World Cities Day: A spotlight on climate change and health

Climate stressors have pervasive impacts, among which the impact on the health populations across the world continues to expand. This has recently come into even sharper focus with COVID-19.

Extreme heat and water scarcity together, for instance, are already creating havoc in cities like Cape Town and Chennai, while vector-borne, and water-borne diseases like dengue, malaria, gastroenteritis and typhoid continue to affect thousands of cities globally. Apart from their obvious impacts on the physical health of the population, with the oldest, youngest, and other vulnerable groups facing the greatest threats, such climate stressors also have serious mental health ramifications.

Floods and wildfires inflict death, disease, and injury, with serious risks associated with evacuations, loss of urban and health services, and destruction of homes – all of which affect physical and mental well-being. This World Cities Day, we draw attention to health outcomes that are affected by climate-related stressors.

It is well known that the impacts of climate-related stressors on human health are not uniform: they pan out differentially along lines of income, gender, ethnicity, migrant status, citizenship, occupation, ability, age, sexual orientation and gender identity, to name a few. Urban neighborhoods themselves are often segregated along some of the same lines and experience the impacts of these stressors in different ways.

In the US for example, historically discriminatory urban and housing policies have led to what is referred to as “thermal inequality”, where certain neighborhoods – with predominantly Black and Latino households -- experience higher local temperatures.

We argue that the built environment is critical to the health of city residents. Despite this, if cities want to address public health challenges, they do so through actions in the health sector.  In our experience, cities seldom think of infrastructure and the built environment as being a channel through which residents can stay healthy and where health risks are mitigated.

For a local government to prepare for climate change-related health impacts, it will need to have an in-depth and forward-looking understanding of potential impacts and how these would likely pan out across households and neighborhoods.

Several infrastructure-related interventions can help alleviate the adverse health impacts on city residents. These include housing and residential patterns, transportation systems, solid waste management and water and sanitation. In addressing these, a city will need to keep its demographic profile squarely in mind in planning new investments. Each of these has implications on the extent of greenness, design standards for stormwater and drainage systems, location and type of homes that are allowed to be built, and building standards, for example.

Thinking of solutions

Many cities are taking the issue of climate impacts on health seriously. They have, for instance, stepped up their focus on expanding their green cover and biodiversity. Overall, there seems to be an increased awareness of the environmental health impacts of climate change in cities and more importantly, that city governments can do something about them in partnership with local communities. While some of the best-known contemporary examples of greening are from Singapore and Kigali, many others are taking similar steps.

Other solutions focus on building well-planned urban neighborhoods with access to quality, affordable housing. Proximity to public and green spaces and access to options for non-motorized and public transport are also key and have multiple benefits to increasing both social interactions and active lifestyles.

A recent international conference on urban health in Valencia, Spain, organized by the International Society of Urban Health, shone a spotlight on cities and towns that have recognized the link between sound urban planning, design, and health outcomes. Such events that convene partners from the health world such as the World Health Organization together with national and local authorities, academics from around the world, urban planners, city officials, non-governmental organizations and funding agencies, are a good way to bring together diverse actors together to address a challenging issue of our time – the intersection between climate change and urban health.

The World Bank is actively working together with cities and partners to finance, plan, and implement such efforts and to enable collaborations among diverse actors. A recent World report, Putting Pandemics Behind Us: Investing in One Health to Reduce Risks of Emerging Infectious Diseases, puts climate change and health at the center of future disease prevention. The World Bank is also developing an action-oriented framework for healthy cities, drawing upon climate-smart, health-positive urban investment examples across the world. With these efforts, we aim to partner with city leaders and urban actors to enhance urban health outcomes through well-planned climate actions in cities in the coming years.