Mediacentre

Urbanhealth:majoropportunitiesfor
improvingglobalhealthoutcomes,despite
persistenthealthinequities
Jointnewsrelease:WHO|KobeCentre|UNHabitat

31MARCH2016|KOBE|GENEVA Newdataonthehealthofcity
dwellersinalmost100countriesshowthatastheworldsurban
populationcontinuestogrow,healthinequitiesespeciallybetweenthe
richestandpooresturbanpopulationsareapersistentchallenge,
accordingtoareportbyWHOandtheUnitedNationsHuman
SettlementsProgramme(UNHabitat).
Forexample,onlyhalfofhouseholdsinurbanareasof91countrieswith
comparabledatahaveaccesstopipedwater,withtherichest20%of
householdsbeing2.7timesmorelikelytohaveaccesstopipedwater
thanthepoorest20%.InAfrica,thisratioiscloserto17times.
About3.7billionpeopleliveincitiestoday.Afurther1billionpeoplewill
beaddedby2030,with90%ofthegrowthbeinginlowandmiddle
incomecountries.ThisintensifiestheneedtorealizetheSustainable
DevelopmentGoal(SDG)targetofensuringuniversalhealthcoverage
(UHC):thatallpeopleobtainthehealthservicestheyneedwithout
sufferingfinancialhardshipwhenpayingforthem,by2030.

Healthinequalitiesundermineprogress
Thereportfindsthatin79lowandmiddleincomecountries,childrenin
thepoorestonefifthofurbanhouseholdsaretwiceaslikelyonaverage
todiebeforetheirfifthbirthdaycomparedwithchildrenintherichest
fifth.Innearly9of10countriesforwhichcomparabledatawas
available,theurbanpoordidnotachievetheMillenniumDevelopment
Goaltargetforreducingunderfivemortality.
Thereportemphasizestheurgencyofaddressinghealthdisparitiesand
theirdeterminantsincitiesascountriesstrivetoachievetheSDGsand
identifiesinnovativewaystoachieveUHCthatareemerginginsuch
diversecitiesasGuangzhouandLagos,LimaandSanFrancisco,
amongmanyothers.
Thereisanurgentneedtoidentifyandreducehealthinequities,
particularlyforthemostvulnerablepopulations,suchasthenearly1
billionpeoplelivinginurbanslumsorinformalsettlementstoday,said
DrMariePauleKieny,WHOAssistantDirectorGeneralforHealth
SystemsandInnovation.Thisreportgivescountriesandcitiespractical
toolstoreducehealthinequitiesandachievetheSDGs.

Whileanumberofurbanareashaveimprovedhealthcoverage,the
reportfindsthatcoverageforthepoorstilllagsbehind.Currently,at
least400millionwomen,menandchildrenaroundtheworldare
excludedfromwhatisabasichumanright:accesstoaffordablehealth
care.Theyhavelittleornoaccessortohealthservices,andhealth
insurancethatisinadequateornonexistent.Thereportincludesanew
UrbanUHCDashboardananalysisofnineindicatorsfor94countries
whichshowsthatvastinequalitiesinhealthservicecoveragepersist,
despiteurbanareasreportinghighercoverageofservicesthantheir
respectivenationalaveragelevels.

Planningcitiesforpeopleandhealth
Increasingurbanizationposesauniquesetofhealthchallenges,
includingthedoubleburdenofnoncommunicableandinfectious
diseases,airpollution,accesstowaterandsanitation,andtheneedto
improvenutrition,increasephysicalactivity,andbuildresilienceto
healthemergencies.Meetingthosechallengeswillrequirecountriesand
citiestotakeboldstepstowardsUHC.
Thewaysthatcitiesareplanned,todayandforthefuture,can
profoundlyaffecttheabilityoftheirresidentstolivelong,healthyand
productivelives.Thereportpresentssolutionsforensuringaccessibility
towaterandsanitation,reducingurbansprawlwhiledevelopingnew
transportoptions,increasingroadsafety,makingcitiesagefriendlyand
accessibleforpersonswithdisabilities,managingurbanhealth
emergenciesandincreasingresiliency,whilealsoimprovinghealthier
homes,particularlyforthoselivinginurbanslums.
Thereportfurtherpresentsacomprehensivesetofinterventionsthat
canreducetheurbanburdenofnoncommunicablediseases.These
includesmokefreecityordinancesandenforcementalteringthebuilt
environmentandpromotingalternativetransportoptionstofostergreater
physicalactivityandreduceairpollutionnewapproachestourbanfood
environmenttoreducemalnutritionandobesityaffordableandhealthy
housingconditions,andsafetyrelatedefforts.
Together,thesehavetremendousimpactonreducingdiarrhealdiseases,
indoorandambientairpollution,noncommunicablediseases,andother
diseasessavingmillionsoflivesandincreasingqualityoflife.Avariety
ofexamplesfromNewYorkCityandChinatoMexicoCity,Barcelona,
andSouthAfricaillustratetheseimpacts,particularlyusingmultiple
interventions.
Incities,progressinhealthdependsnotonlyonthestrengthofhealth
systems,butalsoonshapingurbanenvironments.Capitalizingonsuch
interdependentfactorsleadstoefficiency,synergiesandcobenefits,
andisessentialtoattainingtheSDGs,saidAlexRoss,Directorofthe
WHOCentreforHealthDevelopmentinKobe,Japan,whichledand
wrotethereport.
Ahealthypopulationisessentialforcreatingeconomicallycompetitive
andinclusivecities,saidJoanClos,ExecutiveDirectoroftheUnited
NationsHumanSettlementsProgramme(UNHabitat).Thisnewreport

documentsopportunitiesforjointactiontoimplementtheSDGs,andis
animportantcontributiontotheThirdUnitedNationsConferenceon
HousingandSustainableUrbanDevelopmenttotakeplaceinQuitoin
October2016andtotherealisationoftheNewUrbanAgenda.

Notetoeditors:
Thisreport:
Updatesthe2010jointWHO/UNHabitatglobalreport"HiddenCities:
UnmaskingandOvercomingUrbanHealthInequities",withthelatest
evidenceonurbanhealthinequitypatternsandtheirsocial,economic
andenvironmentaldeterminants.Withoutaddressingtheseissues,the
SDGswillnotbefullyachieved.
Systematicallysynthesisesevidenceforvariousintersectoralactions
andimpactsonhealthforissuessuchasnoncommunicablediseases,
infectiousdiseases,healthemergencies,nutrition,environmentalhealth
(airpollution,waterandsanitation),transport,housing,energyand
safety.
Introducestheneedforenhancedgovernanceandleadershiptorealize
results,includingachievingUHC,andanumberofSDGTargets.A
healthypopulationisthebasisofacitys,andultimatelyanationsand
theworlds,sustainableeconomicgrowth,socialstability,andfull
realizationofhumanpotential.
Highlightsareasforimmediateintervention,aswellasgapsin
knowledge,particularlytodocumenttheimpactofvariousinterventions
onurbanhealth,andmeanstoreducehealthinequities.
Emphasizeshealthinequitiesandvulnerablepopulations,particularly
thenearly1billionpeoplelivinginurbanslumsandinformalsettlements
today,whichareprojectedtodoubleby2050.

Formoreinformation,pleasecontact:
GregoryHartl
Coordinator,WHO
Telephone:+41227914458
Mobile:+41792036715
Email:hartlg@who.int
MamikoYoshizu
CommunicationsOfficer,WHO
Mobile:+818024351859
Email:yoshizum@who.int
JeanetteElsworth
Head,PressandMedia,UNHABITAT
Telephone:+254207625518
Email:jeanette.elsworth@unhabitat.org

Relatedlinks
GlobalReportonUrbanHealth
WHOKobeCentre