The 2030 Agenda as an Innovative Framework for Urban Health

Foto: IISD/ENB-Kiara Worth

Por Oriana Ramírez y Carolyn Daher (ISGlobal)

At ISGlobal, we believe that the 17 Sustainable Development Goals (SDGs) -of the 2030 Agenda- provide a useful framework to understand and integrate our work (whether is research, translation into policies or training) in a way that it is systemic, sustainable and equitable. For an organization such as ours, with a broad portfolio of activities on communicable diseases, child and maternal health, chronic conditions and environmental exposures in both domestic and international contexts, the SDGs feel like home, providing a roadmap to find connections among us. In the field of urban health, where stakeholders and expertise range from epidemiology researchers and public health practitioners to urban and transport planners, this is even more important.

We recently wrote about this for a special issue of the Globalization and Health journal, where experts from different ISGlobal areas further analyzed why we think the SDGs are an added value to understand the work we do on urban health.

Experts from different ISGlobal areas found at least 48 Sustainable Development Goals' targets relevant to urban health

We crosschecked a traditional urban health framework on causal pathways with all 169 SDGs’ targets and found at least 48 SDG targets relevant to urban health, corresponding to 15 SDGs, mainly captured by SDG 3 (Health and wellbeing) and SDG11 (inclusive, safe, resilient and sustainable cities),while four important aspects (indicated by a “+” symbol) contained in our proposed theoretical framework, were not present in the SDGs (physical activity, noise pollution, quality of life or social capital).

From: Oriana Ramírez et al. Urban Health: an example of a “Health in All Policies” approach in the context of SDGs implementation. Global Health 15, 87 (2019) doi:10.1186/s12992-019-0529-z

The main conclusions of this analysis are:

1. The SDGs provide a platform for intersectoral work.

The SDGs are the most holistic shared framework that we are aware of, signed by 193 UN state members, thus providing a shared language (some sort of Esperanto) across actors. Unlike theoretical and practice-based frameworks commonly used in the Public Health arena such as “Health in all policies” or “Social determinants of health” or even more complex eco-social theories, the SDGs are understood and shared across all disciplines and stakeholders (policy makers, civil society, academia or the private sector), thus, truly including them but going beyond and convening us to work intersectorally.

2. The SDGs set up concrete commitments and deadlines for 2030, and push us to investigate interlinkages and find balance on trade offs through policy coherence.

The SDGs help us to set a sense of urgency. They also urge us to consider progress systemically. Action on some SDGs could have reinforcing but also counteracting or nullifying effects on planetary or human health. Health is usually considered a co-benefit, and health outcomes are good mobilizers of policies from other sectors that may be unpopular such as traffic restrictions or speed limits within cities. Cities that work towards decreasing air and noise pollution and increasing physical exercise or green open spaces can dramatically reduce the incidence, morbidity, mortality and associated costs of a wide range of diseases, from heart disease and stroke, to cancer and mental health issues. Diseases that carry a high social and economic cost for society.

3. The SDGs put equity at the core of our research.

Those more vulnerable such as children, older people, women, people with disabilities, and the poor are usually the most often exposed to risks, so it is essential to ensure health gains are distributed equitably. Equity is both a crosscutting issue for the 2030 Agenda, whose general motive is “leave no one behind”, but also contained in specific objectives (SDGs 2, 5 and 10). For gender equality, the overwhelmingly positive interactions with other goals suggest that actions for improved gender equality can be an important lever overall.

Traditionally, most interventions on urban and transport planning are based on the necessities and perspectives of those healthy, wealthy and male.  Participatory processes are required to identify inclusive priorities across vulnerable subpopulations.

4. The SDGs call for close monitoring of goals using high quality evidence-based information and data.

In this regard, ISGlobal’s experience conducting Health Impact Assessments (HIA) in cities around the world is crucial. Based on at least 17 HIAs on more than 40 cities worldwide, we discuss the strengths and limitations of such processes. Particularly those conducted with the city of Barcelona correspond to a long-term trust and collaboration between ISGlobal and local authorities that has positioned our institution into a valid voice when it comes to quantifying health impacts of regional mobility plans or for specific interventions such as the Superblocks urban model.

We truly believe healthy urban policies can significantly reduce the burden of infectious and non-communicable diseases and enhance wellbeing of city dwellers. We feel committed to add to a growing body of scientific evidence able to clarify risks and inform decision-making on the health impacts of urban and sustainable development policies, and deliver tools to do so. We consider that the SDGs are a magnificent mechanism to do so. So, are you ready to incorporate this framework into your daily work as well?

More information

Oriana Ramírez; Carolyn Daher; Gonzalo Fanjul; Mireia Gascon; Natalie Mueller; Leire Pajín; Antoni Plasencia; David Rojas-Rueda; Meelan Thondoo; Mark J. Nieuwenhuijsen. Urban Health: an example of a “Health in All Policies” approach in the context of SDGs implementation. Global Health 15, 87 (2019) doi:10.1186/s12992-019-0529-z