Urbanisation, climate change and health equity: how can health promotion contribute?

Abstract

We live in a world that is constantly changing and is challenging established approaches to managing human and ecological health. Two key drivers of change are urbanisation and global climate change. This commentary is concerned with the interrelationship of these drivers with human and ecological health, proposing that health promotion practitioners need to actively seek a new role in the process of creating urban environments that support social and ecological well-being. It provides practitioners with an up-to-date synthesis of climate change science and future projections, the literature around the health impacts of climate change and potential health challenges to urban communities. We argue that health promotion cannot respond to the challenges created by climate change and urbanisation, nor can it meet its own mandate without shifting from an anthropogenic-focussed approach toward embracing a multi-scale, collaborative approach outside the health sector. We suggest that the underlying principles of health promotion, which include equity and community engagement at all scales, are critical to the evolution of thriving urban environments. Food security is given as an example to demonstrate the proposed shift away from an anthropogenic and urban focus toward a socio-ecological approach (i.e. resilience thinking) that provides a framework for collaboration between sectors working with unpredictable global systems. In so doing, the commentary provides practitioners with guidance on the complex science of climate change and its impact on health in urban settings, as well as highlighting the skills that they can bring to creating resilient urban settlements in these times of change.

Keywords:

• urban
• climate change
• socio-ecological
• equity
• resilience

Acknowledgements

We thank Dr Justin Lawson, from the School of Health and Social Development, and various members of the GWG on Climate Change and Health for their contributions to the original version of the background research paper on Urbanisation, Climate Change and Health Promotion.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

^1. Well-being – people's sufficiency in all aspects of their life, including: satisfactory human relationships, meaningful occupation, opportunities for contact with the natural and human-made environments, creative expression, and making a positive contribution to society (Furnass 1996).

^2. Health equity – absence of systematic disparities in health (or in the major social determinants of health) between social groups that have different levels of underlying social advantage/disadvantage – that is, different positions in a social hierarchy (Braveman and Gruskin 2003, 254).

^3. Resilience – socio-ecological resilience is most commonly described as ‘the capacity of a system to absorb disturbance and reorganise so as to retain essentially the same function, structure, and feedbacks – to have the same identity’ (Walker and Salt 2012, 3).

^4. An ecological perspective on human health acknowledges that human and ecosystem health are interconnected, and that human activities are changing these ecosystems. Thinking from an ecological determinant's perspective requires practitioners to manage relationships between the physical, environmental, social and economic systems to avoid compromising the integrity of the natural systems upon which we depend (Grootjans et al. 2005).

^5. Peri-urban – a transitional zone between the clearly urban and rural areas of a region, characterised by mixed uses including intensive food production (Budge and Slade 2009).