The study assessed 25 cities across Australasia, Asia, Europe, USA, Central and South America, and Africa, with the aim to inform policy directions for more healthy, sustainable cities worldwide.

The team of more than 80 researchers in 25 cities across 19 countries used standardised methods to assess the policy settings and lived experience of city-dwellers. They identified thresholds for urban design and transport features that would increase active transport and promote health, and used spatial indicators to assess the health-supporting nature and sustainability of each city and identify inequities in access.  

The research used indicators such as proximity to public transport and food, walkability, city density and policy settings to determine how healthy and sustainable are the cities of Maiduguri, Mexico City, Sao Paulo, Baltimore, Phoenix, Seattle, Hong Kong, Chennai, Bangkok, Hanoi, Graz, Ghent, Bern, Olomouc, Cologne, Odense, Barcelona, Valencia, Vic, Belfast, Lisbon, Adelaide, Melbourne, Sydney, and Auckland. The research published in TLGH is supported by reports and scorecards that present assessments for each city.

The study found Belfast to be above average in terms of availability and quality of urban and transport policies, supporting health and sustainability compared with other cities in the study. Relative to the 25 cities in the study, the majority of neighbourhoods in Belfast are walkable. Almost three quarters of residents have access to public transport with regular services. However, compared with other cities, fewer residents have some public open space within 500m, and only 47% have access to larger public open space. Belfast scored below average for access to a food market within 500m. 

Professor Ruth Hunter, from the Centre for Public Health at Queen’s, who led the research from Belfast, said: “It is interesting to see how Belfast has scored highly in terms of transport. Despite Belfast having many standards for built environment features to create walkable cities, with the exception of public open space policies, there appears to be a lack of measurable policy targets.  

“There is huge potential for Belfast to be at the forefront of sustainable cities given its size and availability of public transport, and ability to walk to local amenities. Moving forward, we need to focus on promoting its potential for sustainability and set targets so that we can meaningfully create a healthier, more sustainable city.” 

This series presents a first step toward the development of a global system of policy and spatial indicators for healthy and sustainable cities. 

The team developed tools that can be used by other cities to benchmark and monitor progress towards being healthy and sustainable.

The authors are now calling for a 1000-cities challenge to activate a global citizen science program and incentivize collection of open data and create city planning indicators to improve the knowledge base and inform decision-making, with a focus in the most data-scarce areas. These could be used by global agencies to assess progress towards achieving the UN Sustainable Development Goals.

Collaboration lead, RMIT’s Distinguished Professor Billie Giles-Corti, believes that the new indicators can provide policy direction for cities looking to recreate themselves after the COVID-19 pandemic: “The need for reform is now palpable; and our research shows what is needed to achieve reform.  The COVID-19 pandemic has highlighted the vulnerabilities of our cities. Climate change risk is increasingly becoming self-evident; and cities generate 75% of greenhouse gas emissions.  We must reduce our greenhouse gas emissions.  As argued by C40 – the organisation of Mayors of the world’s Mega Cities – delivering 15-minute cities where people can access local amenities by walking and cycling is a priority to ‘build back better’ post-COVID.  Fifteen-minute cities are healthy, sustainable, resilient and equitable.

"The new research is proof-of-concept of the feasibility of assessing health-supportive planning policies and creating spatial indicators of health-supportive urban design and transport. “We have shown it is possible to benchmark and monitor city planning policies that promote health and sustainability, and their level of implementation, globally. This is critical, because without good urban policies, we can’t deliver healthy and sustainable cities.”

The research found that although most cities had aspirations to create healthy, sustainable cities, many of them lacked the measurable targets to achieve their aspirations.

Prof Giles-Corti explained: “Despite positive rhetoric about health, sustainability and liveability in most policy documents, many cities we studied do not have policies in place to deliver healthy and sustainable cities for all. There is inequitable access to neighbourhoods that foster healthy and sustainable lifestyles and many urban design standards fall short of what’s needed to create walkable neighbourhoods that increase active transport.”  

The research builds on Series 1 of ‘Urban Design, Transport and Health’, published pre-pandemic, in 2016, but it has been made even more pertinent by COVID 19. 

As Prof Giles said: “COVID-19 has shown the vulnerabilities of our cities and highlighted just how important city planning is to create resilient cities that can withstand a global shock, like a pandemic.  People who lived in walkable neighbourhoods with local amenities and public open space and cycling infrastructure had more choices when all they could do is shop and exercise for limited times of the day.   This is the future of the healthy and sustainable city:  cities made up of villages and the creation of the 15-minute city, where people can live locally, walk and cycle and have access to amenities they need for daily living”.

The research comes from the multidisciplinary Global Healthy and Sustainable City Indicator Study Collaboration, a team with expertise in public health, urban and transport planning, urban design, architecture, computer and geospatial science, behavioural science, statistics, epidemiology, complex systems science, and public policy.