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Urban Health: How cities influence chronic disease risk

We’re identifying and measuring the association between urban environment features and Noncommunicable diseases (NCDs) in the HORUS project.

How does the urban environment influence our health? Many factors related to our urban surroundings have an impact on our lifestyle choices, and therefore on our health. Studies show that up to 89% of our health is determined by factors that are external to medical care. While our genetics and biology play a role, the major factors that influence our health are related to our physical and social contexts and our behaviour. Whether we have access to services and shops near where we live, or whether our streets are pleasant to walk or cycle along, will encourage us to move around, relate to other people and make use of our surroundings in different ways, leading to healthier or unhealthier lifestyles.

A recent report carried out by Bax and Healthy Cities uncovers the relationship between the configuration of cities and the prevalence of non-communicable diseases. In the frame of the HORUS project, the aim was to analyse the characteristics of the urban environment of three cities: Rijeka, Valencia and Rotterdam, and understand how different urban contexts can promote or hinder a healthy lifestyle.

Bax assessed 18 physical and functional characteristics in each neighbourhood, such as proximity to public spaces, accessibility of the pedestrian network or the density of shops and other basic services, as well as each neighbourhood’s average income and percentage of population with higher education level. By comparing these results with data on unhealthy habits collected through surveys and the existing rate of chronic conditions, it’s possible to identify patterns that highlight the impact of our urban surroundings on shaping our health.

How was this work developed?

  • First, a review of the available literature was carried out, based on previous reviews done by the Healthy Cities team, linking different urban aspects (i.e., proximity to greenspaces, walkability, population density) to health outcomes.
  • Then, the most relevant aspects of the urban environment for this analysis were identified and indicators were defined for each.
  • A data-driven analysis was done with GIS software to map and measure indicators of each urban feature. This consisted of two types of processes depending on the nature of the indicator: either dividing the city into 500-metre cells forming a grid, or using the administrative boundaries of the neighbourhoods or districts.
  • This resulted in a total of 68 maps analysing physical and functional aspects, 6 socio-economic analyses and 25 with health variables, based on data provided by the three cities.
Proximity to services (average number of available services) in Valencia, topography of Rijeka, and percentage of the population with cardiac arrhythmia in Rotterdam.
A comparison for Valencia between an urban aspect (density of open public areas per cell) and a health variable (NCD risk linked to dietary patterns)

This work sets the basis for further analysis. The University of Valencia will use the results to classify each neighbourhood and compare the results not only within each city but also among the three cities, to obtain substantive conclusions on the relationship between the urban environment and the behaviour associated with NCDs.

The results demonstrate the need to work cross-sectionally between different areas, in this case, urban planning and health, to address the problems in a holistic and integral way and to provide solutions that will improve the quality of our cities and general health. Recognising the city’s potential as a tool for health and incorporating health in all policies is key to achieving city-dwellers’ health and wellbeing.

Check out the full report to find out more about the results here and follow us to keep up to date with the project’s progress!

The HORUS (Health Outcomes from Raised Urban Settings) project aims to transform urban health habits and lifestyles to make cities become positive health determinants for people. It is funded by the European Union and led by the Instituto de Polibienestar of the University of Valencia, in collaboration with Bax, the Universities of Rijeka and Rotterdam, Fundació Fisabio and Kveloce.

Learn more about the HORUS project and our work in Healthy Cities

If you want to learn more about how you can make your city healthier, reach out to a member of our team.

Marta Rofín Serrà
Innovation Consultant – Urban Planner
Health
Urban
Víctor Ferran
Innovation Consultant
Mobility
Ruth Gow McLenachan
Innovation Consultant – Urban Planner
Urban
Celia García Albertos
Innovation Consultant – Urban Planner
Urban
Caitlin Ball
Communications Consultant
Nature
Urban