A small-area urban health monitoring for sustainable and healthy urban development

Abstract Background Urban environments are posing different challenges and opportunities for health and well-being of urban dwellers. Social, political and commercial determinants of health like quality of housing and retail, opportunities for quality employment and education as well as active transport, safety of the environment as well as opportunities for social interactions and participation are not equally distributed in cities. Measuring specific aspects of the urban environment on a small-area enables 1) identifying critical aspects and their accumulation within cities that may cause health inequalities and 2) monitoring impact of implemented strategies and interventions that intend to reduce them. Methods A transdisciplinary approach was used to develop an integrated small-area indicator set for assessing health determinants (social and physical environment; access to resources; resilience and adaptation to climate change, etc.). A theoretical indicator set based on a systematic review was discussed in several workshops with actors from the city administration in the City of Bremen, Germany, in order to improve its applicability. QGIS software was used for overlay analysis to test the indicator set with the data from the City of Bremen. Results Integrated data-based analyses of urban environment on a small-area show unequal spatial distribution of health resources and risks that are not visible on a larger spatial scale. Consistent temporal and spatial references are an essential prerequisite for the aggregated overlay of data and indicators. Conclusions This integrated small-area indicators set can be used to inform targeted public health and urban planning interventions and to monitor the progress relevant to local decision-making. On a long term, enhancing our understanding of spatial, environmental and social contextual factors in complex urban systems will be helpful in coping with uncertainties, improving well-being and reducing existing urban injustices. Key messages • An integrated approach to urban health monitoring is important to take into consideration cumulative positive and negative impacts of urban environment. • A small-area urban health monitoring contributes to informed decision-making for reducing inequalities and sustaining health and well-being.