Building healthier, more equitable urban areas through exposome research

In a world where over 55% of the population currently resides in urban areas – a figure expected to rise to 68% by 2050* – understanding the relationship between health and increasingly urbanised environments is crucial. While life in an urban area offers many advantages, it also presents unique health challenges. For example, an alarming 91% of urban residents breathe polluted air*, and insufficiently planned urban transport systems can lead to a range of issues, including road traffic injuries, air and noise pollution, and obstacles to safe physical activity. Moreover, factors present in urban settings, such as varied pollution types, urban heat islands, a shortage of green spaces, and inadequate walking and cycling infrastructure, not only exacerbate non-communicable diseases like heart disease, asthma, cancer, and diabetes but are also associated with higher rates of mental health disorders.
EHEN urban health blog stats

What is an urban area?

An urban area is a city or town and its surrounding areas e.g., the suburbs. Urban areas are very developed, meaning there is a density of human structures, such as houses, commercial buildings, roads, bridges, and railways, as well as high population density.

Understanding the Urban Exposome
The urban exposome is a term gaining attention in the world of public health. Simply put, it means looking at all the things people are exposed to within their environment that can affect their health. This includes not only issues such as air pollution and noise but also factors like access to green spaces, the quality of homes, and how cities are built and designed. By understanding all these factors together, we can get a better picture of how urban areas and particularly cities influence health.
Challenges in Unravelling the Urban Exposome

There are several challenges involved in unpicking the urban exposome. These include:

Data Complexity: Urban environments generate vast and diverse data related to exposure factors. Gathering, integrating, and interpreting this data requires advanced analytical tools and interdisciplinary collaboration.

Spatial Temporal and Contextual Variability: Exposure levels can vary greatly within a city and over time. What people are exposed to in a city can change a lot depending on where they are and why and when they are there.

Health Inequities: Health inequities are more evident in urban areas, often varying between neighbourhoods and sometimes even between adjacent streets. Vulnerable populations in these areas often face disproportionate exposure to environmental risks, exacerbating health disparities. Addressing this inequity requires targeted interventions and policies.

Policy Implementation: Translating exposome research into effective urban health policies can be challenging yet hugely powerful as it offers a comprehensive and integrated view of the challenges ahead. It is essential that policymakers work with researchers and relevant stakeholders to enact meaningful change.

Initiatives Tackling Urban Health Challenges

Amid the complexities and varied challenges of enhancing, numerous global and regional initiatives are forging paths towards more sustainable and healthier urban living. The WHO Healthy Cities Network works to elevate health on the political and social agendas of cities, focusing on equity, participatory governance, and local-level public health movements while emphasizing intersectoral collaboration to address determinants of health. The Green City Accord, an initiative by the European Commission, represents a commitment by European mayors to promote cleaner and healthier cities, aiming to enhance the quality of life for all Europeans and accelerate the implementation of relevant EU environmental laws. Meanwhile, Eurocities fosters a platform for cities across Europe to exchange insights and strategies, addressing urban challenges with key aims such as establishing healthy, prosperous, and inclusive cities, mitigating air, water, and noise pollution, promoting clean mobility, and amplifying citizen engagement. These initiatives highlight the vital role of policy, community involvement, and city collaboration in moving toward healthier urban living, which complements and aligns with exposome research.

Friends talking and walking in the street
Leading the Way in Exposome Research

The methodology being used encompasses a diverse range of strategies, including:

Interdisciplinary Collaboration: Within EHEN projects, experts from various fields, including epidemiology, statistics, environmental science, urban planning, and economics, come together to investigate complex urban health issues through interdisciplinary collaboration.

Longitudinal Studies: Long-term studies follow individuals and communities over extended periods, shedding light on how environmental exposures and health outcomes evolve over time. These studies identify critical windows of vulnerability and long-term health effects.

Data Analysis: Advanced data analysis techniques are employed to investigate data from multiple sources, and better understand patterns, correlations, and trends that could inform policies and interventions.

Community Engagement: Active engagement with urban communities and stakeholders ensures that research remains relevant to the people living in these environments. This collaboration fosters community-driven initiatives and facilitates the dissemination of research findings.

Policy Translation: The ultimate goal is to transform research findings into actionable policies that improve urban health. EHEN engages with policymakers, providing them with evidence-based recommendations for meaningful change.

Innovation and Technology: Innovation and technology are utilised to enhance research capabilities. This includes the use of sensors, data collection tools, and modelling techniques for a deeper understanding of the urban exposome.

Innovation and Technology

In the EXPANSE project, air pollution data is being gathered using mobile monitoring equipment across various cities in Europe, including Athens, Barcelona, Basel, Lodz, Munich and Rome. The data is then used to initially demonstrate small and immediate changes that can be made, around schools for example, to make city streets healthier. Hyperlocal air pollution maps can be used in urban planning.

Collaboration and Engagement

In LongITools, a recent policy forum focused on urban health and brought together policymakers, intermediaries, city planners and researchers to discuss topics such as urban planning, healthy cities, and quality of life, as well as the latest exposome research in this area.

Shaping Healthier Urban Environments

The path toward understanding and improving urban health challenges is a shared endeavour beginning with recognising the role of research, policy, and collaboration. Healthy urban environments cannot be created in silos and stakeholders must work together to enable ‘health equity in all policies’ and successful, joined-up urban planning.

Researchers in the EHEN projects are contributing to defining, describing, and quantifying how the environment, from conception and pregnancy onwards, influences lifelong health and well-being. The aim is to share project results with urban planners and policymakers to accelerate positive change in the creation of fairer and healthier urban environments for all. The research extends beyond academic exploration, serving as a catalyst for concrete changes that foster improved living conditions within urban environments.

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October 30, 2023