Building a fairer and healthier world

#75 - 9 April 2021

Building a fairer and healthier world

The theme of the 2021 World Health Day organized by the World Health Organisation (WHO) is "building a fairer and healthier world". With the pandemic, pre-existing health inequalities have widened, also leading to an increase in socio-spatial inequalities. Disadvantaged social groups, those subject to discrimination, poverty and poor working conditions have suffered the highest death rates. In England and Wales, for example, the number of deaths from COVID-19 infection is double the average in the poorest neighbourhoods, while ethnic minorities account for 34% of the patients who develop severe forms of COVID-19, but only make up 14% of the total population. How can these inequalities in relation to COVID-19 be explained? On the one hand, the most disadvantaged minorities and social groups are those who are also most affected by other comorbid diseases (obesity, diabetes, asthma, hypertension, cancers, etc.); on the other hand, these groups are more exposed both because of housing conditions that make it difficult or even impossible to isolate themselves or to work from home, and because of lesser access to healthcare.

To "build a fairer and healthier world", the WHO identifies five pillars for collective action: providing access to the latest medical technologies, including vaccines, for all countries; developing access to primary care for all; extending social protection to social groups that are deprived of it; strengthening the development of reliable health databases; and building safe, healthy, and inclusive neighbourhoods. Beyond the current crisis, the challenge is therefore threefold: a social challenge to provide protection and economic support for the most vulnerable; an urban and architectural challenge to recognise the impact of the environmental factor (place and associated lifestyles) on health; and finally a public health and spatial planning challenge to guarantee territorial equity in access to quality healthcare.

Sweeping aside the false debate between fighting global warming, guaranteeing food security, improving public health and shared prosperity, Dr Tedros argues that they are all sides of the same coin and that the pandemic has demonstrated the urgency of "investing in health as a motor of development ". While there is constant discussion about the future of small and medium-sized towns and rural areas, it is necessary to return to certain fundamentals that are well known to those working in the field: while a more peaceful living environment is increasingly attractive, employment, training opportunities and health care services remain the sine qua non conditions for a change of lifestyle and a move. While health is recognised as a key factor in the attractiveness and revival of territories, and while cities are becoming increasingly aware of the importance of environmental factors in preventing the onset of diseases and are now at the forefront of organising local vaccination campaigns, can we expect the lines to move in favour of health competences at the city level? If the issue of creating new exclusive competences for cities in the field of environmental health requires the debate to be posed, it is certain that putting health back at the heart of territorial policies requires the activation of a wide range of action levers: from determining the right scale of the catchment area to be covered and the inter-territorial cooperation to be established in order to have a safe and quality health care offer, to a policy of territorial attractiveness enabling new doctors to be attracted and retained, and to the adoption of a new planning paradigm that no longer makes health a simple option. The challenge is certainly important, but it is already possible to capitalise on the initiatives carried out by pioneering local authorities in the field of environmental health in order to clarify the extent of the current possibilities for action and to help other local authorities in their decision-making. – Chloë Voisin-Bormuth, Director of Research and Studies

Related: our work about health producing cities.

No time to read? La Fabrique de la Cité has got you covered.

TELEWORKING TOMORROW – The positive effects of teleworking on the reduction of VMT are dissipating as teleworkers move further from the central city, according to a study. This phenomenon puts mass transit agencies at risk as they will now have to accommodate their offer and deploy their services in places that are relatively difficult to serve. – Camille Combe, Project Manager

→ Related: our note “Behind the words: telecommuting”.

Ikea is partnering with Helsingborg, a city in southern Sweden, to deliver real-life innovations for "sustainable, affordable and practical cities for people, planet and society". Three main themes are addressed: urban agriculture, the future of commerce, and affordable housing. This partnership meets a new demand from cities and residents to be able to "see", experiment and test innovations and thus be able to participate in improving them before adopting them. –Chloë Voisin-Bormuth


BETTER TOGETHER – As vaccination rates increase and businesses start to reopen, cities across the U.S. are cautiously moving forward with economic recovery plans to revive real estate and economic markets pummeled by the pandemic. Some midsize cities — like Austin or Portland — may be poised to rebound faster than others because they have developed strong relationships with their local economic development groups. – Yamina Saydi, Communications Officer

→ Related: our work about mid-sized cities.


OFFER OR PRICE? – What would incentivize people to use mass transit again? Price or the offer? In Washington, where the Metrorail ridership has dropped by 85%, the transport agency is considering the possibility of lowering fares to lure people back… while services will not recover from their pre-pandemic levels until at least 2022. – Camille Combe

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