A major determinant of population health. Health at Work File No. 459 March 2022.

A major determinant of population health.  Health at Work File No. 459 March 2022.

Besides housing, socio-economic status, living conditions, pollution and exposure to harassment, town planning is a major but largely underestimated factor in determining the health of the population. improper or harmful planning of cities is detrimental to the health of the population living there; But solutions do exist, such as “healthy urbanism,” a concept under development.

Healthy urban planning: promoting choices that reduce people’s exposure to risk factors

Health-friendly city planning aims to systematically consider the consequences of any city planning and development project on quality of life, well-being and the environment. This includes encouraging choices that reduce the population’s exposure to risk factors such as air pollution, noise pollution, social isolation, etc., and maximize their exposure to risk factors. Protection such as physical activity through active mobility (non-motorized travel such as walking or cycling), and access to healthcare or green spaces, etc. ; All with the aim of reducing social and regional disparities in health.

Seven years after the publication of the dossier dedicated to urban planning and health-friendly developments, this new issue of La Santé en Action bears witness to the progress and margins of progress in this field. The context has evolved: climate change and its implications for the physical and mental health and quality of life of the population are becoming increasingly well known. Recognition of the complex interrelationships between human health, animal health, environmental health and ecosystems has given rise to three concepts promoted by the World Health Organization: “health in all policies”, “planetary health” and “one health”. These methods are gradually being incorporated into public policies, for example in France in the Fourth National Plan for Environmental Health.

Healthy urban planning: a state of knowledge

The “state of knowledge” portion of the file places the topic of health-sensitive city planning within these developments and points out synergies between public health actions, approaches to environmental protection and biodiversity, and combating and adapting to climate change. Thus, developments in recent years have demonstrated that health-friendly urban planning provides a framework for understanding the interrelationships between developments and determinants of health, health status, the environment, and social and regional disparities in health. , in the “complex”. system “logic.

Health-friendly urban planning is now being implemented in an encouraging and widespread manner, with many reactions. The examples reported testify to the need for a common culture between public health actors and planning actors, but also to the general dynamics at work.

Health-friendly urban planning: the emblematic case of cities, particularly vulnerable to the challenge of climate…

Several articles are devoted to health in urban areas, where 55% of the world’s population lives, a proportion that is expected to rise to 68% by 2050. Cities are particularly vulnerable to climate (extreme events, systemic crises) and environmental (air pollution, wave heat, noise, etc.).

…but there are solutions

Faced with this situation, accessible, effective and favorable strategies exist in terms of climate, biodiversity and public health. Local authorities can act on the condition that they develop a strong desire for multi-sectoral cooperation. For elected officials, municipal technical departments and other actors in regional planning, the establishment of ad hoc organizations and decision-making processes should be a priority. These should make it possible to deal in a coordinated manner with issues of climate change adaptation, biodiversity protection and public health, and to propose solutions adapted to the local context, creative and evidence-based.

Some examples of local actions implemented

The articles relate to the experience of the urban community in Dunkirk, which has made public transportation free, in Miramas, which is demolishing and rebuilding a popular area with an eye on air quality, access to health care and social services, social cohesion and physical activity/nutrition, but also other similar approaches in Rennes Grenoble, Ikerolles, Villeurbanne and Besançon, as well as in Lyon and Toulouse, with the testimony of city planners and researchers.

Examples of actions carried out abroad

This profile also highlights the experience of five cities abroad on the issue of health-friendly urban planning: Glasgow (Scotland), La Chaux-de-Fonds (Switzerland), Pontevedra (Spain), Lathe (Finland) and Sherbrooke (Quebec).

In all, nearly two dozen researchers and professionals in the field have contributed to the issue, including the World Health Organization, which shows how cities such as Lima (Peru) and Freetown (Sierra Leone) have addressed urban planning as the determinant of social and regional disparities in health.

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