Around the world, new agendas are emerging with a renewed focus on the wider determinants of health that are embedded in our urban plans, communities, major infrastructure and the built environment. This perspective is vital to embracing a whole-system approach to urban health and health inequalities. 

In the UK, the new Government has announced a ten-year plan to “fix the NHS”, centred on three important transitions: moving health services from hospital to the community; shifting systems from analogue to digital; and refocusing from treating sickness to health prevention. 

All three play directly into the wider healthy city agenda, which advocates for compact neighbourhoods with care services closer to home, smart city integration, and the design of the urban realm as an enabler of healthier lives and choices. 

A report by the NHS Confederation, ‘The State of Integration at Place’ (2024)¹, underscores the importance of place in “tackling inequalities, delivering more proactive, preventative care, delivering a ‘community first’ health service, and contributing to social and economic development”. 

The UK’s Chief Medical Officer’s annual report on health in cities² for 2024 also identifies physical activity through walking and cycling, access to healthy food, and the outdoor leisure environment as key determinants of urban health. As Prof Chris Whitty observes: “The health of our cities is very important for the health of the nation.” 

Key to the challenge of creating healthier cities for all is finding solutions to a housing crisis, globally and in the UK, marked by a severe shortage of affordable and adequate homes, as rising costs outpace incomes, leading to homelessness and substandard living conditions. Planning reforms, local government reorganisation and devolution offer hope in the UK, so long as health, community building, and sustainable development are not swept to one side in the ‘rush to build’. 

Investing in health to drive growth As countries strive for growth, placing health at the front and centre of social and economic policy and investment is increasingly at the heart of national and municipal government strategies, in recognition that rising economic inactivity, lower productivity, and less innovation and creativity are being driven by declining population health and widening health inequalities.