This document discusses urban health challenges and strategies for improving urban health through an integrated approach. It notes that public health is impacted by urbanization, epidemiological shifts, aging, and climate change. Urban health is also influenced by density, diversity, complexity, and inequity within cities. Improving urban health requires addressing the broad determinants of health, including housing, the built environment, transportation, education, and more. A "Health in All Policies" approach recognizes the influence of multi-sectoral factors on health and the need for collaborative solutions. The Sustainable Development Goals provide a framework for improving urban health and making cities more inclusive, safe, resilient and sustainable.

1. Addressing Resilience (and Health?)
through the Nexus of Water-Food-Energy:
Cities as SDG Laboratories
Jo Ivey Boufford, MD, President
ICSU- Stakeholder Forum
July 17, 2018

2. 2
PUBLIC HEALTH CHALLENGES FOR
THE 21ST CENTURY
• Urbanization
• Epidemiologic shifts
• Aging
• Climate Change

3. 3
UNIQUE CHARACTERISTICS OF URBAN
ENVIRONMENTS
• Density
• Diversity
• Complexity
• Inequity

4. INEQUITY
4
Your zip code is a
better predictor of your
health than your
genetic code.
85 YRS
UPPER EAST SIDE
Average life expectancy
is highest in Battery
Park/Tribeca (85.9
years) and lowest in
Brownsville (74.4
years)
The highest breast cancer
incidence rates occur
among white women in the
wealthiest neighborhoods, while
death rates are highest among
black women in the
poorest neighborhoods
At least some time
during 2013
1.36 Million New
Yorkers (16.5%)
were food insecure
New Yorkers
in low-income neighborhoods
consistently experience
diabetes hospitalization rates
nearly 3x higher than
those living in wealthier
neighborhoods

5. 5
HOW HEALTH IMPROVEMENT IS
PRODUCED
Dahlgren G, Whitehead M. 1991. Policies and Strategies to Promote Social Equity in
Health. Stockholm, Sweden: Instit. for Futures Studies.

6. BROAD
DETERMINANTS
OF HEALTH
Urban health experts
now know that in
order to achieve
healthier cities
worldwide, we must
improve the built,
social, economic, and
physical
environments in
which people live.
HOUSING
HEALTH
SECTOR
ECONOMIC
DEVELOPMENT
NATURAL
ENVIRONMENT
BUILT
ENVIRONMENT
URBAN
PLANNING
EDUCATION
Making cities
healthier
worldwide
TRANSPORTATIONCOMMUNITY
COHESION

7. 7
A HEALTH IN ALL POLICIES APPROACH
RECOGNIZES THAT
• The health and wellbeing of all citizens is essential for overall social
and economic development
• Health is an outcome of a wide range of factors, many of which are
outside the purview of the health sector
• All government policies can have an impact (positive or negative) on
the determinants of health
• The impacts of health determinants are not equally distributed
among population groups: health disparities must be addressed
• Efforts to improve the health of the population require collaborative
government agency and private sector work to develop integrated
solutions
• Many of the most pressing health issues require long term budgetary
commitments and creative funding approaches

8. 8
STRATEGIES FOR NCD PREVENTION
THROUGH GOVERNANCE FOR URBAN
HEALTH
Medical Model Cross-Sectoral Model –
Health-in All Policies
Health Systems Strengthening Urban Planning
Healthcare workforce Built Environment:
Transportation, Housing,
Sanitation systems, etc.
Essential Medicines Natural Environment
SES factors –education,
economic development

9. THE SUSTAINABLE DEVELOPMENT
GOALS AND URBAN HEALTH
Goal 3: Ensure healthy
lives and promote
well-being for all at all
ages
Goal 11: Make cities
inclusive, safe, resilient
and sustainable
9

10. GOAL 11: MAKE CITIES AND HUMAN
SETTLEMENTS INCLUSIVE, SAFE, RESILIENT
AND SUSTAINABLE
• Housing, Basic Services,
• Slum Upgrades
• Transportation
• Participatory, integrated
human settlement planning
• Preservation of
Cultural/Natural Heritage
• Disaster Preparedness
• Air Quality and Municipal
Waste Management
• Green/Public Spaces
• National and Regional
Development Planning to
strengthen urban,
peri-urban and rural
linkages
• Mitigation and adaptation
to climate change
• Construction of sustainable
and resilient buildings
10

11. IMPLEMENTING THE SDGS AND NEW
URBAN AGENDA: CALLING ATTENTION TO
URBAN HEALTH
Partnering to bring together sectors and professionals to promote
collaboration on advancing the urban health agenda:
• The role of health as both input for and outcome of development
• That the health of people living in cities is affected by decisions
made in all sectors, especially the built and natural environment,
economic development, education and transportation
• That healthy people are critical to social and economic
development
• That inclusive, equitable development is critical to sustainability

12. 12

13. 13
Thank you!
www.isuh.org
@IS_UrbanHealth