Supporting a Healthy Planet, Healthy People and Health Equity through Urban and Territorial Planning

ABSTRACT The form of human settlements impacts on planetary health, population health and health equity. Yet goals for urban and territorial planning are only tangentially linked to public health outcomes. The WHO and UN-Habitat support actions to bring health to the fore in planning and design of human settlements, recently publishing ‘Integrating Health in Urban and Territorial Planning: a sourcebook’ focusing on ‘why’ action is needed, ‘how’ to initiate it; and curating several existing resources on ‘what’ to do. Recommendations for research, policy and practice include calls for rapid development of closer relationships between public health and spatial planning.


Supporting a healthy planet, healthy people and health equity through urban and territorial planning Supplementary Materials -Table of resources
The supplemental material contains a table of 149 selected resources. This comprises the 69 resources which appear in the published Sourcebook (UN-Habitat & WHO 2020) and an additional 79 that were selected as relevant but not included (see paper for discussion on inclusion criteria).
For further information on the searches undertaken and how resources were selected or the published version see Appendix 1.
Reference: UN-Habitat and WHO, 2020. Integrating health in urban and territorial planning: A sourcebook. Nairobi: UN-Habitat and Geneva: World Health Organization The nature of the fields for each record in the table are shown in the table below.

Fields
Record built from citation database, snowball or peer recommendation.

Text
Item record as found in citation database. Contains with title and url link. May also contain Author and date depending on database

Description
Analytical tool Tool for use in quantitative analysis.
Briefing Briefing for a specific approach.
Design guide Design process with rationale and instructions.
Evidence Comprehensive subject specific evidence base.
Initiative Reports on successful initiatives.
Network Networks of policy and action.
Overview Broad overview of a subject area.
Self audit Tool to assist with baseline appraisal and analysis.

Toolkit
Comprehensive stepwise instructions, with associated policy and evidence.
Training Training packages.

Web resource
Source of online information and links for policy and action.

Identification of resources
Total from each search.
(details of searches are in appendix 1 )

Number of resource records in spreadsheet
ACfC 1 HUDU 4 UN-Habitat 2018 A multilevel, multi-stakeholder guidance framework and tool to strengthen urban-rural linkages in national and subnational policies and programmes. Protection and promotion of health by balancing urban, periurban and rural health challenges are included in the guiding principles to provide social protection and do no harm.
Policy-makers at all governance levels, programme managers, private sector and civil society actors and implementation partners of local and subnational governments.
Incorporating into public policy and programme provision for social services across the urbanrural continuum such as coordinated health, nutrition and sanitation plans, reduction of spatial and social inequities in quality health services, and mainstreaming efforts to create healthy and safe environments in integrated, resilient and sustainable UTP.
peer Those wanting to explore how cities and their leaders can maximize opportunities to improve population health including public health practitioners.
A wide range of cities covering high-income countries and LMICs.
snowball UN-Habitat. UN-Habitat planning law assessment framework. 2017. https://unhabitat.org/planning -lawassessment-framework Y 5 Self audit planning law; assessmen t; participati on; legal; cities; UN-Habitat 2017 The planning law assessment framework is a selfassessment tool to be used during focus groups for the preliminary identification of strengths and weakness of an urban planning system. The framework looks at all the laws, regulations and decrees applicable in a city, enacted at different levels. It takes into account only black letter law but will stimulate the discussion on eventual discrepancies. This process is useful to change mind-sets, learning process, to create constituency creation; it could be the first step to pursue a reform process.
Wide range of users of planning law in a given jurisdiction. It is recommended to have experts and specialists in planning law leading the assessment. The methodology should take the form of focus groups, interviews and expert group meetings.
Rapid assessment to identify the strengths and weaknesses of an urban planning law and guiding a process to agree on actions that are needed to address the identified gaps. This guide focuses on the law-making implementation challenge: how to make progress with an intention to make better laws for towns and cities in Africa. It proposes an approach to urban law-making that is grounded in an understanding of the local context. Produced largely by the African Centre for Cities, experience from senior practitioner researchers of urban law-making is combined to provide a practical guide for officials and other practitioners. The guide is also available in French and Portuguese.
Wide range of interest groups and officials. UN-Habitat 2019 This legal assessment tool provides urban managers and other stakeholders with a framework to understand how and if their legal and regulatory framework supports participatory citywide slum upgrading or not. It is a self-assessment tool to be used during focus groups, to identify strengths and weakness of the current urban planning system and guide opportunities for citywide slum upgrading. It can provide a clarifying process to make clear what frameworks might need to be revised as part of a longer term reform process and also serve as an entry point to change mind-sets and build capacity around legal and regulatory frameworks for participatory citywide slum upgrading.
Urban managers and other key stakeholders.
Robust domestic legal analysis, supported by a participatory discussion which outlines the strengths and opportunities or impediments of current legal and regulatory frameworks for slum upgrading. UN-Habitat 2013 This training module introduces a practical strategy for improvement of streets through citizen participation as a strategic spatial intervention for citywide slum upgrading. The approach fosters incremental improvement of the physical and socioeconomic conditions in slums and informal settlements and promotes urban regeneration, transformation and their integration into the overall city planning agenda.
Especially useful for participatory planning, advocacy and case making.
Wide range of actors and decision-makers, including public health practitioners. 2014 What started as an initiative in Bogotá, Colombia, then spread to hundreds of towns and cities in many countries. The activity is a time-limited period (weekly and/or on major public holidays) when specific major roads are closed to traffic so that residents have the space for jogging, running, skating, cycling and aerobics. It started as a way of encouraging fitness but now its social benefits of providing spaces to meet with friends, family and fellow city dwellers of all ages are also recognized. The name Ciclovía arises from the seven cycle-friendly routes in Bogotá covering 121 km that the first initiative encompassed.
Mayors and local politicians, local people and public health practitioners.
Bringing activity and social connections into cities without major infrastructure costs. 2018 This work embodies a territorial approach to food security and nutrition policy, but also has strong links to the wider determinants of health and sustainability. This work is part of a broader effort of the FAO to support countries to improve the inclusiveness and sustainability of food security and nutritional systems. It aims to contribute to work on food systems and nutrition indicators, city-region food systems and rural-urban linkages.
All actors and decisionmakers needing to understand and influence the inclusiveness, governance and efficiency of food systems from a food security and nutrition point of view.
Globally applicable methodological approach to analyse the social, institutional and economic dimensions of food systems and their relationships with food security and nutrition outcomes, as well as to assess the spatial patterns of food systems. The toolkit is a software application that facilitates the assessment of within country health inequalities. It can be used on desktops, laptop computers and mobile devices. It enables users to explore inequality in a setting of interest (e.g. a country, province or district) to determine the latest situation of inequality and the change in inequalities over time. It also allows users to compare inequality in the setting of interest with other settings.
Public health practitioners and spatial planners.
Assessing inequalities using disaggregated data and summary measures and advocacy through visualizing results via a variety of interactive graphs, maps and tables. Gehl Institute 2018 A participatory tool for evaluating and creating inclusive, healthy public places that support health equity. This framework supports inclusion to advance health equity through public spaces. The framework is built around four guiding principles for shaping and assessing public space projects. Only one principle addresses physical space, reflecting the need for practitioners to look beyond physical design and placemaking to create change. The process considers context, process and sustainability. The framework allows users to adapt and apply the approach to their situation in different ways. Overview transport GIZ 2014 Urban mobility plans are used as a planning tool and policy instrument to guide the development of transport in urban areas and surroundings. This document reviews urban mobility planning from several countries, showing a shift away from the traditional, infrastructure-oriented approach towards sustainable and people-oriented planning. National guidelines for urban mobility planning provide orientation to local authorities. In several countries, such as Brazil, France and India, the development of urban mobility plans has become an obligatory requirement for receiving national government funds for local transport projects to promote health.
Local policy-makers and planners who want to shape urban mobility processes and policies in an effective and inclusive manner. Policy-makers and experts at national level shaping state-of-the art national policy frameworks for urban transport planning.
Worldwide applicability for supporting low-carbon and active travel. UN-Habitat undat ed The assessment is a brief healthy planning assessment for national planning systems. This has been run as a workshop by UN-Habitat and is still in development.
As a participatory workshop it allows participants to start to gain an overview of their planning system in terms of the degree to which it might be supportive of health outcomes.
Planners and public health practitioners and policy-makers.
Scoping the strengths and weaknesses of a planning system with reference to how it supports population health. The Propensity to Cycle project was designed to assist transport planners and policy-makers to prioritize investments and interventions to promote cycling. It answers the question, "where is cycling currently common and where does cycling have the greatest potential to grow?" The tool can be used at different scales; all data so far and the project itself is based in England and Wales.
Transport professionals and researchers seeking new methodologies to support the promotion of cycling interventions.
Decision support in promoting cycling-based investments and policies. The aim of the project is to develop and trial a prototype low-carbon precinct co-benefits calculator for use by urban planners and designers. The calculator estimates co-benefits associated with a range of alternative precinct designs and transport/land-use configurations across health, productivity and pollution associated with greenhouse gases and particulate emissions. The calculator will estimate population health status (with respect to chronic disease and injury) and productivity at a precinct (or greater) level. Transport for London 2017 The Healthy Streets Approach provides the framework of policies and strategies we will put in place to achieve this. At a street level, direct investment in our walking, cycling and public transport infrastructure is vital to providing a safer, easier, cleaner and more appealing environment for everyone to enjoy. At a network level, we must design and manage our streets and rail systems so that more active travel becomes part of every journey. And we need to plan for the future. As London continues to grow, active travel needs to be designed into the fabric of new developments and regeneration projects. This report considers how to integrate health into urban planning, investments, and policy decisions, so as to support the implementation and achievement of the goals and objectives of the New Urban Agenda. Two core themes run throughout this report. First, to realize Habitat III's collective vision of sustainable, liveable and economically vibrant cities, urban decision-makers must apply a "health lens" -to fully assess the risks and opportunities posed by their policies and programs, and measure their effects. Second, achieving truly sustainable urban development will require much greater cross-sectoral coordination to protect and improve the health of vulnerable populations in the world's fast-growing urban areas.

HUDU
WHO S1 Record built from citation database, snowball or peer recommendation.
In sourcebook? Sourcebook Ref WHO EURO 2016 Important for UTP are the document helps look at the policy implications of the assessment. An air pollution health risk assessment (AP-HRA) estimates the health impact to be expected from measures that affect air quality, in different socioeconomic, environmental, and policy circumstances. As such, it is an important tool for informing public policy decisions. This document introduces the concept of AP-HRA, describes in broad terms how the health risks of outdoor air pollution and its sources are estimated, and gives an overview of the general principles for the proper conduct of an AP-HRA for various scenarios and purposes. The information is aimed at a broad audience of readers who do not need to know how to apply the tools, but seek a general understanding of the concepts, scope and principles of AP-HRA. UN-Habitat 2016 Urban planning is a complex process that requires strong political leadership and commitment, and implementable legal frameworks articulated through a common development vision and social participation. It is exactly in the complexity of this process that UN-Habitat founded its in-house Urban Planning and Design Lab, in order to provide assistance to local, regional and national authorities with urban planning and design. The UN-Habitat´s Lab has been a response to a growing demand from cities, not only providing tools for their urbanization challenges, but also responding to urban planning in general. Within a complex set of actors and technical realities, the Planning Lab finds its existence and application to create, navigate and accelerate the urban strategies and transformative projects for implementation. This publication aims to present the Lab´s approach towards planning and design, management and implementation, as well as to introduce the trajectory of the UN-Habitat's Lab through its working years of experience. The focus on physical activity is explained by the fact that inactivity today accounts for an increasing proportion of deaths and disability worldwide and is associated with significant health care costs and productivity losses.2 Action to increase rates of physical activity will be necessary to achieve global targets on the prevention of premature mortality from noncommunicable diseases -the leading cause of death worldwide -and to halt the rise in obesity. With more than 80% of the European population expected to live in urban areas by 2030, cities play a pivotal role in promoting and protecting health and well-being.3 As cities continue to expand in population, there is a growing need to develop ways of supporting physical activity in dense urban settings. Gonçalves, L., Santos, Z., Amado, M., Alves, D., Simões, R., Delgado, A.P., Correia, A., Cabral, J., Lapão, L.V. and Craveiro, I.
2015 Academic paper looking at health disparities between urban residents in Praia, Cape Verde living in various urban units -formal, transition and informal. Considers multiple health outcomes as well as residents own perception. The lack of high-quality data to support evidence-based policies continues to be a concern in African cities, which present marked social, economic and cultural disparities that may differently impact the health of the groups living in different urban contexts. This study explores three urban units-formal, transition and informal-of the capital of Cape Verde, in terms of overweight/obesity, cardiometabolic risk, physical activity and other aspects related to the urban environment. 2015 Evaluation of a pilot project using Urban HEART in 15 cities, looking at how closely cities had followed the recommendations of the tool, identified barriers and facilitators in the process of using the tool and main suggestions for improving it by pilot cities.

WoS
The East Asian age-friendly cities promotion -Taiwan's experience and the need for an oriental paradigm. 2016 Report on Taiwan's experience using the WHO handbook 'Global Age-friendly Cities (AFC): A Guide'. Argues the need for an East Asian-specific approach in implementing the handbook due to specific cultural aspects around ageing. This paper identifies three key elements for AFC promotion in East Asian countries based on an analysis of Taiwan's experience: during needs assessment take collectivism into consideration, during action plans at the community level community leaders' views will be more important (particularism), and when promoting AFC at the institutional level a top-down approach will be more acceptable (high power distance concept) Nieuwenhuijsen, M. J. 2016 Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also a main source of pollution and disease. We conducted a review around the topic urban and transport planning, environmental exposures and health and describe the findings. Within cities there is considerable variation in the levels of environmental exposures such as air pollution, noise, temperature and green space. Emerging evidence suggests that urban and transport planning indicators such as road network, distance to major roads, and traffic density, household density, industry and natural and green space explain a large proportion of the variability. Personal behaviour including mobility adds further variability to personal exposures. Making cities 'green and healthy' goes far beyond simply reducing CO2 emissions. Environmental factors are highly modifiable, and environmental interventions at the community level, such as urban and transport planning, have been shown to be promising and more cost effective than interventions at the individual level. However, the urban environment is a complex interlinked system. Decision-makers need not only better data on the complexity of factors in environmental and developmental processes affecting human health, but also enhanced understanding of the linkages to be able to know at which level to target their actions. New research tools and assessment approaches can now provide this information. 2016 This study estimates the economic losses suffered by the urban poor in terms of assets and productivity due to climate-induced waterlogging and floods. It examines how the vulnerability of slum dwellers living in informal settlements is exacerbated by a lack of supportive institutional mechanisms, the nature of non-inclusive economic growth, the social exclusion of urban landscapes and discriminative access to public services. The Healthy Cities movement has been in process for almost 30 years, and the features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver the potential health benefits and how to ensure that they reach all citizens in urban areas across the world. Complexity thinking stresses that the development of a plan that anticipates all future change for these issues will not be possible. Instead, incremental attempts to reach a goal need to be tried and tested. Such thinking suggests a new approach to planning for urban health-one with three main components.

IIED
First, there needs to be an emphasis on the promotion of experimentation through diverse projects and the use of trial and error to increase the understanding of how best to improve urban health outcomes in specific contexts. Second, this emphasis on learning from projects in turn suggests the need for strengthened assessment. However, a different kind of assessment is needed to that usually used for public health interventions. Third, consideration of the valueladen nature of policy interventions and the creation of forums to debate the moral and ethical dimensions of different approaches to urban health and city environments are essential. NHS Scotland n/a The Place Standard tool provides a simple framework to structure conversations about place, whether the place is well-established, undergoing change, or is still being planned. It is a resource for participants to think about the physical elements of a place (for example its buildings, spaces, and transport links) as well as the social aspects (for example whether people feel they have a say in decision making). The tool provides prompts for discussions, allowing all the elements of a place to be considered in a methodical way. The tool pinpoints the assets of a place as well as areas where a place could improve. The website describes multiple applications for the tool in the place-making cycle.  , 2014) to engage with local authorities, people and city planners. Hue City has its own special identity that significantly influences its resilience to climate change: health and well-being have been improved by investment in healthcare. In relation to gender roles, our study found that men and women at a grassroots level have different vulnerabilities and contribute differently to building climate resilience in Hue City. Women play key roles in sustaining and enhancing the health and well-being of people within their community, and accruing funds for households, communities and society. They also take part in organising mutual support for each other during times of disruption. By comparison, men are more engaged in activities relating to safety, security and other continuity plans within their communities. However, at the management level, we found that women hold only minor roles. There are therefore significant opportunities to challenge gender-based conceptions of capacity and responsibility, and to improve the gender sensitivity of decision-making processes and forums. This could significantly enhance the resilience of the people living in Hue City. ISGlobal 2017 An overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and will provide answers to many crucial questions on e.g. how different disciplines can effectively work together, how to incorporate citizen and stakeholder opinion into quantitative HIA modelling for urban and transport planning, how different modelling and measurement methods can be effectively integrated, and whether a public health approach can bring about positive changes in urban and transport planning. 2006 This Resource Guide provides gender mainstreaming tools and information for individuals and groups working on policy, design, implementation monitoring and evaluation, capacity building and research in the transport sector and sectors affected by transport. The Resource Guide:

IIED
• Provides checklists, entry points, and tools for mainstreaming gender in transport projects and policies.
• Brings together case studies, best practices, training manuals, tools and reports on gender and transport from the Gender and Rural Transport Initiative (GRTI), and other initiatives of the World Bank and allied agencies.
• Uses a gender lens to analyse transport programs ranging from national infrastructure policies and plans to community driven development projects.
• Presents examples of engendering the full range of transport network interventions ranging from intermediate means of transport (IMT) such as bicycles, donkeys and carts to formal transport subsectors such as roads, buses and boats.
• Provides slide presentations that can be adapted for gender and transport training, gender sensitization, and other events. International journal of environmental research and public health 2017 Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits.

PubMed_S 3
Record built from citation database, snowball or peer recommendation.
In sourcebook? Sourcebook Ref IIED 2017 In this working paper, we examine rural-urban transformations in India in relation to changes in food production, access, consumption, nutritional quality and safety. We demonstrate how efforts to address malnutrition in India are decoupled from urban development initiatives and associated areas of policy and planning. We discuss how a more holistic, food security-based perspective, along with measures to support fragile peri-urban ecosystems and communities engaged with agriculture, could underpin processes to improve the health and nutrition of urban and peri-urban residents. 2019 European project identifying ways of living, moving and consuming that protect the environment and promote health and health equity. INHERIT focuses on living (green space and energy efficient housing), moving (active transport) and consuming (food consumption and production). Encouraging modification of lifestyles, characterised by a 'take, make, consume, dispose' model of growth. INHERIT formulated scenarios for more sustainable future and designed, implemented and tested intersectoral initiatives to achieve triple-win. A booklet brings together results, relevant to professionals across health, environment, food, education, energy, transport, etc.; also policymakers at EU, national, regional and local level, and individuals to take action. Other resources are available from the website such as an extensive case study database.

IIED
The INHERIT Model includes (1) an integrated conceptual framework, including an analytical model, a governance model and an action and evaluation model (2) a set of qualitative and quantitative indicators and (3) a set of health, environment and social impact assessment tools and cost-effectiveness methods. snowball