Urban health

By 2050, nearly 70% of the world’s population will live in cities. In the UK, over four in five people live in urban areas. 

Living in cities carries distinct health challenges, many of which start early in life and are influenced by the wider determinants of health and wellbeing. We try to find solutions to those challenges.  

A definition of urban health

Urban health is a developing discipline, with initiatives like WHO European Healthy Cities Network and organisations like the International Society for Urban Health pushing forward thinking and action around cities and health. 

For us, urban health exists in the intersection between the built environment of a place, the diversity of its communities and the often wide range of household incomes. The interplay between these factors is complex and frequently results in marked health inequalities.  

In places like Lambeth and Southwark where we work, finding solutions to urban health challenges involves navigating the combined impact of all three – and the assets and risks they create for us all. We work to explore this interaction with a large breadth of partners, sharing what we learn with those facing similar challenges elsewhere.  

Health assets, risks and inequalities in urban areas  

Poor and unstable housing, high population churn, air pollution and crime are common health risks present in cities. Others include noise pollution, the fast pace of life and social isolation. 

At the same time, there are many health benefits to living in cities – for example, access to cutting-edge medical care, good transport links and better employment options. Many cities also contain tight-knit communities, green spaces and leisure opportunities that are protective factors for our health.  

These health risks and assets are not experienced equally by everyone in cities. Around the world, and in the inner-city environment where we work, much of the burden falls on the most vulnerable groups, like families on low incomes.  

Our work on health in urban areas

We try to get deep under the skin of what drives health in urban areas.  

In our work, we explore a small number of urban health issues at a time. We do this through focused programmes of work. We’re currently working on reducing childhood obesity and slowing people's progression to multiple long-term conditions. We will begin our next programme in 2019. 

We also target our work on an area in inner-city London that has a lot in common with other urban areas around the world. Our boroughs are typical examples of urban environments — for example, compared to London averages, they have close to twice the amount of social housing; half the amount of green space; and a much wider range of income and health outcomes.  

By focusing on long-term programmes in a typical inner-city environment, we believe we can identify both specific insights for these health issues, as well as broader lessons for those acting on urban health elsewhere.   

We do this through research; testing what works alongside a wide range of partners including, most importantly, our local communities; and evaluating closely, so that we can share what we learn with others.  

Building our knowledge on urban health

Like many others, our work focuses as much on understanding the factors that enable improved health as it does specific interventions, which are often heavily dependent on the context of a place.  

As we build up our knowledge on urban health, we will share with others locally, nationally and internationally. And we will urge other funders, national and local policy-makers, our public services, and commercial organisations to help create urban environments that can improve health, equitably, in the UK and beyond. 

We want to connect and learn with others who are grappling with similar health challenges in other urban areas. If you’re interested in collaborating, contact rowena.estwick@gsttcharity.org.uk 

Learning with others on urban health