WHO Guide Targets Urban Health Gaps
Geneva: Released today on World Cities Day, a study of 363 cities across nine Latin American countries reveals life expectancy gaps of up to 14 years for men and 8 years for women between the healthiest and least healthy urban centres. This highlights stark inequities that the World Health Organization (WHO) said it aims to address with a new strategic guide for decision-makers.
The document titled ‘Taking a Strategic Approach to Urban Health’ offers the first comprehensive framework to integrate health into urban policy, responding to the reality that over 4.4 billion people—more than half of humanity—now live in cities, a share projected to reach nearly 70 per cent by 2050. In these dense environments, health, environment, economy, and inequality converge, creating both profound risks and transformative opportunities.
The most severe outcomes concentrate in slums and informal settlements, where 1.1 billion residents endure unsafe housing, inadequate sanitation, food insecurity, and rising exposure to floods and extreme heat—a population expected to triple to 3.3 billion by 2050. Urban dwellers everywhere face overlapping threats: air pollution that kills around 7 million people annually, with nearly every city resident breathing air below the WHO’s guideline values; unsafe transport; noise; poor housing; and limited green spaces that elevate noncommunicable disease risks. Dense populations also accelerate infectious outbreaks like COVID-19 and dengue.
Jeremy Farrar, Assistant Director General for Health Promotion, Disease Prevention and Care at the WHO, called it a defining moment for cross-level action. He stated that the guide provides national and municipal leaders, planners, partners, and communities with a collaborative structure to build fairer, healthier, and more resilient futures across sectors and scales.
Etienne Krug, Director of Health Determinants, Prevention and Promotion at the WHO, described cities as central to public health progress. He said the guide equips governments with a roadmap to operationalise links with global issues, including climate change, transport, digital transformation, and migration.
The guide outlines four practical steps: understanding urban systems’ complexity and their impact on health and equity; identifying entry points across policy agendas in other sectors; strengthening implementation through governance, financing, data, innovation, capacity-building, partnerships, and participation; and developing comprehensive urban health strategies at national and city levels.
Decision-makers are already bringing community voices directly into urban design for health in several locations. In Nairobi’s Dandora neighbourhood in Kenya, residents are collaborating with local authorities to redesign public spaces, improve waste management, and expand access to clean water and green areas, reducing exposure to pollution and disease vectors. In Suva, Fiji, community-led planning is integrating climate resilience into housing and sanitation upgrades, addressing flood risks and waterborne illnesses in low-lying informal settlements. In Makassar, Indonesia, participatory mapping and health impact assessments are guiding infrastructure investments to enhance pedestrian safety, active transport options, and air quality monitoring. In Coimbra, Portugal, neighbourhood councils are co-creating policies for age-friendly public spaces, mental health support hubs, and inclusive digital access, ensuring older adults and vulnerable groups shape urban environments that support longevity and well-being. These examples illustrate how localised, inclusive strategies can yield broader benefits, including economic vitality through appealing, secure, and opportunity-rich living conditions that attract residents and enterprises.
The WHO today urged leaders to adopt this approach, recognising that health decisions span multiple sectors and scales—from clean air and safe housing to active mobility and digital access. Aligning these choices advances sustainability and fairness.
Alongside the guide, the WHO launched the first three modules of an Urban Health E-learning course via the WHO Academy to build collaborative capacity in urban contexts. Developed with global expert input and decades of the WHO’s urban health work, the guide demonstrates that strategic health integration fosters healthier, more adaptive societies.
Urban environments have now become the dominant day-to-day influence on human health while also driving global challenges such as climate change, resource scarcity, and growing inequality. This positions cities not only as the front line for today’s health challenges but also as the greatest hope for transformative change. People and businesses increasingly seek environments that offer safety, livability, and opportunity.
The guide responds to growing demand for integrated solutions that address health challenges and promote health more broadly in urban settings.
“Taking a Strategic Approach to Urban Health” outlines practical steps for governments to:
- understand the complexity of urban systems and how they shape health and equity;
- identify entry points for action, recognising opportunities to build urban health across policy and practice agendas in other sectors and issues;
- strengthen the means of implementation for urban health, including governance, financing, data, analytics, innovation, capacity-strengthening, partnerships and participation; and
- develop comprehensive urban health strategies at both national and city levels.
It is the first comprehensive framework of its kind to help governments plan urban health strategically, integrating evidence into policy and practice. Health is not the responsibility of one sector alone, nor limited to the decisions of city officials. From clean air and safe housing to active mobility and digital access, to broader financing and regulatory action, decisions made every day by urban authorities across multiple sectors and scales affect the health of billions. Taking strategic action means aligning these choices to build healthier and fairer futures, where urban systems work together to advance equity, sustainability, and resilience.
The WHO called on municipal and national leaders to adopt a more strategic approach to urban health, recognising the crucial role that local and national governments play in creating coherent health action that aligns with other societal goals, and making urban areas not only more livable, but more just and sustainable.
– global bihari bureau
