We are already feeling the effects of climate change. The environmental impacts are clear, and the World Health Organization and U.S. Centers for Disease Control and Prevention, among others, have long drawn attention to related health impacts: It is increasing food and water insecurity, the prevalence of water- and vector-borne diseases, and our exposure to pollutants. No matter where one resides — rural or urban areas, developing or developed countries — climate change will adversely affect our health.
In peri-urban and urban areas, where social and economic ecosystems are clustered, these health risks are rising at an alarming rate, especially for the most vulnerable. Using health to inform climate change adaptation and mitigation in cities is not merely a suggestion; it must be a mandatory part of urban planning moving forward. Creating better policies, empowering city leaders, and strengthening urban health services will build climate-smart cities that better protect the health of our global population — for now and for generations to come.
Here are three ways in which integrating health goals into urban planning can help build more climate-smart cities:
1. Formalize action with climate-smart policies.
Governance sets the foundation for effective urban planning, and stronger climate change adaptation and mitigation policies will improve both urban resilience and public health. Cities are major contributors to climate change, consuming 78 percent of the world’s energy and producing 60 percent of all carbon dioxide, while being particularly vulnerable to a variety of extreme weather incidents. Climate-smart policies can better protect residents against such threats, especially the urban poor who normally live near flood-prone riverbanks or hillsides where landslides are common.
A mix of proactive and reactive policies is ideal, the former to help anticipate obstacles and the latter to shape responses to adverse health effects stemming from climate change events, such as water- and vector-borne diseases following flooding and storms. For example, working directly with the Mozambican coastal city of Quelimane, I have seen firsthand how such policies are pushing for increased mangrove growth and protection, which will prevent erosion.
Other needed policies could help Quelimane better respond to postflood health crises, such as the recent cholera outbreak in the poor neighborhood of Icídua. Without the right mix of policies, cities lack the governance framework needed to produce systematic responses to these threats, which can lead to deteriorating basic services and lower quality of life.
2. Empower leaders for climate resiliency.
Beyond governance, empowering leaders to enact real change will ensure the success of climate-smart policies that incorporate health goals. Increasing the capacity of decision-makers helps leaders better prepare for and more quickly respond to disasters. As part of capacity building, local leaders should be able to access up-to-date information, such as through an integrated urban information management system, to drive decisions around resource allocation.
This is especially valuable in developing countries where resources can be severely limited. And creating an emergency response system with trained local teams that city leaders can quickly launch during weather emergencies is another strategic approach to protecting people’s well-being. However, such systems are only effective when the decision-makers are properly equipped. Planned insurance programs, disaster-risk management, and other social protection methods enhance cities’ long-term resilience as well. A central need of any such initiative is strong leadership to guide its design, implementation, and continual improvement.
3. Strengthen service delivery for resilient populations.
With the right policies and leadership, stronger service delivery systems can improve quality of life and livelihoods for city dwellers. Essential health care services and interventions mitigate diseases such as heat stress and dengue, which are occurring more frequently nowadays due to climate change. In addition, clean water and sanitation services that consider extreme weather and limit pollution go a long way in preventing water-borne diseases that can affect the urban poor.
For example, the daily maritime floods in Paquitequete, Mozambique, are a constant reminder of the non-existent water, hygiene and sanitation system. During my visits to this neighborhood, I have seen residents commonly working and living near waste, unaware of how such behavior increases their risk of diarrheal disease. Seeing these residents live out their days amongst trash truly showed me the importance of improving service delivery systems. With better systems in place, city populations are freer to develop their livelihoods rather than combat flooding, pollution, and illness.
Vulnerability mapping and other urban planning tools can aid in assessing residents’ needs as well as the best locations for service delivery, new residential and commercial areas, waste control and reduction, and much more. When investments in health systems align with urban planning goals, the result are climate-smart cities that are more strategically positioned to provide high-quality services to their residents.
The environmental consequences of climate change are easy to see, and there is no question that these factors are directly damaging public health. These impacts are much more concentrated in peri-urban and urban areas, weighing on both health budgets and systems. As cities become increasingly stretched to deal with the growing health threats brought on by climate change, it is critical that they approach urban planning challenges with measures that incorporate health interventions.
Better governance, more empowered decision-makers, and improved health service delivery mechanisms are three ways to build climate-smart cities that place current and future well-being at the forefront of their responsibility. The world can no longer afford to ignore climate change and how it is influencing our health. It is up to us to make sure that our cities — hubs of economic and social innovation — are poised to take a lead role.
Debora B. Freitas López, a director in the Southern Africa region at Chemonics with almost 15 years of experience in international development, is responsible for the USAID-funded Mozambique Coastal City Adaptation Project (CCAP) and a member of the health technical practice. She is a health and social and behavior change (SBC) expert with in-depth experience in the design, implementation, management, and evaluation of multi-level initiatives, particularly in SBC.
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