Urban Climate Policy and Action through a Health Lens—An Untapped Opportunity

Abstract

Motivated by a growing recognition of the climate emergency, reflected in the 26th Conference of the Parties (COP26), we outline untapped opportunities to improve health through ambitious climate actions in cities. Health is a primary reason for climate action yet is rarely integrated in urban climate plans as a policy goal. This is a missed opportunity to create sustainable alliances across sectors and groups, to engage a broad set of stakeholders, and to develop structural health promotion. In this statement, we first briefly review the literature on health co-benefits of urban climate change strategies and make the case for health-promoting climate action; we then describe barriers to integrating health in climate action. We found that the evidence-base is often insufficiently policy-relevant to be impactful. Research rarely integrates the complexity of real-world systems, including multiple and dynamic impacts of strategies, and consideration of how decision-making processes contend with competing interests and short-term electoral cycles. Due to siloed-thinking and restrictive funding opportunities, research often falls short of the type of evidence that would be most useful for decision-making, and research outputs can be cryptic to decision makers. As a way forward, we urge researchers and stakeholders to engage in co-production and systems thinking approaches. Partnering across sectors and disciplines is urgently needed so pathways to climate change mitigation and adaptation fully embrace their health-promoting potential and engage society towards the huge transformations needed. This commentary is endorsed by the International Society for Environmental Epidemiology (ISEE) and the International Society for Urban Health (ISUH) and accompanies a sister statement oriented towards stakeholders (published on the societies’ websites).

Is climate change affecting mental health of urban populations?

“…Yet, they are also an opportunity to rethink policies and initiatives to embrace health and wellbeing as a primary goal of basic local government functions. Researchers, policymakers, and stakeholders must start working together to create transformative actions that can reshape our cities and living spaces through policies that enable short-term and long-term health benefits for all people, focusing on land use, pollution and clean air and water, waste management, accessible public transport, housing, energy efficient buildings, accessible greenspaces, public open spaces that offer opportunities for social interaction [9], foster communication with citizens and raise awareness, improve residents’ quality of life [42 ▪ ], and create the opportunity to engage in collective actions to build sense of agency in addressing climate change [43]. Moreover, institutions must avoid reinforcing inequalities among the more vulnerable groups or create new inequalities [42 ▪ ], taking into consideration also the repercussion on citizens’ mental health, a topic that deserves more attention by psychiatry research.…”

“…Urban climate change mitigation and adaptation strategies have the potential to prevent worsening global warming and, in doing so, promote population health [9].…”

A health-based long term vision to face air pollution and climate change

“…To encompass all these complexities, transdisciplinary co-production 2 is vital, combining interdisciplinary science and professional collaboration with the knowledge of the local community sectors (stakeholders and citizens), including the most vulnerable which are often primarily affected by status-quo and intervention. In recent time, more examples and studies of how to put co-production can be set into practice have become available ( 21 – 24 ).…”

“…Importantly, interventions need to be accompanied by monitoring e.g., with carefully chosen indicators or other assessment tools ( 24 – 26 ), to follow up on desired endpoints but also to keep an eye open for inadvertent side events. Health needs to be at the center of these considerations which could follow the ideas of the recently proposed Planetary Health Watch ( 27 ).…”

“…Importantly, for coproduction to be effective devoted personnel/funds, interdisciplinary training and exchange, transparency and good communication building trust are essential ( 24 , 25 ). Also to be reconsidered are current systems of research funding and career development which are mostly based on competitive principles rather than fostering cooperation for participatory science.…”