We focus on four complex health issues more prevalent in urban areas
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Urban health
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In Melbourne, we saw how changes in infrastructure, from housing to transport to public landscaping, can help to embed health outcomes in the development of cities.
This city profile is part of a series of ten, exploring how cities around the world are addressing health inequalities. Read the full report and sign up to receive more insights from us.
Melbourne is the fastest growing city in Australia with 4.8 million residents and population growth averaging 3.8% a year between 2011 and 2020. It also has the tenth largest immigrant population among global metropolitan areas, with most new arrivals coming from India, China, UK, Vietnam and New Zealand.
Covering an area much larger than London, it has a much lower population density: around 453 people per square kilometre. Compared to its suburban neighbourhood, the city’s central district has a greater intensity and variety of development and character, with active street frontages organised along a traditional urban grid. This approach has been promoted by proactive municipal leadership that has prioritised public transport, walkability and mixed-use development.
Melbourne is ranked eleventh on the 2021 Healthy Lifestyle Cities Report and residents generally have high rates of access to healthcare and important factors of wellbeing. Social variations, however, drive inequitable outcomes between different populations. While overall life expectancy is high, averaging 84.4 years, Aboriginal people are expected to live on average seven years less than their non-Aboriginal counterparts.
Self-reported measures of wellbeing are also highly differentiated, with lower-income respondents rating their wellbeing more than ten points lower than those in higher income brackets. These variations can also be mapped to Melbourne’s urban geography. A 2019 study found that social indicators tend to deteriorate with distance from central Melbourne, including essential health determinants such as obesity rates, reports of heart disease, on-track child developmental milestones and levels of social cohesion.
We explored several of these city-wide initiatives, including transport design hubs, health foundations, innovation hubs, new housing developments, academic research institutes and internationally backed city-wide renewal projects. Each initiative is taking on a different systemic lever, sector or environment to counteract imbalances across the city and ensure that, wherever possible, it evolves to allow all residents to access its positive aspects.
Much of the city-wide initiatives focused on the development and impact of changes to the built environment, in contrast to neighbourhood initiatives we saw elsewhere which took people’s interaction with place as a starting point. We observed that changes in infrastructure, for example housing, transport and urban forestry, provide opportunities for interdisciplinary research and planning to embed and measure health outcomes in future city development.
In a constantly evolving city, putting health as a core outcome of success is possible. For example, Melbourne’s 20-minute neighbourhood is a good example of how expanding cities can accommodate the needs of residents by actively considering the health objectives of changes to the built environment. However, the challenge is how best this can be done while managing and meeting the needs of its current populations.
As can be observed in many cities, displacement and disenfranchisement of established communities as a city expands and evolves can create a tension in terms of resource allocation and in perceptions of whose voice is or is not heard. There is a growing tension and debate on whether city-wide initiatives that attract high earners into declining urban neighbourhoods with improved built environment is indeed regeneration or gentrification. While there is no clear evidence on whether gentrification is positive or negative for existing residents and communities, gentrification of previously underinvested urban neighbourhoods can undoubtedly amplify feelings of disenfranchisement and social segregation.
Fishermans Bend is an urban renewal project covering approximately 480 hectares connecting the city’s central business district to the bay. By 2050, it’s planned that it will be home to approximately 80,000 residents and provide employment for up to 80,000 people. The vision is to create liveable and vibrant neighbourhoods that are world-leading examples of urban renewal. Working to a framework with robust evaluation, the project is focused on creating parks, schools, roads, transport and community facilities and services to ensure liveability as the precinct grows over the next 30 years. The framework is supported by a suite of evidence-based research reports, strategies and plans and its development benefited from more than 12 months of engagement with community and other stakeholders.
Melbourne is made up of 32 local government authorities (councils), comprising hundreds of diverse local neighbourhoods, each with its own character, cultural mix and set of advantages and disadvantage. The city is growing, and by 2051 is expected to be home to approximately 7.7 million people. The shared administration means city-wide challenges cannot be dealt with independently. Resilient Melbourne offers a rare opportunity to tackle these challenges in new collaborative ways. Melbourne’s first resilience strategy was endorsed by the City of Melbourne’s Future Melbourne Committee in 2016.
It is the first resilience strategy produced by any Australian city and is the first metropolitan plan that has been led by local government in Melbourne’s 180 year history. Developed with the support of 100 Resilient Cities – pioneered by the Rockefeller Foundation – the strategy sets out a series of distinct, yet connected, actions that will help make Melbourne a viable, liveable and prosperous city, long into the future. The city has put in place another of initiatives as part of the strategy, including the development of a metropolitan urban forest, and early research suggests the strategy has led to increased knowledge exchange across sectors and urban innovation.
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