We focus on four complex health issues more prevalent in urban areas
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Health effects of air pollution
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Air pollution is a complex issue that requires a whole-systems lens. Here we share the key lessons that are guiding our approach to tackling the health effects of poor air quality.
Globally an estimated 4.2 million premature deaths are linked to outdoor air pollution and 4 million deaths are linked in indoor air pollution. In London, up to 9,500 deaths a year are attributed to long-term exposure.
Over the last few months we’ve explored this issue – looking at how people living in inner-city London think about and experience air pollution. We’ve reviewed the evidence base, analysed data and talked to a range of partners, from academics to campaigners and local residents. We want to answer a simple question: where should we focus our work?
We’ve come up with the key lessons to guide the early stages of our 10-year programme on the health effects of air pollution, the third in our portfolio of urban health programmes.
While air pollution can impact everyone living in inner-city areas, we know that the health of some groups is more affected than others – children from pregnancy through to early adolescence, people with heart and lung conditions and older people.
A recent study looking at GP data from Lambeth over a 5-year period found that after short spikes of air pollution children and older people were more likely to go to their GP, the same pattern was not found for working-age adults.
We’ve also learnt that despite the media attention, air pollution is not a concern at the top of many people’s minds and they often feel powerless to do anything about it.
In our research, only 12% of people mentioned air pollution as a concern when unprompted. When asked, more than half of local people (52%) couldn’t think of something that could be done to tackle air pollution. A majority (70%) see it as the responsibility of government and therefore out of the hands of local people and businesses.
Here in London there is a groundswell of action to address air pollution and its impact on our health. Large scale interventions such as the expanded ultra-low emission zone are expected to reduce traffic related emissions in our city, however we’ve still got a long way to go to tackle the issue.
All of the London Boroughs of Lambeth and Southwark are currently above the WHO guidelines for a safe level of particulate matter (PM) – and this is not projected to change.
We’ve been using the London Atmospheric Emissions Inventory data to look at sources of PM in our boroughs and have found that while vehicles are a significant source, there are other major contributors like construction and commercial food production.
As an urban health foundation, we believe we can play a key role in addressing the effects of air pollution on people’s health.
We know from research by our partners at the Clean Air Fund that globally only $30 million was spent on funding work on air pollution in 2018 – that’s 0.02% of total philanthropic investments annually. And that more than 75% of this funding is spent in three countries: China, India and the USA.
There is an opportunity to show that progress is possible on this issue in inner-city environments like London.
We plan to do this by focusing on the groups of people most vulnerable to the health effects of air pollution. While, ultimately, we want clean air for all, we should prioritise action for these groups in the short term.
To do this in practice, we’ll be targeting our efforts on the places where they spend their time and on understanding the opportunities to intervene.
One of our first investments is a partnership with our hospital partners Guy’s and St Thomas’ NHS Foundation Trust to understand both exposure of patients, and what they can do to reduce air pollution as a healthcare provider and major employer in central London.
We want to support work that can both protect people’s health now, whilst also improving air quality.
We’re funding work with the urban designers Gehl around Oval and Vauxhall to understand the exposure of children living in this area and opportunities to reduce this exposure in the short-term and feeding into longer-term work to redesign the public realm.
We think that by starting with a small number of focus geographies we can better understand the current causes of air pollution and test and understand the impact of interventions.
This will be critical to understanding if the project’s we are investing in are having an impact, and to create evidence that will be useful for others tackling this issue in cities around the world.
We do not expect this to be easy – we will need to bring together leading experts in atmospheric science, transport, construction, behavioural economics and political science.
Critically we think by working in a place we can broaden this coalition to include those with real levers for change – schools, the NHS, local businesses and citizens themselves.
Over the next few months, we will be beginning to look for partners to work with on this ambitious programme. We want to learn from, and work with, many others. If you’re interested in sharing your insights or partnering with us, please get in touch.
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