050, with 75% living in cities, city planning is now being recognised as a part of a comprehensive solution to tackling adverse health outcomes. The series unravels the intersection of urban design, transport and population health outcomes to provide a paradigm shift for approaches to tackle the growing burden of chronic disease and road trauma in cities.

The authors identify the health gains that could be achieved if cities encouraged a modal shift from private motor vehicle use to active transport, namely bicycling and walking, and increased public transport use, services and amenities. The findings offer policymakers evidence that substantial health benefits can be achieved for urban populations by adopting different approaches to urban and transport policy and planning.

Series lead Professor Mark Stevenson said momentum and awareness is growing around the health and wellbeing benefits available through changes to city planning and transport modal shift. “By quantifying the need for integrated city planning and its focus around modal choice for cities,” he said, “[the research] emphasises the need for sustainable transport that will deliver health gains for the future.”

The first paper of the series, led by Professor Billie Giles-Corti, identifies eight integrated interventions that, when combined, encourage walking, cycling and public transport use while reducing private motor vehicle use. These include having services and facilities within walking distance, a mix of employment and housing across the city, reducing the availability and increasing the cost of parking, infrastructure that supports safe walking and bicycling, open spaces, reducing distance to public transport and making neighborhoods safe, attractive and convenient for public transport.

“We concluded that focusing on walking and cycling infrastructure alone is critical but not enough — to create cities that promote health needs joined-up policies and input across multiple sectors: land use, transport, housing, economic development, urban design, health and community services, and public safety,” Professor Giles-Corti said.

The second paper proposes a ‘compact city’ model that incorporates health-inclusive urban planning interventions. The model is based on a 30% increase in land-use density, a 30% reduction in distance from public transport, a 30% increase in diversity of land use and a 10% shift away from private vehicle use.

“Adopting the compact cities model, that places an emphasis on active transport, provides a huge reduction in chronic diseases burden, particularly respiratory and cardiovascular disease and Type 2 diabetes,” Professor Stevenson said. “The provision of safe infrastructure for active transport also reduces road trauma and transport-related particulate emissions.”

For Melbourne, this would result in improved health outcomes, with a 14% reduction in Type 2 diabetes and a 19% reduction in cardiovascular disease, resulting in 622 healthy years of life gained for 100,000 residents.

The final paper in series focuses on how data can guide city-planning policy and practice to create compact cities that promote health.

The findings provide a blueprint for achieving a number of the United Nations’ Sustainable Development Goals that include promoting healthy living by making cities inclusive, safe, resilient and sustainable.

To access the article series, visit www.thelancet.com/series/urban-design.

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