Busy bus stop with passengers waiting

Urban health

By 2050, nearly 70% of the world’s population will live in cities. In the UK, over four in five people already live in urban areas. And so, we believe an understanding of urban health is more relevant than ever.

The places that we grow up, live and work impact how healthy we are. Living in urban areas, like inner-city London, carries distinct health challenges, many of which start early in life and are influenced by the wider determinants of health and wellbeing.

We seek to understand the deep causes of these health issues and explore different ways of addressing them through combining the best sources of data, robust evidence, lived experience and practical interventions.

We believe that by removing the obstacles to good health, we can make urban areas healthier places for everyone to live.

 

Defining urban health

The health challenges in urban areas are distinct from those elsewhere – in cities, the best health outcomes exist alongside the worst. Comparing two adjoining neighbourhoods of Clapham in South London, men in one area live in good health for an average of 12 years longer than those a few streets away. For women, the gap is 7 years.

The reasons for this are complex and sit at the intersection of urban diversity, the built environment and income inequalities. We spend our time exploring these intersections.

For example, if you are from a minority ethnic background you are more likely to live in an inner-city area. If you live in an inner-city area, regardless of ethnicity, you are also more likely to:

  • have low paid employment or be unemployed
  • be exposed to high levels of air pollution
  • live with multiple long-term health conditions from an earlier age
  • have access to fewer affordable, healthy food options in your local food retailers, restaurants and take-aways

These intersections also lead to challenges for health equity. Health risks and assets are not experienced equally by everyone in cities, and often much of the burden falls on the most vulnerable groups.

Urban health is not just one sector’s responsibility. It goes much wider than the healthcare system and public health authorities, and includes urban planners, civic institutions, investors, employers and residents.

For a city to be healthy, it also needs to centre the voices of all urban communities. However, many existing processes – from public engagement to policy-making and planning – disproportionately exclude organisations that are led by people from minority or lower-income backgrounds.

Life expectancy varies more in urban areas

Targeting urban health issues to work on

Urban health is a developing discipline, with initiatives like WHO European Healthy Cities Network pushing forward thinking and action around cities and health. The UN’s Sustainable Development Goals have also shone a light on sustainable cities and the importance of urban health.

Trying to improve health in cities is a complex task which involves co-ordination across sectors, over time, with different areas of focus. In order to have the most impact, we focus on a few health issues that disproportionately impact people living in cities.

These issues are exemplars of types of urban health challenges. We think of them as coordination, exploration, innovation and targeting questions. As a portfolio they engage across the commercial, social, environmental and digital determinants of health.

And while we focus on health issues prevalent in our inner-city place, our programmes also target global health problems. By focusing on global issues in a typical inner-city environment, we believe we can identify both specific insights as well as broader lessons for those acting on urban health elsewhere.

Lower incomes are linked to worse health - and we see a bigger range of incomes in urban areas

The health issues we work on are global problems

We apply social, demographic and economic data and evidence at a local level to identify what to target and where to focus, and we work with local, national and international organisations, groups and individuals to tackle these within our long-term urban health programmes.

We do this through research and projects with thorough evaluation, testing what works alongside a wide range of partners. We are part of Guy’s and St Thomas’ Charity, and under Impact on Urban Health, we continue that historic work on health issues impacting our local communities.

230 million

children are predicted to be obese by 2030

90%

of the world's population live in areas where air pollution is above WHO guidelines
High street in Glasgow

Urban health

Working to understand urban health

We believe there’s a lot to learn from how cities around the world are tackling urban health. Our place is like many other inner-city areas. So, as we build our knowledge, we share our insight, evidence and practical learning with other funders, public services, and commercial organisations. By sharing what we learn here in our place and learning from others, we believe we can improve global health through improving health in global cities.

International learning project with Innovation Unit Personal perspectives on urban health and wellbeing report