International Journal of
Environmental Research
and Public Health
Commentary
Urban Climate Policy and Action through a Health Lens—An
Untapped Opportunity
Audrey de Nazelle
1,2,
* , Charlotte J. Roscoe
3
, Aina Roca-Barceló
2
, Giselle Sebag
4
, Gudrun Weinmayr
5
,
Carlos Dora
4
, Kristie L. Ebi
6
, Mark J. Nieuwenhuijsen
7,8,9
and Maya Negev
10
Citation: de Nazelle, A.; Roscoe, C.J.;
Roca-Barcel ´ o, A.; Sebag, G.;
Weinmayr, G.; Dora, C.; Ebi, K.L.;
Nieuwenhuijsen, M.J.; Negev, M.
Urban Climate Policy and Action
through a Health Lens—An
Untapped Opportunity. Int. J.
Environ. Res. Public Health 2021, 18,
12516. https://doi.org/10.3390/
ijerph182312516
Academic Editor: Paul B. Tchounwou
Received: 4 November 2021
Accepted: 25 November 2021
Published: 27 November 2021
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1
Centre for Environmental Policy, Imperial College London, London SW7 1NE, UK
2
MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics,
School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK;
a.roca-barcelo@imperial.ac.uk
3
Landmark Centre, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA;
croscoe@hsph.harvard.edu
4
International Society for Urban Health, New York, NY 10003, USA; gsebag@isuh.org (G.S.);
cdora@isuh.org (C.D.)
5
Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany;
Gudrun.Weinmayr@uni-ulm.de
6
Center for Health and the Global Environment (CHanGE), University of Washington, Seattle, WA 98195, USA;
krisebi@uw.edu
7
Institute for Global Health (ISGlobal), 08003 Barcelona, Spain; mark.nieuwenhuijsen@isglobal.org
8
CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
9
Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
10
School of Public Health, University of Haifa, Haifa 31905, Israel; mnegev@univ.haifa.ac.il
* Correspondence: anazelle@imperial.ac.uk
Abstract: Motivated by a growing recognition of the climate emergency, reflected in the 26th Confer-
ence of the Parties (COP26), we outline untapped opportunities to improve health through ambitious
climate actions in cities. Health is a primary reason for climate action yet is rarely integrated in
urban climate plans as a policy goal. This is a missed opportunity to create sustainable alliances
across sectors and groups, to engage a broad set of stakeholders, and to develop structural health
promotion. In this statement, we first briefly review the literature on health co-benefits of urban
climate change strategies and make the case for health-promoting climate action; we then describe
barriers to integrating health in climate action. We found that the evidence-base is often insufficiently
policy-relevant to be impactful. Research rarely integrates the complexity of real-world systems,
including multiple and dynamic impacts of strategies, and consideration of how decision-making
processes contend with competing interests and short-term electoral cycles. Due to siloed-thinking
and restrictive funding opportunities, research often falls short of the type of evidence that would
be most useful for decision-making, and research outputs can be cryptic to decision makers. As a
way forward, we urge researchers and stakeholders to engage in co-production and systems thinking
approaches. Partnering across sectors and disciplines is urgently needed so pathways to climate
change mitigation and adaptation fully embrace their health-promoting potential and engage society
towards the huge transformations needed. This commentary is endorsed by the International Society
for Environmental Epidemiology (ISEE) and the International Society for Urban Health (ISUH) and
accompanies a sister statement oriented towards stakeholders (published on the societies’ websites).
Keywords: climate change; co-benefits; systems thinking; co-production; cities
1. Climate and Health—Missed Opportunities for Synergies
The frequency, intensity and severity of extreme weather events are rapidly increasing
and are projected to continue rising unless humanity takes strong and immediate action.
The public health impacts of climate change are widely acknowledged in research [1].
Int. J. Environ. Res. Public Health 2021, 18, 12516. https://doi.org/10.3390/ijerph182312516 https://www.mdpi.com/journal/ijerph