# name
Urban health: an example of a "health in all policies" approach
                in the context of SDGs implementation

# metadata.dc.description.abstract[].value
Background: Cities are an important driving force to implement the Sustainable Development Goals (SDGs) and
the New Urban Agenda. The SDGs provide an operational framework to consider urbanization globally, while
providing local mechanisms for action and careful attention to closing the gaps in the distribution of health gains.
While health and well-being are explicitly addressed in SDG 3, health is also present as a pre condition of SDG 11,
that aims at inclusive, safe, resilient and sustainable cities.
Health in All Policies (HiAP) is an approach to public policy across sectors that systematically takes into account the
health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population
health and health equity. HiAP is key for local decision-making processes in the context of urban policies to
promote public health interventions aimed at achieving SDG targets. HiAPs relies heavily on the use of scientific
evidence and evaluation tools, such as health impact assessments (HIAs). HIAs may include city-level quantitative
burden of disease, health economic assessments, and citizen and other stakeholders’ involvement to inform the
integration of health recommendations in urban policies.
The Barcelona Institute for Global Health (ISGlobal)‘s Urban Planning, Environment and Health Initiative provides an
example of a successful model of translating scientific evidence into policy and practice with regards to sustainable
and healthy urban development. The experiences collected through ISGlobal’s participation implementing HIAs in
several cities worldwide as a way to promote HiAP are the basis for this analysis.
Aim: The aim of this article is threefold: to understand the links between social determinants of health,
environmental exposures, behaviour, health outcomes and urban policies within the SDGs, following a HiAP
rationale; to review and analyze the key elements of a HiAP approach as an accelerator of the SDGs in the context
of urban and transport planning; and to describe lessons learnt from practical implementation of HIAs in cities
across Europe, Africa and Latin-America.
Methods: We create a comprehensive, urban health related SDGs conceptual framework, by linking already
described urban health dimensions to existing SDGs, targets and indicators. We discuss, taking into account the
necessary conditions and steps to conduct HiAP, the main barriers and opportunities within the SDGs framework.
We conclude by reviewing HIAs in a number of cities worldwide (based on the experiences collected by co-authors
of this publication), including city-level quantitative burden of disease and health economic assessments, as
practical tools to inform the integration of health recommendations in urban policies.Results: A conceptual framework linking SDGs and urban and transportplanning, environmental exposures,
behaviour and health outcomes, following a HiAP rationale, is designed. We found at least 38 SDG targets relevant
to urban health, corresponding to 15 SDGs, while 4 important aspects contained in our proposed framework were
not present in the SDGs (physical activity, noise, quality of life or social capital). Thus, a more comprehensive HiAP
vision within the SDGs could be beneficial.
Our analysis confirmed that the SDGs framework provides an opportunity to formulate and implement policies with
a HiAP approach. Three important aspects are highlighted: 1) the importance of the intersectoral work and health
equity as a cross-cutting issue in sustainable development endeavors; 2) policy coherence, health governance, and
stakeholders’ participation as key issues; and 3) the need for high quality data.
HIAs are a practical tool to implement HiAP. Opportunities and barriers related to the political, legal and health
governance context, the capacity to inform policies in other sectors, the involvement of different stakeholders, and
the availability of quality data are discussed based on our experience. Quantitative assessments can provide
powerful data such as: estimates of annual preventable morbidity and disability-adjusted life-years (DALYs) under
compliance with international exposure recommendations for physical activity, exposure to air pollution, noise, heat,
and access to green spaces; the associated economic impacts in health care costs per year; and the number of
preventable premature deaths when improvements in urban and transport planning are implemented. This
information has been used to support the design of policies that promote cycling, walking, public, zero and lowemitting modes of transport, and the provision of urban greening or healthy public open spaces in Barcelona (e.g.
Urban Mobility, Green Infrastructure and Biodiversity Plans, or the Superblocks’s model), the Bus Rapid Transit and
Open Streets initiatives in several Latin American cities or targeted SDGs assessments in Morocco.
Conclusions: By applying tools such as HIA, HiAP can be implemented to inform and improve transport and urban
planning to achieve the 2030 SDG Agenda. Such a framework could be potentially used in cities worldwide,
including those of less developed regions or countries. Data availability, taking into account equity issues,
strenghtening the communication between experts, decision makers and citizens, and the involvement of all major
stakeholders are crucial elements for the HiAP approach to translate knowledge into SDG implementation.

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Urban health: an example of a "health in all policies" approach
                in the context of SDGs implementation