The collective responsibility for urban health

Health is a collective outcome

Urban health is also not just one sector’s responsibility: it goes much wider than the healthcare system or our public health authorities. It includes urban planners, investors, employers, and communities themselves. In the main, we also know exactly what to do – the challenge is mobilising to do it.

Urban planners around the world are using this moment to create healthier streets, with widened pavements, car-free zones and easier access to cycling. They could go further – for example, demanding better quality housing that determines so much of our health.

Long-term investors and insurers are particularly exposed to the health effects of urban inequalities. These include workforce shortages, rising healthcare costs, customer expectations and all manner of reputational risks. 

Our own Healthy Markets campaign has attracted over $1tn of assets from pension funds and other investors dedicated to engaging with retailers and food manufacturers on tackling obesity. We need this across other urban health issues too.

Employers are increasingly aware of their obligations in tackling the sharp divisions in the health of their workforces. Economic recovery relies on a healthy workforce and this is clearly time for a new contract. In return for the taxpayer stepping in to support private enterprise, we should raise the bar on working standards, job security and decent pay; all of which are amongst the most effective urban health interventions known.

Centring communities in decision making

Most importantly, though, we need to centre the voice of urban communities in our response. Unfortunately, many existing processes – from public engagement to policy-making, to planning, to philanthropy – disproportionately exclude organisations that are led by people of colour or from lower-income backgrounds. 

So we need to change the processes. Many cities are embracing approaches such as citizen assemblies, mutual aid groups and open digital platforms, but these need to be on the issues that matter, and not just the ones left over.

In short, there is much to do, but healthcare institutions cannot, and should not, be left to tackle this alone. We need a collective response to urban health.