Creating healthy cities

This is the third in a series of special issues of the International Review of Applied Economics analysing the economic impact and consequences of the Covid-19 pandemic. The articles from the first two special issues were republished in Michie and Sheehan (2023), analysing the political economy of Covid-19, including its effect on inequality, and government responses globally to the pandemic. That book includes a paper by the leading expert on organisational studies and organisational behaviour, Professor John Child, who notes that while the Covid-19 pandemic intensified many of the economic and social problems that societies were already facing, the public response to the crisis pointed to a constructive way forward, including people participating in collective activities to contribute to addressing the common challenge, arguing that:

… it is timely to widen participation in organisational decision-making as an approach to addressing many of the problems which will continue to be with us post-Covid, and which indeed the pandemic has exacerbated (Child 2023, 9).

Governments have failed to respond as they should have to the need – and indeed the opportunity – which John Child details. Instead, the UK Prime Minister Boris Johnson was forced to resign and leave office in disgrace, in September 2022, as was his successor Liz Truss in October, having survived as Prime Minister for only 44 days; the USA appears stuck in a post-Trump era where ‘fake news’ is widespread; China is pursuing a ‘zero Covid’ lockdown strategy which is widely regarded as unsustainable; and many other countries globally are suffering from similar failures of leadership. There had been pledges to ‘build back better’, to target ‘net zero’ for environmental sustainability, and even to do this through a Global Green New Deal that would deliver social sustainability. These must remain the goals, and political movements need to be generated to achieve them, but this promises to be a long and difficult road ahead.

1. The papers in this double special issue

In ‘An Empirical Analysis of the Early Impact of Covid-19 on Income-related Inequality in Household Stress’, Sucharita Ghosh and Francesco Renna analyse the impact in the UK of Covid-19 on both mental stress and financial stress, finding that the mortgage holiday (whereby repayments on the loans taken for house purchases were suspended) was effective in lowering financial stress, and the Coronavirus Job Retention Scheme was effective in dealing with mental stress. In ‘Towards the Reversal of Poverty and Income Inequality Setbacks Due to Covid-19: The role of Globalisation and Resource Allocation’, Isaac K. Ofori, Mark K. Armah and Emmanuel E. Asmah consider similar matters for the Middle East and North Africa, regarding both the economic and social aspects of globalisation, finding that the effects on income inequality differ, with economic globalisation appearing to reduce inequality while social globalisation had increased income inequality.

In ‘An Empirical Investigation of the Economic Impacts of Covid-19: Micro-level Evidence from Europe’, using firm level data Ruohan Wu finds that Government support for firms did have an impact, although this varied between high-income and low-income countries. In ‘Covid-19 and the China Opportunity Narrative: Investment, Trade, and the Belt and Road Initiative’, Kerry Liu notes that the global effects of Covid-19 brought about a structural break in 2020 regarding narratives around China, which up until then had been largely around the opportunities presented by Chinese investment and trade, and their ‘belt and road’ initiative, but Covid-19 saw a halt to such narratives, which became more negative. In ‘The Covid-19 Pandemic Economic Impacts and Government Responses across Welfare Regimes’, Jalil Safaei and Andisheh Saliminezhad examine the economic impacts and government responses in selected OECD countries as differentiated by their welfare regimes, finding that the adverse effects on output and employment were worse in the ‘free market’ systems, whilst the social democratic countries fared better. In ‘Gender Roles and Safety of Women at Home in the Covid-19 Era: Evidence from 101 Countries’, Michael Batu and Bosu Seo find that travel restrictions increased the proportion of women who felt unsafe at home, and also led to a rise in home production for both genders, but more so for men.

In ‘Investigating initial responses to Covid-19: evidence across 59 countries’, Amrita Saha, Marco Carreras and Evert-Jan Quak find that some countries were more effective than others in applying packages of measures which were able to provide short-term, medium-term and longer-term support, although country characteristics of course impacted, for example differences in internet coverage making it easier for people to work from home in some countries than others. In ‘Mexico: the populism/Covid-19 syndemic’, Eduardo Gilberto Loría Díaz de Guzmán and Arely Paola Medina González find that while such structural variables do indeed explain variations in fatalities, the responses across countries did matter, and in particular their variable representing populist countries was found to be significant, demonstrating ‘as Shiller (2017) stated, narrative plays a major role in shaping behaviour and economic outcomes’.

A potentially major impact on the global economy remains China’s “covid-zero” policy, because of the implications this may have on the country remaining closed to the rest of the world, with the impact this may have on trade, foreign direct investment, and economic activity more generally. In ‘China’s dynamic covid-zero policy and the Chinese economy: a preliminary analysis’, Kerry Liu analyses this policy and its economic implications, finding that while the Shanghai lockdown in 2022 was less severe than those in early 2020, nevertheless there was a negative economic impact, operating in part through the relatively weak expectations of the Chinese household and corporate sectors in 2022.

2. The Commission on Creating Healthy Cities

As indicated above, several of the papers published in this double special issue provide evidence that demonstrates two things: firstly, that Government intervention can and did have positive economic effects in cushioning the negative impact that Covid-19 – along with the measures that were taken to limit the spread of the disease – would have otherwise had on production and employment; and secondly, that the effectiveness of such policies did vary, depending on a number of factors, including the ‘macro’ one of whether there were social democratic institutions and behaviours in place. When the Covid-19 pandemic was first announced, a Commission on Creating Healthy Cities was launched in the UK, with an International Advisory Board to learn lessons internationally. The Commission was chaired by Lord Best, with the International Advisory Board chaired by Lord Crisp. The immediate purpose was to consider how different types of urban areas tend to fare under the impact of such pressures, with the longer term purpose being to suggest how urban development in the future might best promote individual health, and community well-being. The Commission’s 2022 Report (Commission on Creating Healthy Cities, 2022) is available free of charge, at https://www.healthycitiescommission.org/

As you will see if you access the link, the Commission’s overarching recommendation was that ‘health creation’ – interventions that positively improve health and wellbeing – should be the determining factor for policies around the built environment, planning, and placemaking. In other words, ‘Think health – thing place!’, and at the same time, ‘Think place – think health!’.

The Commission surveyed the huge amount of literature around health and urban environments, and created a ‘Healthy Cities Toolkit’, enabling researchers and others to check what studies have been conducted and with what results, what systematic reviews have been undertaken and what they found, and so on. This toolkit is now being hosted, updated, and made available free of charge for others to utilise by the Global Centre on Healthcare and Urbanisation at Kellogg College, University of Oxford – see www.healthycitiescommission.org/toolkit

It is to be hoped that lessons will be learned from what worked, and what didn’t – and from what the research literature suggests needs to be done to promote the health and well-being of our populations as a whole. There will be further pandemics. We do need to take steps both to limit the likelihood of such outbreaks, and also to make our urban areas more resilient in the face of them. The evidence is there, and it is growing – and is now freely available in a user-friendly form to interrogate, via the Healthy Commission Toolkit.

Disclosure statement

No potential conflict of interest was reported by the authors.