Climate and health benefits from climate actions – a new research framework for cities

Bagger M1, Huxley R2, Lund N1

1: Health Advocacy, Novo Nordisk A/S, Novo Allé 1, 2880 Bagsværd, Denmark
2: C40, North West Entrance, City-Gate House, 39-45 Finsbury Square, Level 7, London EC2A 1PX, United Kingdom

Background:
Climate change and non-communicable diseases (NCD), including type 2 diabetes, are two of the defining challenges of the 21th century (1). Climate change and NCDs share the same root causes such as urbanisation, overconsumption, motorised transportation, lack of green space, and air pollution. However, that also means that there are shared opportunities for joint action. Cities are home to more than half of the world’s population (2), two thirds of the 415 million people with diabetes live in cities (3), cities are responsible for 70% of the total carbon emissions (4), and 80% of people living in urban areas that monitor air pollution are exposed to unsafe air (5). That puts cities at forefront for tackling these challenges.

By urban planning facilitating physical activity eg. biking and walking, it is possible to induce a more active lifestyle for citizens. In turn, the physical activity reduces the risk of developing type 2 diabetes and one of its major drivers, obesity (6).

Outdoor air pollution is a consequence of inefficient combustion of primarily fuels for transport and power generation and urban outdoor air pollution is estimated to cause 1.3 million deaths worldwide per year (5). Long-term exposure to high levels of air pollutants is significantly associated with elevated risk of type 2 diabetes (7).

C40, a network of the world’s megacities committed to address climate change, and Novo Nordisk, the largest global healthcare company within diabetes care are collaborating in partnerships to tackle the joint root causes of climate change and type 2 diabetes. The partnership offers a unique opportunity to empower cities to drive meaningful, measurable and sustainable urban climate actions with both climate and health benefits for their citizens. The research partnerships focus on climate actions such as bikeability and walkability due to potential increased physical activity and reduced air pollution.

Aims:
The aim is to demonstrate social (incl. type 2 diabetes specifically and health in general), environmental, and economic benefits of bikeability and walkability in eleven cities. Given the urgency of climate change and health implications, the aim is furthermore to understand how cities can highlight climate and health benefits from action using best available city data.

Methods:
Collection and analysis of raw city data are provided by relevant city teams directly supported by C40. Further data exploration is undertaken with a wider range of city departments and organisations and from existing literature to identify data from similar research in other cities that could be used to fill gaps in ‘raw’ data from the specific city.

Results:
The social, environmental, and economic benefits of bike share scheme in Mexico City were evident (8):
•	An average bike share user 	spends 47-82 min/week biking.
•	Nearly 1,190 tonnes greenhouse gas emission/year saved.
•	The monetised health benefits gained by shift from cars to bikes are estimated at 26 million USD.
Further results from additional cities will be presented at the congress illustrating the wider benefits, incl. impact on obesity and type 2 diabetes, of bikeability and walkability.

Discussion:
By demonstrating wider benefits from climate action, cities can facilitate urban development that reduces air pollutants, greenhouse gas emissions and climate risks, while increasing the citizens’ health, wellbeing, and economic opportunities. The research aims to accelerate actions on climate and health by enabling cities to make a stronger case for action. Connecting human health, air quality and climate change will unlock mainstream behaviour and policy change at the pace and scale needed.

References:
1. International Diabetes Federation: Diabetes and Climate Change Report. 2012.
2. United Nations: World urbanization prospects, the 2014 revision, highlights. 2014.
3. International Diabetes Federation: IDF Diabetes Atlas. 7th edn. 2015.
4. UN-Habitat: Cities and Climate Change: Global Report on Human Settlements. 2011.
5. World Health Organization: Ambient (outdoor) air quality and health. Factsheeet, September 2016.
6. Aune D, Norat T, Leitzmann M, et al: Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 2015;30:529-42.
7. Wang B, Xu D, Jing Z, et al: Effect of long-term exposure to air pollution on type 2 diabetes mellitus risk: a systemic review and meta-analysis of cohort studies. Eur J Endocrinol 2014;171:R173-82.
8. C40: Benefits of climate action. 2016.