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Chapter 3. The impacts of climate change on societies and organizations: adaptations to protect health

Healthy, climate resilient urban environments: Evidence to action

Melanie Lowe
p. 106-111

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1Urban environments and infrastructure play a key role in shaping human and planetary health. Climate resilient cities can have multiple health benefits by supporting active, low-carbon lifestyles, and enabling urban populations to survive, adapt, and thrive in the face of climate change. Indicators like those shared by the Global Observatory of Healthy and Sustainable Cities, can inform urban and transport policy and help monitor progress towards healthy, climate resilient cities. City governments and leaders should prioritise interventions that promote active and public transport, deliver mixed land use neighbourhoods, support urban greening and biodiversity, and reduce residents’ exposure to air pollution, heatwaves and other extreme weather events. Reducing inequities in risk exposure and access to climate resilient urban environments should be at the heart of city planning. The necessary transformation of urban environments to mitigate the health impacts of climate change requires an evidence-informed and coordinated approach across sectors and levels of government.

Introduction

  • 1 Giles-Corti, B., Moudon, A. V., Lowe, M., Cerin, E., Boeing, G., Frumkin, H., et al. (2022). What n (...)

2Home to most of the world’s population, urban environments are a key human habitat. Health and climate change are among the biggest challenges facing urban areas in the 21st century, as reflected in the United Nations’ Sustainable Development Goals (SDGs). Cities are a major driver of climate change, as they produce 75% of global energy-related greenhouse gas emissions, with 24% of global emissions coming from transport.1 Meanwhile, urban populations face escalating health impacts from climate change. Extreme weather events, climate-related illnesses, involuntary displacement, food insecurity, physical damages to buildings and income losses pose direct and indirect health threats.

3However, it is also possible to transform urban environments to promote health and climate resilience. This article outlines the need for urban climate resilience to protect and promote health, the importance of indicators for tracking progress, and key urban and transport planning interventions that can maximise benefits for human health and the environment.

The challenge of urban climate resilience

  • 2 Lowe, M., Adlakha, D., Sallis, J. F., Salvo, D., Cerin, E., Moudon, A. V., et al. (2022). City plan (...)

4Our 2022 Lancet Global Health Series on Urban Design, Transport and Health highlighted the urgent need for cities to develop and implement policies that prioritise healthy and resilient urban environments through evidence-informed approaches.2 City planning policies across a range of sectors shape urban environments, including transport, housing, public open spaces and urban design. Urban environments, in turn, influence travel behaviours, lifestyles, access to services and economic opportunities, as well as greenhouse gas emissions. Some health risks associated with urban environments, such as air pollution, heat islands, biodiversity loss and infrastructure failure, are further exacerbated by climate change. For example, more frequent and severe heatwaves increase risk of heat stress, especially in areas with limited green space and tree canopy cover.

5Globally, climate risks and mitigation imperatives have been inadequately considered in city planning, as highlighted in the most recent Intergovernmental Panel on Climate Change report. In many cities, this has resulted in unchecked urban expansion in flood- or fire-prone areas, car-dependent suburbs, and housing densification with insufficient green spaces and amenities. There are significant inequities in risk exposure, as disadvantaged communities often have poorer access to high-quality and resilient urban environments. In Australia’s major cities for example, disadvantaged areas are less walkable and liveable than more affluent areas.

  • 3 Lowe, M., Bell, S., Briggs, J., McMillan, E., Morley, M., Grenfell, M., et al. (2024). A research-b (...)

6It is essential for city planning to focus on creating resilient urban environments in the face of climate change-related health impacts. Urban resilience refers to the ability of cities and their inhabitants to withstand, adapt and positively transform in response to shocks and stresses, including climate change-related disruptions.3 From this perspective, the threat of climate change should be used as an opportunity for positive transformation of urban environments to optimise health and future resilience. Climate resilient cities can have multiple health benefits, by supporting active, low-carbon lifestyles, and enabling urban populations to survive, adapt, and thrive in the face of climate-related acute shocks and chronic stresses. Climate change and health can therefore be addressed synergistically in cities. City governments and leaders have essential roles to play in developing comprehensive and evidence-informed policies that optimise outcomes for human and planetary health.

Indicators to measure and monitor urban environments

  • 4 Global Healthy and Sustainable City-Indicators Collaboration. (2022). Global Observatory of Healthy (...)

7Indicators can assist city leaders to set evidence-informed priorities and assess progress on actions that affect urban health and climate resilience. Key urban indicator endeavours at the global level include UN-Habitat’s Global Urban Monitoring Framework released in 2022, which measures the objectives of safe and peaceful, inclusive, resilient and sustainable cities. The UN SDGs include a specific goal and associated indicators focused on cities (SDG 11, Sustainable cities and communities). There are also now numerous urban observatories and indicator tools developed by government, non-government and research organisations. I co-direct one such effort: the Global Observatory of Healthy and Sustainable Cities.4 This initiative is an international, collaborative, open-data platform for sharing policy and spatial indicators that assess the health, resilience and sustainability of cities worldwide. Created by an international collaboration of researchers and practitioners, the Global Observatory provides comparable and evidence-based indicators, city scorecards and reports, to help inform urban policy and planning. We are scaling up the number of cities included through the 1000 Cities Challenge, which invites researchers, city planners, advocates, and geospatial data scientists to use our open-source tools to generate indicators for their city. Using an open science approach and engaging local collaborators, our central aim is to build capacity to positively influence city planning policies and practices that affect human, ecosystem and planetary health.

Figure 1: The Global Observatory of Healthy and Sustainable Cities

Figure 1: The Global Observatory of Healthy and Sustainable Cities
  • 5 See reference cited in footnote #4.

8The Global Observatory’s policy indicators assess a wide range of policies that shape the health and resilience of urban environments. These include requirements for housing density, pedestrian infrastructure provision, public transport access, public open space access, disaster risk adaptation and reduction, air pollution, urban greening, and biodiversity protection and promotion. The indicators help identify policy strengths and limitations. As an example, initial testing of the indicators on 25 cities showed that São Paulo in Brazil had higher quality policies compared with many cities in high income countries, in terms of being specific, measurable, and aligned with healthy cities research evidence.5 As part of policy quality assessment, the indicators identify whether cities have evidence-informed policy targets. For example, we found that Odense in Denmark had an exemplary cycling participation target of 45% of work trips by 2028. On the other hand, Melbourne in Australia had a housing density target of 20 dwellings per hectare, which is too low to support walkability.

  • 6 Boeing, G., Higgs, C., Liu, S., Giles-Corti, B., Sallis, J. F., Cerin, E., et al. (2022). Using ope (...)

9Spatial indicators available from the Global Observatory measure access to urban design and transport features such as public open space, public transport, walkability, street connectivity, and healthy food stores. Through research supported by the AXA Research Fund, new globally applicable, open-source climate resilience spatial indicators are being developed, including urban greening, air quality and heat vulnerability. Spatial indicators can be mapped to highlight disparities within and between cities. For example, many US and Australasian cities included in the Global Observatory to date have relatively low walkability, especially in their outer suburban areas. As another example, the public transport indicator was able to show that 62% of the population of Bangkok in Thailand has access to a regularly serviced stop, whereas in Chennai, India it is only 3%.6 The spatial indicators can be used by cities globally to set evidence-informed urban design, urban planning and transport policy goals. When repeated over time, these assessments allow tracking of urban environment changes and guide necessary policy adjustments to achieve healthier and more resilient cities.

Figure 2: São Paulo’s scorecard included in the Global Observatory of Healthy and Sustainable Cities

Figure 2: São Paulo’s scorecard included in the Global Observatory of Healthy and Sustainable Cities

Creating healthy, climate resilient urban environments

10City planning has a key role in creating healthy and climate resilient urban environments. To protect health, city planners and leaders need to ensure urban areas can withstand and quickly recover from inevitable disruption. This includes emergency management, ensuring the robustness of housing and critical infrastructure and banning or significantly restricting development in areas at high risk of climate hazards such as flooding and bushfire. However, achieving urban health and resilience will also require adaptation and large-scale innovation and transformative change to the planning, delivery and management of existing and new urban environments. Pilot projects and tactical and temporary changes to public spaces, such as converting car parking spaces into parklets, are important for testing ideas. When shown to be effective, pilots need to be scaled up, embedded in policy and strategy, and funded for the long-term.

  • 7 Co-benefits are achieved where a policy or intervention simultaneously delivers positive impacts to (...)

11There are several priorities for adapting and transforming city planning to deliver healthy and resilient urban environments. Transport planning and urban design should promote active and public transport ahead of private motor vehicle transport. Active, low-carbon transport such as walking and cycling has multiple health and environmental co-benefits7, including mitigation of climate change through reduced greenhouse gas emissions, improved air quality and increased physical activity. Convenient and frequent public transport is also essential for ensuring equity of access to jobs, shops and services at the regional scale. The transition to electric vehicles is important for reducing carbon emissions and air pollution. However, private electric vehicle use foregoes the physical activity co-benefits that can be achieved from active transport modes, so should be viewed as only one part of transport de-carbonisation. Car use demand can be managed through approaches such as congestion charges, parking restrictions, traffic calming measures and closing streets to cars. Congestion charges are fees payable by drivers to enter city centres. Since their implementation in 2003, central London has seen its traffic reduced by 33%. However, most successful cities use a combination of different policy instruments that both encourage more sustainable travel choices and restrict driving and parking.

12Neighbourhoods with diverse land uses support walkable access to daily living destinations. Local living policy goals have attracted increasing policy interest as part of COVID-19 response and recovery efforts and have been framed in various ways internationally. For example, cities like Paris have focused on creating 15-minutes cities, whereby residents can access daily necessities and services within a 15-minute walking or cycling trip from home. Delivering 20-minute neighbourhoods is a strategic planning objective in Melbourne and Portland, Oregon in the US has accelerated progress towards creating ‘complete neighbourhoods’. To optimise health benefits, neighbourhoods need a mixture of destinations, and high-quality walking and cycling infrastructure, underpinned by well-designed high-density housing that protects residents from extreme weather and air pollution. Exposure to air pollution can be further managed by siting apartment buildings and schools away from major highways and roads and limiting industrial pollution in residential areas (e.g., regulating buffer distances). Opportunities to reduce greenhouse gas emissions from land use changes and construction of built environments should be accelerated, including retrofitting existing buildings and public spaces rather than demolishing and rebuilding.

  • 8 Nature-based solutions are actions to address societal challenges through the protection, sustainab (...)
  • 9 See reference cited in footnote #2.

13Nature-based solutions8 can help green cities and enhance biodiversity, with co-benefits of reduced urban heat and air pollution, carbon sequestration, and mental health promotion from access to nature.9 Evidence-informed interventions include creating new green spaces in underserved areas, which can also promote social and physical activity. Increasing tree canopy and vegetation cover (e.g., tree retention and planting, green walls and street verges) can help cool urban environments. Biodiversity-sensitive design is required to protect natural areas and green corridors from urban expansion and development, and maintain and enhance native species diversity. For example, to enhance citizens' health and liveability during droughts and heat waves, Barcelona's Master Plan for Trees 2017-2037 promotes green infrastructure, particularly through an extensive tree-planting initiative. The plan aims to ensure that 40% of tree species are resilient to climate change and to mitigate urban heat islands by expanding the city's tree canopy from 5% to 30%.

  • 10 See reference cited in footnote #4.

14Delivering these urban design and transport interventions requires evidence-informed, integrated policy and coordinated implementation between governments and the private and community sectors.10 Alignment of policy actions and funding commitments across sectors and all levels of government responsible for city planning can help avoid unintended contradictions and negative health and environmental effects. Health impact assessment to scope out potential health impacts from major development proposals, projects or policies is a specific approach to ensure health considerations are embedded in all aspects of city planning. It can be used alongside, or combined with, environmental impact assessment to address health and environmental issues synergistically.

  • 11 See reference cited in footnote #7.
  • 12 Participatory budgeting is a democratic process in which communities decide how to allocate a part (...)

15Inclusion is a key quality of resilient urban systems.11 Communities need to be involved in city planning decisions that impact their neighbourhoods and daily lives. Government should provide opportunities for community engagement in all planning stages from identification of problems, through to designing and implementing solutions on-the-ground. Participatory budgeting12, particularly through “co-decision” measures, enables citizens to actively engage in local urban governance. Since its first experiments in Latin America in the late 1980s, the region now accounts for nearly one-third of global participatory budgeting initiatives. In Paris, this model of collective decision-making will facilitate the creation of the city’s third urban forest.

16Geographic and health equity should also be at the heart of priority setting and decision-making, to ensure that everyone has access to healthy and climate resilient urban environments. Neighbourhood-level spatial information can help inform targeted policies and interventions to reduce inequities in access to urban design and transport that supports health and well-being.

  • 13 See reference cited in footnote #4.

17Clear, measurable targets should be included in policies to facilitate their implementation and ensure accountability. Such targets should be evidence-informed and sufficiently ambitious to drive the necessary changes and prevent cities from perpetuating unhealthy urban development patterns.13 City planners and leaders should use indicators—like those in the Global Observatory of Healthy and Sustainable Cities—to identify priority issues and measure and monitor progress towards policy targets. Figure 3 below highlights the pathway to participate in the Global Observatory’s 1000 Cities Challenge. Participants are supported to calculate indicators for their city, generate a city report and scorecard and present the findings to local policy makers and other relevant actors to ensure indicators help inform goal-setting and progress-tracking locally.

Figure 3: Pathway to Participation in the 1000 Cities Challenge launched by the Global Observatory of Healthy and Sustainable Cities

Figure 3: Pathway to Participation in the 1000 Cities Challenge launched by the Global Observatory of Healthy and Sustainable Cities

Conclusion

18Urban areas contribute to and disproportionately experience the health impacts of climate change. However, urban environments can also spearhead climate resilience. Cities need to be able to persist, recover, adapt, and transform in ways that maximise health and climate co-benefits. This includes preparing for climate change impacts that cannot be avoided, while accelerating the transition to net-zero emissions and preventing run-away climate change. Integrated cross-sectoral coordination is needed to create neighbourhoods that support sustainable, local living, and reduce exposure to climate change-related hazards such as air pollution, urban heat and extreme weather events. Cities need to work together to mitigate and prevent the health consequence of climate change, and share policy insights and best-practice approaches with their peers and through relevant networks such as C40 Cities. Policies and their implementation should target health inequities and be guided by measurable targets and evidence-informed indicators to benchmark and track progress over time.

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Notes

1 Giles-Corti, B., Moudon, A. V., Lowe, M., Cerin, E., Boeing, G., Frumkin, H., et al. (2022). What next? Expanding our view of city planning and global health, and implementing and monitoring evidence-informed policy. The Lancet Global Health, 10(6), e919–e926. https://doi.org/10.1016/S2214-109X(22)00158-1.

2 Lowe, M., Adlakha, D., Sallis, J. F., Salvo, D., Cerin, E., Moudon, A. V., et al. (2022). City planning policies to support health and sustainability: An international comparison of policy indicators for 25 cities. The Lancet Global Health, 10(6), e882-e894. https://doi.org/10.1016/j.lancetgh.2022.04.013.

3 Lowe, M., Bell, S., Briggs, J., McMillan, E., Morley, M., Grenfell, M., et al. (2024). A research-based, practice-relevant urban resilience framework for local government. Local Environment, 1-16. https://doi.org/10.1080/13549839.2024.2092341​:contentReference[oaicite:0]{index=0}​:contentReference[oaicite:1]{index=1}.

4 Global Healthy and Sustainable City-Indicators Collaboration. (2022). Global Observatory of Healthy and Sustainable Cities. Washington University in St. Louis. https://www.healthysustainablecities.org/.

5 See reference cited in footnote #4.

6 Boeing, G., Higgs, C., Liu, S., Giles-Corti, B., Sallis, J. F., Cerin, E., et al. (2022). Using open data and open-source software to develop spatial indicators of urban design and transport features for achieving healthy and sustainable cities. The Lancet Global Health, 10(6), e907–e918. https://doi.org/10.1016/S2214-109X(22)00072-9​:contentReference[oaicite:0]{index=0}.

7 Co-benefits are achieved where a policy or intervention simultaneously delivers positive impacts towards multiple goals (e.g., human health promotion and environmental sustainability).

8 Nature-based solutions are actions to address societal challenges through the protection, sustainable management and restoration of ecosystems, benefiting both biodiversity and human well-being (IUCN definition).

9 See reference cited in footnote #2.

10 See reference cited in footnote #4.

11 See reference cited in footnote #7.

12 Participatory budgeting is a democratic process in which communities decide how to allocate a part of the public budget.

13 See reference cited in footnote #4.

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List of illustrations

URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-1.jpg
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Title Figure 1: The Global Observatory of Healthy and Sustainable Cities
URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-2.jpg
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Title Figure 2: São Paulo’s scorecard included in the Global Observatory of Healthy and Sustainable Cities
URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-3.png
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URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-4.jpg
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URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-5.jpg
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Title Figure 3: Pathway to Participation in the 1000 Cities Challenge launched by the Global Observatory of Healthy and Sustainable Cities
URL http://journals.openedition.org/factsreports/docannexe/image/7814/img-6.png
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References

Bibliographical reference

Melanie Lowe, “Healthy, climate resilient urban environments: Evidence to action”Field Actions Science Reports, Special Issue 27 | 2025, 106-111.

Electronic reference

Melanie Lowe, “Healthy, climate resilient urban environments: Evidence to action”Field Actions Science Reports [Online], Special Issue 27 | 2025, Online since 15 December 2024, connection on 14 February 2025. URL: http://journals.openedition.org/factsreports/7814

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About the author

Melanie Lowe

Vice-Chancellor’s Senior Research Fellow in the Centre for Urban Research, RMIT University, Australia and AXA Research Fund fellow

Dr Melanie Lowe is an AXA Research Fund fellow and Vice-Chancellor’s Senior Research Fellow in the Centre for Urban Research, RMIT University, Australia. Melanie Lowe investigates how to plan healthy and resilient cities and develops evidence-informed indicators to monitor and inform policy. She works at the interface of the urban planning and public health fields and collaborates with researchers and policymakers internationally. She is Co-Director of the Global Observatory of Healthy and Sustainable Cities, which shares data and indicators of healthy and sustainable urban design and planning for cities across the globe.

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Copyright

CC-BY-4.0

The text only may be used under licence CC BY 4.0. All other elements (illustrations, imported files) are “All rights reserved”, unless otherwise stated.

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