20% of all deaths could be prevented if cities were better designed

[Source Image: Yevgen Liashko/iStock]

Many of the models for healthy urban design, like the superblock city or the 15-minute city, are rooted in Western cultural ideals. Here’s why that’s a problem.


By 2050, it is projected that almost 70% of the world’s population will be living in cities, up from 55% today. The fastest urban growth is happening in Asia and Africa, which is also where we’re seeing a rapid rise in people suffering from, and dying of, heart disease.

The impact of noncommunicable diseases on the world population’s health is growing. Noncommunicable diseases are those that are not directly transmissible from one person to another. By 2030, scientists predict they will account for 77% of the global burden of disease. Cardiovascular or heart disease is the most common type, responsible for 44% of all deaths related to this category.

New research from the University Medical Center in Mainz, Germany, explores how urbanization exacerbates the risks of such diseases. Young people are increasingly concentrated in the world’s cities. Their future health is at risk. Can city planning be harnessed to protect their health?


The Mainz study synthesizes the existing evidence on the impact of several urban environmental risks. These include air pollution (more than half of the global deaths from air pollution are due to cardiovascular disease); transportation noise (which contributes to the risk of metabolic disease by raising stress hormone levels, heart rate, and blood pressure); and light pollution at night (associated with changes to the circadian rhythm, which is linked to conditions including obesity and heart disease).

The study then highlights how human health and climate change are linked, and what can be done to help. Urban infrastructure is destroyed and populations harmed by the effects of extreme weatherfloods, and heat stress.

Scholars speak about this enmeshing of human health and the well-being of the natural systems on which we depend as planetary health. Increasingly, this is seen as a guiding principle that should drive all urban policies.


Building cities for cars and urban sprawl encourages car use, traffic congestion, air pollution, and noise. The result is more stress, road trauma, and physical inactivity as well as worse health overall and more deaths.

It follows that we need better designs for our cities. Research has shown, for instance, that 20% of all deaths could be prevented if cities were designed to meet the recommendations for physical activity, air pollution, noise, heat, and green space.

The Mainz authors have identified four urban models that can be described as healthy. The first is the compact city: high-density, with direct public transport and bountiful green space. Melbourne, Australia, is currently being transformed along these lines.

The second model is the superblock city. Here, blocks are bounded by arterial roads, within which pedestrians and cyclists have priority and residential traffic only is permitted, with a maximum speed limit. In Barcelona, urban planning in this way is estimated to prevent almost 700 premature deaths every year from air pollution, road traffic noise, and heat.

The 15-minute city, meanwhile, has recently regained popularity as a means of rebuilding in the wake of the pandemic. Here, the idea—to which Anne Hidalgo, the mayor of Paris, pegged her 2020 reelection campaign—is that all residents be able to easily fulfill their essential needs (grocery shopping, the school run) within a 15-minute walk or bike ride from their home.

Lastly, the car-free city model, of which the Vauban neighborhood of Freiburg in Germany, is a successful example, reduces unnecessary, private traffic and provides easy access to active and public transportation.

All four models are designed to promote active transportation and to minimize car use. This in turn reduces air pollution, noise, and heat and increases physical activity, which improves heart health.

While laudable, these models don’t take into consideration the urban sprawl that characterizes the cities growing the most rapidly across the globe. Without due consideration of the historical and colonial contexts of spatial segregation, as in, say, South Africa’s urban centers, the 15-minute city could inadvertently exacerbate spatial inequity.

Similarly, the informal ways in which residents in these cities appropriate the built environment require different approaches to promote active living. In IndonesiaColombiaRwanda, and Nigeria, to name a few, people are increasingly implementing temporary programs—such as car-free days—to promote active living. These creative initiatives are crucial, as is robustly investigating the health benefits they bring…



F. Kaskais Web Guru

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