From climate hazards to diet and physical activity pathways: Investigating policy intersections for health in five global South Cities

Introduction Climate change, rapid urbanization, and non-communicable diseases (NCDs) pose intersecting threats to public health in low- and middle-income countries. While evidence supports integrating health into climate policy, limited attention has been paid to how climate change and urban resilience policies address key NCD-related pathways, particularly diet and physical activity. Methods As part of the Global Diet and Activity Research (GDAR) Network, this study analyzed 34 climate change and urban resilience policies (2012–2022) across five Global South cities: Belo Horizonte, Yaoundé, Lagos, Johannesburg and Cape Town. The analysis focused on three lenses: climate hazards, pathways to health (diet and physical activity), and social vulnerability considerations. Results Policies frequently incorporated climate mitigation and adaptation strategies, but explicit consideration of diet, physical activity, and NCD prevention and management was limited. Of 34 policies, 26 addressed diet primarily through food security (n = 19) and agriculture (n = 15), while only two linked food systems to NCDs. Physical activity received limited attention and was mainly framed through active transport goals. Health considerations focused predominantly on immediate climate and disaster-related impacts, with less attention to longer-term NCD-related pathways. Conclusion Findings highlight important gaps and opportunities for more integrated climate-health policy approaches.