Just like housing, socioeconomic status, living conditions, pollution, and exposure to environmental hazards, urban planning is a major yet largely underestimated determinant of public health. Inappropriate or harmful urban planning undermines the health of the people who live there; however, solutions exist, such as “health-promoting urban planning,” a concept that is gaining traction.

Health-Promoting Urban Planning: Encouraging Choices That Minimize Population Exposure to Risk Factors

Health-promoting urban planning aims to systematically consider the consequences of any urban planning and development project on quality of life, well-being, and the environment. The goal is to encourage choices that minimize residents’ exposure to risk factors such as air pollution, noise pollution, social isolation, etc., and maximize their exposure to protective factors such as physical activity through active mobility (non-motorized travel like walking or cycling), access to healthcare or green spaces, etc.; all with the aim of reducing social and regional health inequalities.

Seven years after the publication of a special issue on urban planning and health-promoting development, this new issue of La Santé en action highlights the progress made and the areas where further progress is needed in this field. The context has changed: climate change and its impacts on physical and mental health and on people’s quality of life are increasingly well-known and visible. Recognition of the complex interrelationships between human health, animal health, environmental health, and ecosystem health has led to the rise of three concepts championed by the WHO: “Health in All Policies,” “Global Health,” and “One Health.” These approaches are gradually being integrated into public policies, for example in France’s 4th National Health and Environment Plan.

Health-Promoting Urban Planning: State of Knowledge

The “State of Knowledge” section of this report situates the topic of health-promoting urban planning within these developments and highlights the synergies between public health initiatives, efforts to protect the environment and biodiversity, and actions to combat and adapt to climate change. Advances in recent years have thus shown that health-promoting urban planning provides a framework for understanding and addressing the interrelationships between urban development, health determinants, health and environmental conditions, and social and territorial health inequalities, within a “complex system” approach.

Health-promoting urban planning is now being applied in an encouraging and increasingly widespread manner, with several case studies providing feedback. The examples cited demonstrate the need for a shared culture between public health and planning stakeholders, as well as the broader dynamics at play.

Health-Promoting Urban Planning: The Emblematic Case of Cities, Which Are Particularly Vulnerable to Climate Change…

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

…but solutions exist

In response to this situation, there are accessible and effective strategies that benefit the climate, biodiversity, and public health. Local governments can take action provided they develop a strong commitment to multisectoral collaboration. For elected officials, municipal technical departments, and other stakeholders in land-use planning, a priority should be to establish ad hoc organizations and decision-making processes. These should enable a coordinated approach to addressing the challenges of climate change adaptation, biodiversity protection, and public health, and propose solutions that are tailored to the local context, creative, and evidence-based.

Some examples of local initiatives implemented

Articles report on the experience of the Dunkirk Urban Community, which has made public transportation free; Miramas, which is demolishing and rebuilding a working-class neighborhood with a focus on air quality, access to healthcare and social services, social cohesion, and physical activity/nutrition; as well as other similar initiatives in Rennes, Grenoble, Echirolles, Villeurbanne, Besançon, as well as in Lyon and Toulouse, with testimonials from urban planners and researchers.

Examples of initiatives implemented abroad

This special issue also highlights the experiences of five cities abroad regarding health-promoting urban planning: Glasgow (Scotland), La Chaux-de-Fonds (Switzerland), Pontevedra (Spain), Lathi (Finland), and Sherbrooke (Quebec).

In total, some twenty researchers and field professionals contributed to this issue, including the World Health Organization, which demonstrates how cities such as Lima (Peru) and Freetown (Sierra Leone) have addressed the issue of urban planning as a key determinant of social and territorial health inequalities.