“Health is a Political Choice”: Advancing Public Health for Better Urban Life

As we celebrate European Public Health Week (EUPHW) 2024 , coordinated by EUPHA - European Public Health Association , it’s essential to recognise the strides made in public health and the innovative approaches that cities are adopting to enhance the well-being of their citizens. This year’s EUPHW theme – Health is a political choice! – ?highlights “the interplay between politics and health to create sustainable change for better health in the future” while also emphasising the importance of community health, sustainable living and resilience, aligning perfectly with the ethos of smart, sustainable cities.

Recent Developments in Public Health?

Since I last wrote about the role of public health in smart cities in December 2020 , there have been several notable developments relevant to this topic:?

1. Technological Advancements: The integration of AI and IoT in public health has seen a significant boost. Smart sensors and wearable devices are now widely used to monitor real-time health data, providing early warnings for potential health crises. For instance, Barcelona has implemented a network of environmental sensors that monitor air quality and its impact on respiratory diseases, enabling proactive public health responses.?
2. Policy Changes: The European Union has introduced new regulations to enhance data sharing across member states, improving the tracking of disease outbreaks and streamlining response efforts. Additionally, largely also in response to the COVID-19 pandemic, policies promoting telemedicine have been expanded, ensuring that remote communities and even patients in urban areas can have better access to healthcare services.?
3. Innovative Projects & Co-creation: Projects like the Healthy Streets initiative in London are transforming urban spaces to promote physical activity and reduce pollution. These projects focus on redesigning streets to prioritise space for pedestrians and cyclists, contributing to healthier lifestyles and lower emissions.?

Aligning with European Public Health Week Goals?

European Public Health Week 2024 focuses on building healthier communities, and smart cities are at the forefront of this transformation. The week highlights themes such as mental health, sustainable environments and inclusive health systems, all of which are integral to a smart city framework that ultimately is focused on improving quality of life for a city’s residents:?

• Mental Health: Smart cities are using technology to address mental health issues. Mobile apps offering mental health support and AI-driven chatbots providing counselling services are becoming more common. Digital dashboards, like the one created through the "Nature Impact on Mental Health Distribution (NAMED)" project in Brussels, Belgium , can evaluate environmental exposures and their impact on mental health. Additionally, a new Bloomberg Philanthropies-supported effort is providing rapid-response psychological assistance to school children and other vulnerable populations impacted by the ongoing war in Ukraine, rolling out in Kyiv.?
• Sustainable Environments: The push for green infrastructure is evident in cities like Copenhagen, where green roofs and urban gardens are helping to reduce urban heat islands and improve air quality. These initiatives are crucial in promoting environmental health and sustainability. As another example, Nature-based Solutions initiatives in Leuven, Belgium, transform urban spaces through the co-creation of green areas, improving resilience and well-being.

• Inclusive Health Systems: Ensuring that health systems are inclusive and accessible is a key priority. Smart cities are implementing platforms that provide multilingual health information and services. For instance, the city of Cascais, Portugal, implemented an integrated digital health management system during the COVID-19 pandemic . The platform enabled city leaders to obtain a real-time, holistic view of the pandemic’s impact on the local population toward the aim of more efficient management of health and emergency resources, ensuring that all residents, including vulnerable populations, received timely and adequate health services. The system also supported citizen engagement and maintained a high level of trust and morale among residents.?

Climate Justice and Health Equity?

Importantly – and also in alignment with the EU Mission on Climate-Neutral and Smart Cities – we?must also work to address climate justice and health equity in any ‘smart’ solution, ensuring that all segments of the population can benefit from such advancements.??

Environmental factors such as poor air quality, extreme weather events and lack of green spaces disproportionately impact vulnerable populations, including low-income communities, minorities and the elderly. For example, low-income neighbourhoods often face higher levels of pollution and have less access to healthcare services. Addressing these issues requires targeted interventions and policies that prioritise the needs of these communities.??

In some cases, community members are also successfully beginning to advocate for themselves, e.g. the recent European Court of Human Rights case won by the Swiss group Senior Women for Climate Protection , but in most cases, we should not expect this level of empowerment to drive self-advocacy efforts. Rather, cities need to be proactive in preventing disproportionate environmental impacts – and smart technology can be one tool to assist in doing so.?

Additionally, while technological advancements hold great promise for improving public health, it’s vital to ensure that all segments of the population have access to these technologies. This includes providing affordable internet access and digital literacy programs, as well as ensuring that health apps and services are accessible to people with disabilities.?

Success Stories from Around Europe?

Cities and communities both large and small can take advantage of technology and data-driven solutions toward improving public health outcomes. Read on for examples from a major city, a midsize city and a more rural community showcasing a spectrum of possibilities:?

• Stockholm: As a major city, Stockholm has launched a “Smart Health” initiative that integrates various health services into a single digital platform. This platform allows citizens to book medical appointments, access their health records and receive personalised health tips based on their data. Efforts are made to ensure that these services are accessible to all, including marginalised communities.?
• Tartu: A midsize city in Estonia, Tartu has implemented a city-wide bike-sharing scheme aimed at encouraging the use of bicycles as an alternative to cars. This initiative has contributed to reducing environmental problems, improving air quality and promoting healthier lifestyles through increased physical activity.

• Orkney Islands: In a rural setting, the Orkney Islands (UK) have benefited from the Cisco 5G RuralFirst project , which has improved broadband connectivity and enabled better access to digital health services. This project has had a significant positive impact on the health and well-being of the island's residents.?

A Call to Action: The ‘Start with Children Summit’?

Are you a mayor, policymaker or urban leader who works on healthy futures for children? Join the Start with Children Summit in Bratislava, Slovakia, this 28-29 May to collaborate on strategies to build cities that prioritise the health and well-being of kids. This summit will provide a platform to share best practices and innovative solutions while also fostering partnerships aimed at creating healthier urban environments.

The Role of Smart City Solutions in Improving Public Health?

If you’ve read this far, it’s hopefully clear now that smart city solutions are pivotal in fostering public health, sustainability and resilience. By leveraging technology and data, cities can create environments that promote health, prevent diseases and respond swiftly to health crises. For example, these solutions can include:?

• Enhanced / Interoperable Internet of Things (IoT): Enhanced IoT enables seamless integration and interconnectivity of IoT-enabled devices, vastly expanding the potential for technology usage in smart city problem-solving, from traffic congestion to smart home monitoring and energy efficiency.

• Electric Bus Systems: Electric bus systems reduce emissions and improve public transportation quality by using electric buses, contributing to cleaner air and quieter cities.

• Urban Air Quality Platforms: These platforms collect, process and visualise hyperlocal data about urban emissions, providing transparency and raising awareness about air pollution.

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As we observe European Public Health Week 2024, it’s clear that the integration of smart city technologies with public health initiatives is not just beneficial but essential for the future of urban living.?

The journey towards healthier, smarter cities continues, driven by innovation, collaboration and a commitment to enhancing the quality of life for all citizens. Let’s embrace these advancements and work together to build a healthier, more sustainable and equitable future for everyone.?

To be inspired by further examples, be sure to visit the BABLE Smart Cities Knowledge Hub for neutral Solution blueprints, Use Cases and more!