Regenerative Cities: The Future of Megacities
Industrialisation fundamentally changed the way we live.
Although the world was mostly rural until the 1900’s, large urban settlements have existed for most of our existence just not at a scale we are more familiar with today. Urbanisation has since become a global phenomenon but the relationship between industrialisation and urban population growth is no longer as it once was.
Current trends show that the majority of future urban population growth will occur in developing countries (including countries with no large industrial base) largely a result of high birth rates, improvement in public health, reduced infant mortality and ensuring more women survive beyond adolescence.
Lagos, Nigeria/ 88.3 million
Kinshasa, DRC/ 83.5 million
Dar Es Salaam, Tanzania/ 73.7 million
Mumbai, India/ 67.2 million
Delhi, India/ 57.3 million
The world’s five most populous cities by the end of the century are projected to have over 50 million residents. This is dramatic growth when compared with today, where the world’s most populous city, Tokyo, has just 37 million inhabitants. Although projections lose certainty over such a long time frame, they reveal a glimpse into the scale of what lies ahead in 2100 and how fundamentally different the world will look, feel and function compared to today.
Urban-rural divide
Traditionally, living in the city has always involved a trade-off - convenience and success for a price to our health. As cities have grown and become more sophisticated in their offering and appeal, it can be difficult to recognise the growing challenges of extensive urban-rural divides and how poorly both places can perform structurally in terms of liveability. Considering that by 2050, 70% of the global population will be urban and that most of this growth will take place in developing countries where progress is lagging the current focus needed is very much urban.
What is a healthy city?
According to the WHO, a healthy city is a process and not an outcome. A healthy city is “one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential.”
The role of health is holistic and a concern for all as illustrated by WHO’s Healthy Cities Approach and the UN Sustainable Development Goals (SDGs)
in the same way that the UN places good health and well-being at the centre of their Sustainable Development Goals (SDGs), emphasising the role of health as a holistic concern for all.
Digital health will boost liveability in cities
The integration of personalised, digital health (or eHealth) with smart city ecosystems will be instrumental in improving urban liveability.
Traditionally health knowledge and decision-making has been monopolised by centralised healthcare providers. Over time, eHealth has transformed patients to consumers of products and services through the likes of wearables and tracking services shaping a new, digitally-enabled frontier for more accessible and convenient exchanges between citizens and healthcare. A survey conducted by the Pew Research Center found that 80% of internet users have searched for health-related information online with many specifically trying to diagnose a medical condition.
Cities can collect more data than ever before on health and use it to support first mile health in a more actionable way. The pandemic accelerated the adoption of eHealth strategies and technologies at a global scale and tracking apps have become a primary example of the potential relationship between future cities and citizens.
Urban mobility will help create more liveable and accessible cities
Cities shape the way we live. How we navigate them will play a critical role in how we tackle the challenges of urban mobility - air quality, noise, space demand and safety. Not only is the way we move being challenged but why we move is also undergoing a rethink.
Despite more than half of Europeans living in cities are exposed to harmful noise pollution associated with cardiovascular diseases, cognitive impairment and premature death, traffic calming measures across Europe and the US, have become an unlikely source of a new conspiracy theory - a “climate lockdown”. However, reducing the amount of cars from city streets and having greater choice in the availability and access of daily amenities within walking or cycling distance can help cities rethink mobility from the ground up.
By creating more compact, walkable and accessible cities, we can collectively reduce the environmental impact of urbanisation, improve public health and enhance social interaction.
Most importantly, we can provide more choice, not reduce it.
Understanding social determinants of health will help cities make progress for all
Social determinants of health (SDH) are the non-medical influences over health and account for as much as 90% of health outcomes - making them the foundation of future societies. SDH are defined by the WHO as the surroundings that people are born into, grow around and all other wider forces and systems shaping daily life. Such forces and systems include economic, social and political policies and systems, development goals and normative behaviours.
The first mile of health is about supporting good health long before resorting to medical care. Supporting good health means:
Understanding what local communities truly need.
Understanding peoples dynamic needs.
Giving people the knowledge, tools and incentives to support wellbeing.
Housing is a particularly concerning component of SDH: in developing countries, between one third and 90% of the urban population living in slums. High population density and lack of appropriate water, sanitation, and hygiene (WASH) allow disease to spread quickly in vulnerable populations and is responsible for over 800,000 deaths from diarrhoeal disease in 2016. In addition to environmental risk and instability, developing nations can find it a complex task to provide adequte housing for not just growing but increasingly at risk populations.
This can be an opportunity for every sector to bring a positive impact to peoples lives and to the way we all live.
With the right systems and strategies, urban centres that promote health are best equipped, more sustainable and less at risk. The challenge is making progress that will reach everyone regardless of city size, demographics, social status, or geography.