Cities are economic powerhouses, offering residents access to higher-quality healthcare. But the urban environment also takes a toll; city dwellers suffer higher rates of myriad health problems, from cardiovascular and respiratory disease to depression, psychosis and generalized anxiety disorder. Rapid urbanization has heightened the need for inclusive and livable cities.
It's not surprising, then, that in recent research—conducted by ThoughtLab and co-sponsored by Cognizant—almost 90% of 200 city officials from around the world said they included health and safety in their action plan for future-readiness. Alarmingly, though, only 49% say they’ve made good or very good progress in this area. (For the full study on future-ready cities, see our ebook.)
The good news is that widespread adoption of digital technologies offers cities an opportunity to transform public health. And the work cannot stop there. Urban planning must put health front-and-center to create more equitable societies designed for walkers and cyclists and with green spaces within reach of all.
The state of health in cities today
Public health, including mental health, is a key challenge for cities; 61% of local officials in our survey called it one of the main challenges they will face in the next five years, second only to climate change. Despite mass vaccinations, healthcare systems remain strained following the COVID pandemic. In Europe, for example, excess deaths are 10% above expected levels. Surprisingly, however, while 49% of citizens said their cities need a major transformation of “living and health” to become future-ready, only 13% of local officials concurred.
High levels of inequality have been associated with poor health outcomes. This is true even when technology is deployed. In the US, for instance, vigorous expansion of telemedicine over the last two decades has been found to remove geographical barriers to care—but not so much social ones.
Growing urbanization and demographic change are creating additional challenges. As the rural poor become urban poor, they encounter easy and cheap access to unhealthy foods and beverages. As a result, they often struggle with problems such as obesity, under-nutrition and micronutrient deficiencies. In much of the world, they also face dangers associated with inadequate access to sanitation.
Another substantial, and growing, challenge for public health in cities is an aging population. People over 60 are the fastest growing segment of urban populations. This means cities need to factor age-friendliness into their plans and promote healthy aging.
Addressing these challenges is key to developing future-ready, healthy, livable cities. This can only be done when people are put front-and-center of all initiatives, creating communities of healthcare that involve social groups, governments and the private sector. The road to success includes three crucial steps.
1. Capitalize on digital
City governments and healthcare systems and providers understand the power of data and digital technologies to improve health outcomes, but many have done little more than dip their toe in the water. Now is the time for cities to embrace a profound digital revolution in their approach to healthcare. Numbers point toward a shift in this direction—69% of surveyed officials say they will prioritize the provision or expansion of telehealth services (see Figure 1).
This desire is reflected in cities’ technology priorities, which include key enablers of virtual care. Nine in 10 local officials identify automation as a key technology to their future-readiness plans, while 89% named artificial intelligence (AI), 83% mobile technologies and 75% cloud computing. When combined with the power of 5G and the Internet of Things (IoT), cities can lay the foundation for smooth delivery of remote care, as well as swift response to emergencies.
Top 5 health priorities
Q: Which of the following actions will your city prioritize over the next five years to improve how citizens live and stay healthy?