Christine Waddell
MSc Evidence-Based Health Care student, University of Oxford
Email: [email protected]
Managing environmental health risks requires a comprehensive and coordinated effort, from the choices we make every day as individuals, to the laws, policies, and programmes at local, national, and international levels of society.
The origin of the phrase ‘think globally, act locally’ is difficult to pin down, but whoever said it first, the concept has weaved its way into many aspects of life. In the context of city planning and the impact of blue, green, and grey infrastructure on public health in urban areas, ’think globally, act locally’ is central for the management of the environmental and health effects of urbanization.
Environmental health risks exist no matter in what habitat people live, whether urban, suburban, or rural. However, major urban centres with dense populations, high levels of paved surfaces, and aging grey infrastructure pose an exceptional challenge to public health through poor air quality, waste and storm water management, and reduced access to green space. The aging grey infrastructure of many cities may seem a financial burden, but presents an opportunity to innovate and to incorporate improved, multifunctional blue and green infrastructure to improve urban environments and subsequently public health.
Recent research evaluating cities from around the world has shown measurable benefits for health and wellness from the implementation of World Health Organization (WHO) initiatives on urban green spaces, and of the United Nations sustainable developments goals. An impact study on green space and mortality of over 978 cities, across 31 European countries, showed a statistically significant reduction in all natural-cause mortality associated with high exposure to green spaces. The WHO proposed an average increase of 25% of green space within 300m of each urban household as an effective guide for healthy urbanism, but a further study showed that even just a 10% increase in green space correlated with a decrease in all-cause mortality.
Positive measures to improve health and wellness are more than just limiting exposure to the environmental health risks related to mortality, or to the causes of non-communicable diseases such as chronic obstructive pulmonary disease, cancer, or depression. Health is a complex connection between social, intellectual, emotional, and physical wellness, which urban developments readily provide with access to work, museums, hospitals, cultural events, gardens, and restaurants. The benefits of city-dwelling bring us back to the grassroots aspect of ‘think globally, act locally’, as it relates to managing infrastructure development in urban areas, but at a community level.
It might seem that public and professional opinion on building environmentally healthy and sustainable cities are sometimes at odds, but when surveyed, perceptions of blue-green infrastructure (BGI) are more closely aligned. Both the public and the professionals responsible for building infrastructure want improved air and water quality, enhanced biodiversity, reduced health risks, and to live in a place of which they can be proud.
The drivers for successful implementation of BGI initiatives require collaboration between these private, public, and professional stakeholders, but are primarily dependent on the local culture, political belief system and reflect the area’s immediate environmental challenges that are affecting public health in that specific region. Each community benefits from assessing their own unique challenges, and what strategies might best enhance their environment and health through multifunctional BGI. It might be the introduction of bioswales to manage increased storm water runoff, or community vegetable gardens where private green space is scarce. Whatever the initiative, pride of place is key in effective collaboration. The idea of how to assign value to a place might require a movement away from the concept of management and into local stewardship, where all elements including the participants, human and environmental are considered within the designs of urban planning.
As each community works to address their local concerns, the overall health of the city, both of its environment and its citizens, improve. Cities could be seen as the largest on-going experiment to assess the effects of urban development on human health, and the impacts of humans on environmental health. From any perspective, whatever research, or evidence you want to use, if the world has learned anything from the study of urbanisation, it is that human health and environmental health are mutually dependent.