WHO is calling for a new era of strategic urban health action with a global guide to unlocking healthy, prosperous and resilient societies

On World Cities Day, the World Health Organization (WHO) is calling on national and city leaders to transform urban areas into engines of health, equity and sustainability.

More than 4.4 billion people, more than half of humanity, now live in urban areas, and the figure is predicted to rise to almost 70% by 2050. In cities, health, inequality, the environment and the economy intersect in powerful and dramatic ways, creating both complex risks and unique opportunities for progress. While health challenges loom in all urban settings, the worst health outcomes are often concentrated in slums and informal settlements, where residents experience unsafe housing, inadequate sanitation, food insecurity, and increasing exposure to flooding and heat. Today, 1.1 billion people live in such conditions, and that number is expected to triple by 2050.

With a new guide for decision makers launched today “A strategic approach to urban health“ WHO provides concrete ideas for the beginning of a new era of urban health action. The guide responds to the growing demand for integrated solutions that address health challenges and promote health more broadly in urban environments. It is the first comprehensive framework of its kind to help governments strategically plan for urban health, integrating evidence into policy and practice.

“This is a moment for decision-makers at all levels to act together,” said Jeremy Farrar, Assistant Director-General, Health Promotion, Disease Prevention and Care, WHO. “The guide gives national and municipal leaders, planners, partners and communities a framework for working together, across sectors and scales, to build a fairer, healthier and more resilient future.”

Health risks and inequalities are visible in all urban areas: a study of 363 cities in nine Latin American countries found differences in life expectancy of up to 14 years for men and 8 years for women between the healthiest and least healthy cities. Urban dwellers everywhere face multiple and overlapping risks – from air pollution and unsafe transportation to poor housing, noise and climate hazards. Air pollution alone kills about 7 million people a year, and almost every city dweller breathes it air that does not meet WHO guidelines for air quality. Dense population increases the risk of outbreaks of infectious diseases such as COVID-19 and dengue fever, and limited access to green spaces increases the risk of non-communicable diseases.

Urban environments have now become the dominant daily influence on human health – while driving global challenges such as climate change, resource scarcity and growing inequality. This makes them not only the front line for today's health challenges, but also the greatest hope for transformative change.

Strategic action on urban health can promote equity and create resilient, attractive urban environments that are conducive to economic development, environmental sustainability and better lives. People and companies are increasingly looking for environments that offer security, livability and opportunity.

Decision makers. Suva, Fiji; Susar, Indonesia; Coimbra, Portugal and many others.

“Cities are key to improving public health,” said Dr. Etienne Krug, director of the Department of Health, Prevention and Promotion. “This guide offers governments a blueprint for strategic action, establishing operational links with other major global policy issues such as climate change, transport, digital transformation and migration.”

The guide emphasizes that health is not the responsibility of just one sector, nor is it limited to the decisions of city officials. From clean air and safe housing to active mobility and digital access, to broader funding and regulatory actions, the decisions urban authorities make every day across multiple sectors and scales affect the health of billions of people. Taking strategic action means aligning these choices to build a healthier and fairer future, where urban systems work together to advance equity, sustainability and resilience.

“Taking a Strategic Approach to Urban Health” outlines practical steps for governments to:

• understand the complexity of urban systems and how they shape health and equity;
• identify entry points for action, recognizing opportunities to build urban health through policy agendas and practice in other sectors and issues;
• strengthen means of implementation for urban health, including governance, financing, data, analytics, innovation, capacity building, partnerships and participation; and
• develop comprehensive urban health strategies at national and city level.

WHO calls on municipal and national leaders to adopt a more strategic approach to urban health, recognizing the key role that local and national governments play in creating coherent health action that aligns with other societal goals and makes urban areas not only more livable, but also more equitable and sustainable.

Alongside the Guide, WHO is launching the first three e-learning modules on urban health, hosted by the WHO Academy, to strengthen capacity for collaborative work in urban contexts.

Note to editors

Developed with input from a wide range of global experts, “A Strategic Approach to Urban Health: A Guide for Decision Makers” it builds on decades of WHO work on urban health, showing that when health is approached strategically, it can drive healthier and more resilient societies.