How Cities are Addressing the Climate Health Nexus

The Forum session, “Supporting climate- and health-friendly urban communities and economies” was part of the OECD COP 28 Virtual Pavilion, focusing on the fact that COP28 was expected to lift the political profile of the climate-health nexus, mainstreaming health in the global climate change agenda.
How Cities are Addressing the Climate Health Nexus
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The Forum Virtual session, “Supporting climate- and health-friendly urban communities and economies”, was part of the OECD COP 28 Virtual Pavilion, focusing on the fact that COP28 was expected to lift the political profile of the climate-health nexus, mainstreaming health in the global climate change agenda.

Many organisations have been requesting this at past COPs, and in response COP28 in collaboration with World Health Organisation (WHO) organised the first ever Health Day and Climate-Health Ministerial. COP 28 also brought cities into the discussions to a much larger degree than in the past, as an Urbanisation Ministerial, and a Local Climate Action Summit were organised for the first time, recognising the critical role cities play in supercharging efforts to move further and faster on climate progress. These COP28 meetings were quite key in terms of the issues discussed in the virtual session, as the health impacts of climate change are felt disproportionately in urban communities, with the most economically and socially marginalised people in cities in the OECD and even more so across less developed countries most impacted.

According to the OECD's Regions and Cities at a Glance report, two-thirds of cities in the OECD suffer from hazardous air pollution according to WHO, which poses health risks such as heart disease, stroke, lung cancer, respiratory illnesses, and even a potential link to dementia. In addition to this, new research also suggests that mental health can be negatively impacted by the noise and traffic in urban environments.

Also on the Forum Network: How governments and decision makers can capitalise on the health benefits of climate action by Professor of Environmental Change and Public Health, London School of Hygiene and Tropical Medicine

Despite increasing awareness of the growing and unequal impacts of climate change on health, progress towards global climate goals is insufficient to avoid disaster.

Francesca Colombo, Head of the OECD Health Division, mentioned that people living in urban areas often lead sedentary lives, with around two-thirds of daily journeys made by car, contributing to both increased air pollution and less healthy lifestyles. The OECD has looked at the impact of 13 case studies aiming to encourage the use of more active modes of transport. The analysed case studies broadly fit into four categories of policy instruments as defined by the Intergovernmental Panel on Climate Change: physical infrastructure projects such as cycling paths; economic tools such as congestion charges and tax breaks for using active modes of travel; provision of information and education, for example, on safe cycling practices; and regulatory approaches such as car-free zones.

The research shows that physical activity related to transport increased by between 20% and 75% due to these interventions, primarily through the promotion of cycling and walking. Air pollution also reduced significantly, with reductions in levels of fine particulate matter (PM), which poses the greatest risk to health, falling by 10% to 61%, and carbon dioxide levels decreasing to a level equivalent to removing between 2,000 and 30,000 cars from circulation for one year. Additionally, when these interventions are scaled up, they have the potential to reduce up to 27 million cases of chronic diseases from 2023-2050, including cancers, respiratory diseases, and diabetes. This would also lead to significant savings in health spending.

Philippe Crist, Senior Advisor for the International Transport Forum (ITF), explained that the positive impacts of walking and cycling are approximately 18 to 20 times greater than the negative impact of accidents and air pollution. We often still imagine big and bulky vehicles, but there are many other types of smaller vehicles available, catering to a wide range of urban  mobility needs. By diversifying types of vehicles, cities can organise urban space in a more climate and human health friendly way. This is very valuable, as the introduction of electric vehicles is a step towards sustainability but has brought new challenges. The batteries in these vehicles add weight, causing increased emissions of particulate matter. This can be especially harmful to individuals who walk, cycle or scoot. To address this, it is important to reallocate urban pace, while developing more urban green spaces can also help mitigate the impact of urban heat islands, improve mental well-being, and provide communities with areas for social interaction.

Soo-Jin Kim, OECD Deputy Head of Cities, Urban Policies and Sustainable Development, highlighted that University College London conducted research that revealed a 20-year difference in life expectancy in London between areas such as Oxford Circus and the Docklands Light Railway, using a map of the London subway, highlighting the disparities in health outcomes based on geographical location within a city. She emphasised that the cost of inaction is too high. The OECD Champion Mayors for Inclusive Growth brings together 70 mayors focusing on making their cities cleaner, healthier, and fairer. The group is chaired by the mayor of Reykjavik,  Dagur-Eggertsson, who trained as a medical doctor before he went into politics.

According to the latest information, approximately 2.5 billion more people are expected to live in urban centres by 2050, leading to a doubling of the global building stock.

Cassie Sutherland, Managing Director, Climate Solutions and Networks, C40 Cities is currently collaborating with almost 100 cities worldwide, primarily focusing on the world's largest cities, including megacities with populations of 3 million and above, as well as smaller but highly ambitious cities, to address climate issues. The network involves mayors collectively committing to the highest level of ambition for climate action. The overarching objective is to achieve a 50% reduction in emissions by 2030.

According to the latest information, approximately 2.5 billion more people are expected to live in urban centres by 2050, leading to a doubling of the global building stock. To put this into perspective, it is like constructing a city the size of Milan or Stockholm every week or a city the size of Singapore or New York every month until 2050. It is crucial to recognise that we must view cities not just in their current state but also consider their growth while ensuring they remain inclusive, healthy, and prosperous.

The Clean Air Accelerator, an initiative by C40, joins 48 cities from around the world who have committed to implementing effective policies and programmes to address the major causes of air pollution within five years. More than half of the cities participating are expanding air pollution monitoring, while many others are developing and implementing low and zero-emission zones, emphasising a shift towards sustainable and active travel. Moreover, numerous cities are electrifying their bus fleets, such as Bogota, for example, having the largest electric bus fleet outside of China.

Christopher Yip, Dean of the Faculty of Applied Science & Engineering at the University of Toronto, explained that the University is doing significant work on air quality in cities, examining the intricate relationship between vehicle density, traffic patterns, and vehicle types (such as passenger versus commercial, electric versus petrol). The research also delves into how the local built environment contributes to the dispersion and concentrations of pollutants, considering the seasonal variations that play a role in this dynamic.

This research is a part of the School of Cities initiative at the University of Toronto, which is a cross-disciplinary effort that primarily focuses on urban mobility known as the mobility network. The mobility network aims to investigate all aspects related to urban mobility, including the interplay of a range of factors influencing air quality in cities.

The group is actively researching how policies affecting heavy-duty vehicles impact socially disadvantaged communities. Their work involves identifying communities with varying degrees of air quality and transportation accessibility. In cities like Toronto, understanding local mobility is crucial. The challenge also lies in efficiently moving goods in and out of urban centres while addressing air quality concerns. Particularly, the team is examining areas on the outskirts of the city, hosting major delivery sites.

Since 2018, there has been a 5% improvement in air quality across the C40 cities, with over 93 million residents benefiting.

Francesca, Philippe and Cassie explained that while initiatives aimed at improving urban environments clearly seem like a win-win, it is important to acknowledge potential drawbacks, especially regarding equity. One consequence could be the displacement of communities to less desirable areas, which could have negative environmental and social impacts. It is essential to intentionally consider the needs and challenges faced by disadvantaged populations when considering these changes. This includes assessing the impact on housing prices and developing strategies to address the specific needs of these communities, ensuring that the positive changes do not worsen existing inequalities.

Cassie Sutherland mentioned that about three-quarters of C40 cities are reducing carbon emissions faster than their respective national governments. Since 2018, there has been a 5% improvement in air quality across the C40 cities, with over 93 million residents benefiting. This demonstrates tangible positive outcomes at the city level, impacting a large population. There is a growing recognition of the need for urban climate funds to support cities in advancing crucial climate actions, yet mobilising private finance for city-level actions remains a challenge, as such financing is usually distributed at the national government level. C40 emphasises the importance of collaboration through initiatives like The City Climate Alliance, which engage businesses, particularly those with significant assets and headquarters in the city, to collectively work towards shared goals.

One way to attract more financing is to focus on how climate linked initiatives improve air quality and public health. This approach aligns with the strategy employed in London by Mayor Sadiq Khan when expanding the ultra-low emission zone. Mayor Khan highlighted the public health emergency caused by rising air pollution and its disproportionately negative impact on the city's poorest residents, especially children attending schools near busy roads. By framing the issue as an unjust public health crisis, Khan gained public support and a mandate to expand the ultra-low emission zone.

The session concluded by highlighting that it is essential to involve various stakeholders from both the public and private sectors to ensure a comprehensive and inclusive decision-making process in discussions related to urban planning, public transport initiatives and addressing climate change. In this context, the OECD recommends that in scaling up urban renewal projects health benefits are more explicitly considered, and health authorities are more closely involved.




Learn more about OECD's COP28 Virtual Pavilion

Featuring a programme of 30+ virtual events, the OECD COP28 Virtual Pavilion ran from 23 November to 12 December 2023. Covering a broad range of topics and convening leading experts, policymakers, and civil society, the pavilion presents key OECD contributions with insights to drive ambitious and globally effective action on climate change. Explore the programme, find key resources and register to join the discussions and watch session replays

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