Urban health: landmarks, dilemmas, prospects, and challenges

Abstract

EDITORIAL EDITORIALAs we near the end of the second decade of the 21 st century, a question emerges for urban health researchers: "What progress have we made in the field?" In a forum published in CSP ten years ago 1 we asked: "What is urban health?"Urban health is the area of knowledge nested in public health that allows us to rethink the health impact of interventions in cities by the public sector, including interventions that do not necessarily originate in the health sector itself. The health of urban populations is a function of global, national, and local influences and of a network of interconnected determinants. The proposal's fundamental thrust is that the social and physical environments define the urban context and are modulated by proximal and distal factors and by actors at various levels. Global trends, national and local governments, civil society, the private sector, and markets thus modulate the configurations in which these local factors operate.Urban health is therefore a fruitful field for knowledge translation, with strong social and political ties, guided by innovative metrics (namely valid, reliable, robust, and wellconstructed indicators and analyses for evaluating interventions in the city that can impact health), and close association with the public administration and its inter-sector relations, including governance.This special thematic edition of CSP on urban health focuses on milestones, dilemmas, perspectives, and challenges, featuring innovative concepts and metrics for measuring urban and social determinants and public policies originating both within and outside the health sector.The majority of the articles in this special edition consider the interconnections between urban and health determinants. In addition to theoretical approaches that involve an interesting debate on complex systems, considering that they can potentially range all the way from epigenetics to health iniquities in the urban environment, this volume includes empirical studies with innovative concepts and methods, including those designed to evaluate urban public policies and developed with an inter-sector approach. This special issue also features a high-level forum on the work of urban observatories, developing and testing potential urban health solutions to local problems based on international experiences and health intelligence.Maintaining the focus on the exposure to urban living conditions represents a strong argument backed by a growing body of evidence, according to which the underlying causes of disease in the urban context can be found in the physical and socioeconomic environments. Important strides have been made in discerning poverty as a poison, the built-up environment as one of the principal determinants of health, and the social environment as helpful or harmful, capable of modulating our capacity to stay healthy.Considering that urbanization is global, that global is universal, and that the universe relates to our planet 2 , we have a gigantic and complex jigsaw puzzle before us, interweav...

Demandas funcionais e fatores do ambiente: uma análise geoespacial em usuários da atenção primária em saúde

“…As políticas executadas em um setor específico (como transporte, energia ou resíduos) podem gerar benefícios em outras áreas, como redução dos impactos ambientais globais e locais, se estendendo à saúde pública (Oliveira et al, 2015). Desta forma, estratégias em saúde pública devem repensar o impacto das intervenções do setor público nas cidades, incluindo aquelas que não necessariamente têm origem no setor saúde, como administração e governança (Caiaffa et al, 2015).…”

“…Estas devem ser voltadas para melhoria urbana, com a criação de ambientes favoráveis, saudáveis, sustentáveis e com menos barreiras, permitindo maior mobilidade, autonomia, segurança e acesso a serviços públicos e de qualidade (Levasseur et al, Research, Society and Development, v. 11, n. 12, e386111234783, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i12.34783 13 2015; Caiaffa et al, 2015;Dutra et al, 2018). Apesar de frequentes, as barreiras 'políticas' e as barreiras 'atitudinais e suporte' e 'trabalho e escola' não se mantiveram no modelo final.…”

Inclusive Cities: Healthy Cities for All

“…Urban governance, therefore, relates to the systems and processes that guide the management of cities ( UN-Habitat, 2002;United Nations, 2016). Urban health scholars have acknowledged the implications that a city's governance system may have on the health and well-being of city residents (Caiaffa et al, 2015;Vlahov et al, 2007), as well as climate-related cobenefits in cities (Oliveira et al, 2015). Some evidence has emerged from low-and middle-income countries of the impact governance structures can have on health outcomes, including infant nutrition and mortality, immunization rates, life expectancy, maternal mortality, self-reported health, prenatal care, and mental health, among others (Ciccone et al, 2014).…”

Inteligencia artificial e innovación para optimizar el proceso de diagnóstico de la tuberculosis

“…La salud urbana es una rama de la salud pública que nos permite reflexionar sobre el «impacto en la salud de las intervenciones del sector público en las ciudades, incluyendo aquellas que no necesariamente tienen origen en el sector salud» (1) . La salud urbana exhibe una mayor vulnerabilidad a medida que la población mundial se está volviendo más urbana, pero no necesariamente ecológicamente sostenible (2) .…”