Why should cities be at the centre of the healthy living discussion?

What will the future of health and healthcare look like? In a joint series of blog posts by the World Economic Forum’s Strategic Foresight and Health team, a number of leading voices will present their own visions for the future. Contributions are linked to the Scenarios for Sustainable Health Systems project, the Workplace Wellness Alliance and the Healthy Living Initiative. In the following post, Johanna Ralston, Chief Executive Officer of the World Heart Federation, will share her perspective on the future of health.

Non-communicable diseases (NCDs) – like cardiovascular disease, diabetes, cancer and chronic respiratory disease that kill 36 million people per year –  are so commonplace, chances are that you or someone you are close to have personally been affected by NCDs. While we may think of treating NCDs in terms of individual diseases – surgery and medication targeting cancer or heart disease, insulin to address diabetes, targeted medications for chronic respiratory disease – aggregating them across common risk factors can have much greater impact and prevent disease and death by addressing upstream causes linked to the environment in which we live, including the food we eat, the way we exercise and the air we breathe.

However, addressing NCDs and building healthy communities is a long game often out of sync with the quick wins that elected officials want and need. The effect that changing political winds have on health policies is a significant challenge to the long-term needs of the NCD agenda. Mayor Bloomberg has been able to implement unprecedented healthy policies in New York City, but will these changes continue after he leaves office?

Increasingly, most people live and work in cities. This puts cities at centre of the challenges and opportunities for addressing NCDs. And while it is recognized that we need to work across sectors (food, agriculture, transportation, education, and many more) to create environments that promote health, different sectors have different drivers and ways of measuring success. This makes working with communities more vital, because it is more practical to work with different sectors in a contained geography than at the national or international level. Proven tactics that demonstrate positive impact in relatively short time periods, such as smoking bans, are key to move an action agenda forward.

We need to create incentives for families, communities and cities to make healthy living as much a priority as green living, and we can borrow lessons learned from the environmental movement to get there.  Working across generations is crucial to ensure success, as the risk factors children are exposed to create the conditions for later disease. In fact, cardiovascular disease has been called a paediatric disease that manifests in adulthood.

At the World Heart Federation we have highlighted cities as a critical starting point for healthy change. If we start to address risk factors in early childhood by planning cities with health in mind, we can prevent these risk factor exposures from ever occurring. We have outlined this approach with the SPACE framework but it will undoubtedly take work and input from other sectors and stakeholders if we are to truly quell the growing human and economic costs of NCDs.

Author: Johanna Ralston, Chief Executive Officer of the World Heart Federation

Image: motorists wear masks to protect themselves from air pollution REUTERS/Stringer