Creating healthy and sustainable cities: what gets measured, gets done

WashU Affiliated Authors: Deborah Salvo (Brown School)

Abstract: This second Series on urban design, transport, and health (Series 2) moves beyond describing why societies need to make the transition to healthier, more sustainable cities, to focus on how and what must change. A glossary of terms is available in the appendix. Series 2 shows the feasibility of assessing health-supportive city planning policies and creating spatial indicators of urban design and transport features, by use of standardised methods across cities worldwide. To do this, we formed the multidisciplinary Global Healthy and Sustainable City-Indicators Collaboration, with expertise in public health, urban and transport planning, urban design, architecture, computer and geospatial science, behavioural science, statistics, epidemiology, complex systems science, and public policy. The goal of Series 2 is to facilitate the development of a global system of policy and spatial indicators for healthy and sustainable cities. Building on methodologies developed in Australia, we measured a modified list of the indicators recommended in Series 1 for 25 cities in 19 middle-income and high-income countries. We sought to answer multiple questions: (1) Is it feasible to measure policies in cities worldwide? (2) If so, do cities have city planning policies that will lead to healthy and sustainable cities? (3) What are the thresholds for urban design and transport features to achieve active and sustainable lifestyles? (4) Is it feasible to consistently measure spatial indicators of urban design and transport features that enable active and sustainable lifestyles in cities worldwide? (5) If so, are there inequities in access to supportive environments between and within cities? Given the rapidly evolving global challenges that have arisen since our original framework and indicators were published in 2016, the final paper in Series 2 considers “where to next?” It updates and expands our 2016 framework of the pathways through which city planning affects ecosystem, human, and planetary health and recommends additional city planning indicators to benchmark and monitor cities. It then outlines global, national, regional, and local actions urgently needed to move from evidence to implementation. Series 2 underscores that integrated city planning has never been more important and identifies actions that must be taken. It is well known that what gets measured, gets done. We therefore provide open-source tools to facilitate measurement of city planning policies and interventions and to enable immediate action. Our vision is that evidence-informed indicators measuring city planning policies and outcomes will be used worldwide to benchmark and monitor progress to hasten the transition to a healthy, sustainable future.