Health and sustainable development

HEALTH & SUSTAINABLE DEVELOPMENT

-DR. NEELAM SRIVASTAVA (JR-II)

-DR. BHARATBHUSHAN BHAURAO TELANG (JR-II)

GUIDE: DR. ANITA G. SHENOY.

• WHO definition of HEALTH

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. • SUSTAINABLE development has been defined in many ways, but the most frequently quoted

definition is from ”Our Common Future”, also known as the Brundtland Report:

"Sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs. It contains within it two key concepts: 1. The concept of needs, in particular the essential needs of the world's poor, to which overriding priority should be given; and 2. The idea of limitations imposed by the state of technology and social organization on the environment's ability to meet present and future needs."

Principle I of the Rio Declaration on Environment and Development states that,

The goals of sustainable development cannot be achieved when there is a high prevalence of debilitating illnesses, and population health cannot be maintained without ecologically sustainable development.

• STEADY GAINS IN GLOBAL HEALTH:

- Over the past decade, average life expectancy has increased, infant and child mortality rates have declined, and the proportion of underweight and stunted children has decreased.

GLOBAL REPORT ON URBAN HEALTH: EQUITABLE, HEALTHIER CITIES FOR SUSTAINABLE DEVELOPMENT

Published by WHO in March, 2016 at KOBE, JAPAN.

Presents new data on the health of urban residents from nearly 100 countries,

updating the first joint WHO-UN Habitat global report on urban health

titled Hidden cities: unmasking and overcoming health inequities in urban settings.

It presents a special analysis on the impact of persistent urban health inequities

on achievement of the Millennium Development Goals.

It sets a baseline for the new global health and development agenda in the

Sustainable Development Goals and Universal Health Coverage.

It also presents evidence that in cities, progress in health depends not only on the

strength of health systems, but also on shaping healthier urban environments.

GLOBAL REPORT ON URBAN HEALTH: EQUITABLE, HEALTHIER CITIES FOR SUSTAINABLE DEVELOPMENT

• From 2016 to 2030, the global community will focus its attention on achieving the 17

Sustainable Development Goals (SDGs) agreed by 193 United Nations (UN) Member States.

• GOAL 3 – the “HEALTH GOAL” – of the SDGs includes 13 targets on ensuring healthy lives

and promoting well-being for all at all ages.

• This goal vastly extends the ambitions of the Millennium Development Goals (MDGs) by

including targets on maternal and child health, infectious diseases, non communicable diseases

(NCDs), universal health coverage (UHC) and environmental health.

• GOAL11 – the “CITY GOAL” – consists of 10 targets that aim to make cities inclusive, safe,

resilient and sustainable. These 10 targets include a variety of critical issues such as housing,

transport, economy and environment that strengthen the physical and social fabric of a city.

• Importantly, this is the first time that cities have been prioritized on the global development

agenda.

Continued…

• There are two main reasons for this increased interest: • First, since 2008, a majority of the world’s population has started living

in cities. This proportion is likely to continue rising and it is projected that two in three people will live in cities by 2050. The economic, social and environmental impact of cities will determine quality of life experienced globally in the future.

• Second, cities are increasingly providing leadership in resolving global development issues such as climate change, public health and food security.

• . It is, therefore, no surprise that SDG 3 and SDG 11 are strongly

interlinked

Continued…

• Both goals SDG-3 & SDG-11 have explicitly targeted improving road safety and air quality.

• Target 4 for cities directly links to health by aiming to reduce mortality due

to disasters. • Additionally, all targets of Goal 11 that aim to improve the living and

working conditions of people in cities will support the achievement of the health goal.

• The first global report on urban health titled Hidden cities – unmasking and

overcoming health inequities in urban settings argued that insufficient concern for health equity in cities was hindering achievement of the MDGs.

• Unlike the MDGs, the SDGs have incorporated equity as a core value of

achieving its targets.

SDG11:

SALIENT FEATURES OF GLOBAL HEALTH REPORT:

While there are substantial inequalities across regions, there are also high inequalities that exist within cities, countries and regions across various dimensions such as gender, age, wealth status, education levels and ethnicity.

An analysis of urban data from 79 LMICs across four global regions revealed that children in the poorest fifth of urban households are more than twice as likely to die before their first birthday as children in the richest fifth of urban households are, with substantial variations within regions (Figure 1(a)).

As another example, solid fuel use for cooking, a major contributor to deaths due to indoor air pollution, is uncommon among the richest populations in three of the four regions, Africa being the exception (Figure 1(b)).

However, in the Asia-Pacific region, one in two people in the poorest fifth use solid fuels for cooking. In Africa, 90% of the poorest fifth are likely to use solid fuels for cooking compared to 50% of the richest fifth.

These two examples illustrate that it is not enough to monitor urban averages. It is also necessary to disaggregate data by sociodemographic characteristics of the population. This information can then inform policies and programmes to improve equity.

ACTION ON HEALTH INEQUITIES USING URBAN HEART:

More than 100 cities in 53 countries around the world have used the WHO

URBAN HEART tool, to plan action for reducing health inequities. • WHO URBAN HEART TOOL :

Urban HEART : i.e. Urban Health Equity Assessment and Response Tool Urban HEART guides local policymakers and communities through a standardized

procedure of gathering relevant evidence and planning efficiently for appropriate actions to tackle health inequities.

Three main approaches applied to measure and tackle inequities in health are: • Targeting disadvantaged population groups or social classes • Narrowing the health gap • Reducing inequities throughout the whole population.

HEALTH AS THE PULSE OF THE NEW URBAN AGENDA (UNITED NATIONS CONFERENCE ON HOUSING AND SUSTAINABLE URBAN DEVELOPMENT (HABITAT-III), QUITO, 17-20TH OCT. 2016)

This paper was developed by the World Health Organization

(WHO), in close consultation with international experts and

organizations working on urban health and development.

It draws significantly on the Global Report on Urban Health:

EQUITABLE, HEALTHIER CITIES for Sustainable Development,

produced earlier this year by the World Health Organization Centre

for Health Development in Kobe, Japan, MARCH 2016.

UN-HABITAT HABITAT I: In 1976, alarmed by rapid and uncontrolled urban growth, particularly in the developing world, the UN General Assembly called for the First United Nations Conference on Human Settlements “Habitat I in Vancouver, Canada, May 31 - June 11, 1976” addressing the challenges and future of human settlements. HABITAT II (Popularly called the "City Summit” ), the Second United Nations Conference on Human Settlements was held in Istanbul, Turkey from June 3–14, 1996, to assess the member nations’ progress made towards tackling urbanization issues since the Vancouver Declaration (Habitat I) 20 years before. It formulated UN-Habitat’s (then still the Habitat Commission) current main twin goals, namely 1) to ensure adequate shelter for all and 2) to guarantee sound development of human settlements in an urbanizing world.

UN HABITAT-III:

• This century will see a substantial majority of the world’s population living in urban centers. It is now estimated that 54.5% of people live in urban areas.

• The adoption of a New Urban Agenda—an action-oriented document which

will set global standards of achievement in sustainable urban development, rethinking the way we build, manage, and live in cities (right to the city) through drawing together cooperation with committed partners, relevant stakeholders, and urban actors at all levels of government as well as the private sector.

• The world urban population is expected to nearly double by 2050.

Focus on URBAN DESIGN and PLANNING:

PRINCIPLE 100: “We will support the provision of well-designed networks of safe,

inclusive for all inhabitants, accessible, green, and quality public spaces and streets,

free from crime and violence, including sexual harassment and gender-based violence,

considering the human scale and measures that allow for the best possible commercial

use of street-level floors, fostering local markets and commerce, both formal and

informal, as well as not-for-profit community initiatives, bringing people into the

public spaces, promoting walkability and cycling towards improving health and well-

being.” • Principle 100 is a clear statement of support for state-of-the-art thinking about

public space and its importance in establishing sustainable urban development that results in good quality of life.

• In the New Urban Agenda sub-national and local governments are acknowledged as key players in addition to national governments.

HEALTH AND SUSTAINABLE DEVELOPMENT:

1. WHO BREATHE LIFE CAMPAIGN

2. TRANSPORT AND HEALTH

3. HOUSING AND HEALTH

4. CITIES AND HEALTH

BREATHE LIFE CAMPAIGN: WHO in partnership with the Climate and clean air coalition (CCAC) & Govt. of NORWAY. • Air pollution causes 1 in 8 deaths, nearly 7 million deaths

annually. • Outdoor pollution causes more than 3 million premature

deaths every year. • Indoor pollution causes more than 4.3 million premature

deaths every year.

A campaign to raise awareness about the health risks of short-lived climate pollutants, which contribute significantly to global warming and air pollution.

It advocates action in the areas of

knowledge sharing between cities, increasing monitoring, supporting solutions and educating people.

BREATHE LIFE CAMPAIGN

SOME SOLUTIONS TO CLEANING AIR AND IMPROVING OUR PLANET- “TO ENSURE A HEALTHY FUTURE FOR ALL”:

2. TRANSPORT & HEALTH:

• Transport strategies that prioritize rapid transit/public transport, and safe walking and cycling networks can support physical activity and reduce traffic injuries. These same strategies can also reduce emissions of carbon dioxide as well as short-lived climate pollutants such as black carbon - a major air pollutant.

• Healthier transport strategies can also yield health equity gains by providing vulnerable groups with greater access to social and economic opportunities, particularly for low wage earners, women and the elderly, who often lack access to a private vehicle.

PINK AUTO

PRIYADARSHINI TAXI

TRANSPORT AND HEALTH RISKS:

1. CLIMATE IMPACTS:

A. Long-lived carbon dioxide (CO2) emissions and; B. Short-lived black carbon generated primarily by diesel vehicles. Eg. Black Carbon, Ground level Ozone. 2. AIR POLLUTION:

Air pollution-related deaths and illness are linked most closely to exposures to small particulate matter (PM) of less than 10 or 2.5 microns in diameter (PM10 and PM2.5). 3. TRAFFIC INJURIES:

Road traffic injuries are one of the top ten causes of death worldwide, resulting in some 1.25 million deaths annually. Between 20 and 50 million sustain non-fatal injuries each year with long-term adverse health consequences

• Travel by rail and bus is generally safer than private motorized transport, per unit of travel.

• Absent or weak infrastructure for walking and cycling are

major factors responsible for the increased risk of traffic injury among pedestrians and cyclists.

• Making walking and cycling safer is also important to

supporting moves to reduce carbon emissions and encouraging physical activity.

4. PHYSICAL ACTIVITY:

Per year, 2 million deaths globally are attributable to a lack of physical activity. It is a leading risk factor for poor health, and is one of the factors driving global increases in obesity and non communicable diseases, such as cardiovascular disease, type 2 diabetes, and some types of cancer. Compared with motorized transport, walking and cycling both reduce emissions and improve health through physical activity.

5. NOISE:

-Road traffic is the biggest cause of community noise in most cities, and typically noise levels increase with higher traffic volumes and speeds. -Environmental noise exposure is responsible for a range of health effects, including increased risk of ischaemic heart disease as well as sleep disturbance, cognitive impairment among children, annoyance, stress-related mental health risks, and tinnitus. - In high-income European countries it account for a loss of 1-1.6 million disability adjusted life years (DALYs).

TRANSPORT & HEALTH EQUITY:

Transport provides access to jobs, education, services, and recreational activities - critical social determinants of health.

Many vulnerable groups, such as women, children and youth, disabled persons, low-income groups, and the elderly, have less access to a personal vehicle; they rely on walking, cycling, and public transport.

Improving public and non-motorized transport can improve health equity in two ways: i. Directly reducing air pollution, noise, and injury risks in poor neighbourhoods, and ii. Secondly, by increasing mobility and accessibility for the poorest and most vulnerable

sectors of society.

OVERVIEW of strategies for healthy, sustainable transport:

Well-designed transport policies and infrastructure investment priorities can lead to far-reaching reductions in traffic-related health risks from air and noise pollution and injuries.

Overarching goals of healthy transport include:

Reduced deaths and disease from transport-generated air, noise and water pollution;

Reduced exposures of disadvantaged groups to transport-related injuries and health risks;

Safer and more efficient access to jobs, services and social opportunities;

Increased physical activity, including safe walking and bicycling;

Reduced greenhouse gas emissions from transport that contribute to long- and short-term health impacts.

• Major sustainable transport strategies

• in light of their potential to both mitigate climate change and achieve health gains, including:

I. Investments in, and prioritization of, rapid transit/public transport,

such as rail, metro and bus; II. Investments in, and prioritization of, transport networks for

pedestrian and cyclists; III. Compact land use systems that increase density and diversity of

uses; IV.Adoption of cleaner vehicular technologies; V. Adoption of cleaner fuel technologies.

INDIA & SUSTAINABLE TRANSPORT SYSTEM:

• CONNECTKaro is part of a global series of events focused on sustainable transport and urban development is organized and hosted by “WRI India (EMBARQ INDIA)”

• This annual conference is held every year from 2013 starting from the city Mumbai.

• The current CONNECTkaro conference was held in NEW DELHI with the theme of “Advancing Ideas to

Action in Cities”

5 KEYS TO SUSTAINABLE TRANSPORT IN INDIA:

1. BUS RAPID TRANSIT SYSTEM,

2. TRANSIT ORIENTED DEVELOPMENT,

3. CITY BUS SYSTEM, 4. PEDESTRIANS AND CYCLING NETWORKS,

5. ENGAGEMENT WITH THE PRIVATE SECTOR.

1. BUS RAPID TRANSIT SYSTEM: This system is based on the idea of “local innovations for local conditions”.

It has special separate corridors, bus stations, bus terminals and intelligent transit management system on the roads so that the public transport buses can easily pass through the heavy traffics.

eg. a) PMPML PUNE 2006,

b) JANMARG in AHMEDABAD, INDIA’s first fully fledged BRT launched in 2009. c) THE RAINBOW PROJECT, PIMPARI CHINCHWAD & PUNE 2015

Normal bus transit system vs RAINBOW BRT PROJECT, PUNE

2. TRANSIT ORIENTED DEVELOPMENT is the “Next big thing”:

• Merely increasing the supply of mass transport will not be enough, the integration of land use and transportation is also essential, this would ensure the creation of truely walkable and attractive neighbourhoods.

• For developing such TOD, the significant technical and financial support is given by Ministry of Urban Development, Central Govt. through JNNURM.

3. CITY BUS SYSTEM will remain the backbone of urban transport: • Redesigning bus networks and routes to make services more efficient and

user-friendly, as well as using technology to improve passenger information systems will be essential.

4. PEDESTRIANS AND CYCLISTS must be at the core of urban and transport planning:

Every year, more than 130,000 people in India die as a result of traffic accidents — one-tenth of the global total.

One of the reasons for this danger is the disproportionate allocation of road space.

80 percent of road space is allocated for only 15 percent of users (those driving private vehicles).

ITDP India works with cities to transform streetscapes to incorporate features such as protected footpaths and cycle lanes.

ITDP is working towards improving conditions for non-motorised transport in Coimbatore, Pimpri-Chinchwad, Pune, Nashik, Ranchi, and Tiruchirapalli.

WALKING AND CYCLING CORRIDORS

IN CHENNAI developed by ITDP

CYCLING TRACKS AT BKC,

MUMBAI.

5. ENGAGEMENT WITH THE PRIVATE SECTOR IS CRITICAL:

• There is a significant opportunity to channel the actions of private sector players into sustainable transport and urban development initiatives— whether through real estate developers embracing sustainable transport principles in their projects; entrepreneurs creating companies that deliver sustainable transport services; or financiers providing the capital that allows these outcomes to materialize.

VEHICLE & FUEL TECHNOLOGIES:

1. ELECTRIC & HYBRID CARS IN INDIA:

Mahindra Reva e2o Tata Indica vista electrical Tata Megapixel

2. CNG, BIODIESEL & ETHANOL as alternative fuels:

CNG BUSES IN INDIA GREEN (ETHANOL) BUSES IN NAGPUR

FIRST SOLAR POWERED TRAIN IN INDIA developed by CEL (Central Electronics Ltd),

Indicators, guidance and tools for effective sustainable transport:

• Transport and Environment Reporting Mechanism (TERM) is one example of a transport indicator set that tracks progress towards transport-related environmental targets, including greenhouse gas emissions, air quality and noise.

• Health Impact Assessment (HIA) can be used to identify and address the health co-benefits and risks of transport and land-use policies and projects.

• The Health Economic Assessment Tool (HEAT) for cycling and walking, developed by WHO is an example of a tool that can help value the health benefits from investments in walking and cycling systems.

• The United Nations Framework Convention on Climate Change Clean Development

Mechanism (CDM) is a financial mechanism by which high-income countries committed to reduce greenhouse gas emissions under the Kyoto Protocol are allowed to invest in projects that reduce emissions in low- and middle-income countries.

3. HOUSING AND HEALTH:

• The housing sector (commercial and residential) is responsible for

approximately 19% of global greenhouse gas emissions and approximately

one-third of black carbon emissions - a major component of particulate air

pollution.

• Numerous housing strategies are available to improve health and mitigate

climate change. Eg. Biogas cookstoves

• The design and quality of housing structures can also pose numerous health

risks by way of exposure to extremes of heat and cold; insect and pest

infestations; toxic paints and glues, and dampness and mould.

• Household cooking and heating systems can generate indoor smoke that is a

source of cardiovascular and respiratory health risks, as well as cancers.

HOUSING & HEALTH RISKS:

Housing has an impact on health and well-being through numerous environmental pathways. Key housing related environmental health risks include: I. household air pollution from cooking, heating and lighting, particularly rudimentary

biomass and coal cooking and heating stoves; II. indoor air quality risks from dust or gases emitted by toxic building materials etc. III. exposure to extreme heat and cold; IV. exposure to disease-bearing vectors, including pests and insects; V. exposure to damp and mould; VI. lack of access to clean drinking-water and sanitation VII. outdoor air pollution – both from household emissions and other sources; VIII. urban siting and design features, which affect exposures to flooding and extreme

weather; access to green spaces for physical activity; noise exposures; and access to transport routes;

IX. use of unsafe construction materials and poor construction practices.

These environmental factors impact on a range of disease and disability

conditions, including: 1. Airborne infectious diseases, including TB; 2. Vector-borne diseases (e.g. malaria, Chagas, leishmaniasis); 3. Waterborne/diarrhoeal diseases related to unsafe water and sanitation; 4. Non communicable diseases, including risk of stroke, heart failure and other

cardiovascular disease (from air pollution as well as extreme temperature exposures;

5. Allergies (from mould and damp); and cancers, e.g. from radon exposures; 6. Domestic injuries; 7. Mental health and neighbourhood social cohesion; 8. Occupational health risks, ranging from injuries and falls to environmental

exposures to toxic building materials.

HOUSING & HEALTH EQUITY:

• Slum environments, are by definition, neighbourhoods characterized by structurally deficient or unsafe housing.

• Most slums are overcrowded, lack of access to appropriate utilities, such as safe drinking-water

and sanitation.

• Children living in slums are more at risk of diarrhoeal disease.

• Crowding also exacerbates risks of airborne disease transmission, particularly of tuberculosis.

• Furthermore, the elderly are the most at risk of mortality associated with extreme heat or cold.

• Insufficient housing quality is associated with stress and mental health impacts.

• Access to structurally sound dwellings, safe drinking water, improved sanitation, and affordable, secure energy can promote health equity.

STRATEGIES FOR HEALTHY AND SUSTAINABLE HOUSING:

• Well designed housing strategies can both reduce energy use as well as create healthier environments for occupants.

• The most attractive measures for healthy, sustainable housing involve: I. insulation and thermal envelope; II. heating and cooling systems; III. improved ventilation; IV. solar energy (passive and photovoltaic), eg “LIGHTING A BILLION LIVES”; V. efficient cooking and lighting technologies; VI. safer building materials; VII. “compact” urban planning of neighborhoods with easy access to schools,

commerce, transport – and green spaces; VIII. healthy home behaviours

LIGHTING AND DAYLIGHTING:

• Exposure to natural light is important for vitamin D production, sleep cycle regulation and mood.

According to the Intergovernmental Panel on Climate Change, lighting energy use can be

reduced 75-90% through…..

AKSHAY URJA SHOPS PROGRAMME: The objective of the programme is to support the establishment of one shop in each district for creation of a network of retail outlets in form of “Akshay Urja Shops” in all the districts for sale and service of solar energy and other renewable energy products.

CLEANER COOKSTOVES:

• Over 3 billion people in low- and middle-income countries rely on solid fuels (wood, animal dung, charcoal, crop wastes and coal) burned in inefficient and highly polluting stoves for cooking and heating.

• Currently resulting in some 4 million premature deaths annually.

INDIA’S INITIATIVE TOWRDS CLEANER COOKSTOVES:

PRADHANMANTRI LPG SUBSIDY “PAHAL” YOJANA (DBTL):

National Biomass Cookstoves Initiative (NBCI) was launched by MNRE on 2ndDecember 2009 at New Delhi with the primary aim to enhance the use of improved biomass cookstoves.

As follow up to the National Biomass Cook-stove Initiative (NBCI), the

Ministry initiated a new proposal for promoting the development and deployment of Unnat Chulhas (Biomass Cookstoves) in the country, so Unnat Chulha Abhiyan was formulated on 27th June 2014.

IMPROVED BUILDING MATERIALS:

• Building materials such as asbestos and lead have the potential to damage human health. Insulation, paint and dust derived from harmful materials can result in cancer, lung disease and impaired growth and development.

• While dwellers may suffer from exposure to these materials in existing structures, workers

may also suffer from exposure during the building and renovation process.

URBAN PLANNING & RESIDENTIAL ENVIRONMENT:

• Urban design impacts powerfully on residential environments and, in turn, on health outcomes. Medium housing density, with easy pedestrian access to local businesses, schools, and green spaces, is associated with safe, accessible pedestrian environments, more access to healthy physical activity and to basic services for women, children, elderly and those without cars.

PRADHAN MANTRI AWAS YOJNA- HOUSING FOR ALL (Urban):

Launched on 25th June 2015, with an objective of providing affordable houses to Indian citizens. Target of building 2crore houses till 2022. Primary targets under this scheme are people belonging to LIG & EWS group. The Mission is being implemented during 2015-2022 and provides central assistance to Urban Local Bodies (ULBs) and other implementing agencies through States/UTs for: In-situ Rehabilitation of existing slum dwellers using land as a resource through

private participation Credit Linked Subsidy Affordable Housing in Partnership Subsidy for beneficiary-led individual house construction/enhancement.

INDICATORS, GUIDANCE AND TOOLS FOR SUSTAINABLE HOUSING:

• The Housing Health and Safety Rating System (HHSRS), developed by the United Kingdom government in 2001, is a good example of a housing rating system that considers energy-saving measures and health impacts.

• Health impact assessment: eg. Healthy Housing Program (HHP), China.

• Financing health co-benefits: The United Nations Framework Convention on Climate

Change Clean Development Mechanism (CDM) finances emissions reductions and supports sustainable development in developing countries through tax exemptions; subsidies and grants; loan incentives.

4. CITIES AND HEALTH: • Already 3.6 billion people, more than half of the world’s population, live

in cities. By 2050, the world’s urban population will double in size, and most of that growth will occur in low and middle-income cities. Cities & towns in India constitute the 2nd largest urban system in the world.

• About health risks in cities

• WHO estimates 63% of global mortality, about 36 million deaths per year, is due to noncommunicable diseases (NCDs).

• Outdoor air pollution alone is responsible for 3.7 million deaths annually, mainly attributed to NCDs. Furthermore, physical inactivity is responsible for 3.2 million deaths annually, and traffic injuries cause some 1.3 million deaths annually – both health risks are likely to be much larger among urban populations.

• Communicable diseases also are associated with an unhealthy urban environment.

CLIMATE RISKS:

Cities’ impacts on climate:

Cities, especially those in high-income areas, are significant contributors to climate change insofar as they represent some 67-76% of global energy ( CO2, short lived climate pollutants-methane, ozone, black carbon) use according to the Intergovernmental Panel on Climate.

Climate change impacts on cities:

Sea level rise, “urban heat island” effect, urban poor are the worst affected by climate change such as slum dwellers’ homes.

AIR POLLUTION:

The world’s cities occupy just 3% of the earth’s land, but account for 60-

80% of energy consumption & 75% of carbon transmission.

Some 3.7 million premature deaths annually are attributed to outdoor air pollution. About 80% of those deaths are due to heart disease and stroke, while another 20% are from respiratory illnesses and cancers related to exposure to fine particulate matter (PM2.5), the most health-harmful air pollutant.

According to WHO’s most recent survey of 1600 cities worldwide, only 12% of the urban population surveyed live in areas that comply with WHO air quality guideline levels for PM2.5.

HOUSING RELATED HEALTH RISKS IN CITIES: Poorly planned or unplanned urbanization patterns represent a major public

health challenge.

This most vividly represented by the persistence of urban slums which are one third of the world’s urban population.

UN-HABITAT defines a SLUM as lacking at least one of the following; a) access to safe water b) access to sanitation c) safe and secure tenure d) durable housing structures.

“Durable” housing mean housing that is located away from natural or

manmade hazards; is structurally safe, and protective against extreme weather.

NUTRITION INSECURITY & UNHEALTHY DIETS: Urban households with lower socioeconomic status tend to spend more than 70% of

their income on food, impacting the availability of funds for education, child care and other activities.

Rapid urbanization has been associated with an increase in energy-dense diets, characterized by high levels of refined sugars, salt, and other additives, increased saturated fat intake (mainly from animal source foods), and reduced intakes of complex carbohydrates, fibre, fruits, and vegetables.

These changing dietary patterns have been referred to as the “NUTRITION

TRANSITION”. In cities around the world, obesity and overweight, cancers, diabetes, cardiovascular diseases associated with high sugar and saturated fat consumption (among higher income consumers) are on the rise.

The consequent dearth of nutritious food outlets makes healthier diets far more expensive; such urban areas have been described as “FOOD DESERTS.”

UNSAFE DRINKING-WATER, SANITATION & WASTE MANAGEMENT:

Diseases due to poor drinking-water access, unimproved sanitation, and poor hygiene practices cause 4.0% of all deaths and 5.7% of all disability or ill health in the world.

Contaminated drinking-water is estimated to cause more than 500 000 diarrhoeal deaths

each year.

Health risks are often exacerbated by poor sanitation. Some 20% of the urban population still lacked access to improved sanitation in 2012 and 100 million city dwellers still practiced open defecation.

Urban solid waste disposal is another sanitation-related challenge. Recent estimates also

suggest that cities generate 1.3 billion tonnes of solid waste per year, a figure expected to rise to 2.2 billion tonnes by 2025.

URBAN GREEN SPACES:

Green spaces such as parks and sports fields as well as woods and natural meadows,

wetlands or other ecosystems, represent a fundamental component of any urban ecosystem

Urban parks and gardens play a critical role in cooling cities, and also provide safe routes for walking and cycling for transport purposes as well as sites for physical activity, social interaction and for recreation

Recent estimates show that physical inactivity, linked to poor walkability and lack of access to recreational areas, accounts for 3.3% of global deaths.

Green spaces also are important to mental health.

SUSTAINABLE DEVELOPMENT STRATEGIES FOR CITIES WITH SIGNIFICANT

HEALTH CO-BENEFITS include:

Energy-efficient transport: eg. BRT system, Low-sulphur diesel fuels and low-emissions vehicles

Healthy urban planning: HEALTHY URBAN DIETS:

Urban farmer’s market connecting consumers with local producers of fresh fruits and vegetables and other foodstuffs, rooftop and community gardens which can promote local production and increase education and awareness of food production techniques, and peri urban projects which set aside land to grow fresh produce within a short distance of city limits. • Urban agriculture projects can help reduce the prevalence of “FOOD

DESERTS”.

SLUM UPGRADING:

Simple, climate-friendly housing initiatives in slum areas have included innovations such as: roof insulation; installation of rooftop solar hot-water heaters; PV solar panels for lighting and grid electricity backup; improvements in piped drinking-water and sewage infrastructure; and the creation of pedestrianized corridors in narrow alleyways to keep out motorcycle traffic, reduce noise, and protect children’s safety.

SLUM REHABILITATION AUTHORITY, MUMBAI

HEALTHY, ENERGY-EFFICIENT HOUSING:

Structurally sound, safe, climate-adapted and energy-efficient housing design can reduce exposures not only to household air pollution, but also to excessive heat, cold, and dampness – all of which are risk factors for stroke, heart attacks, respiratory illnesses and other cardiopulmonary diseases.

Effective use of natural ventilation helps to reduce indoor temperatures in warm months and hot climates, reducing health risks from heat stroke.

IMPROVED URBAN WASTE MANAGEMENT:

Strategies for waste reduction, separation, processing, management and recycling and

reuse are feasible, low-cost alternatives to the open incineration of solid waste, which is common now in developing cities.

Improved collection, management and disposal of urban waste.

Sustainable waste management activities can serve as a catalyst for local economic development as well.

SMART CITIES Mission is an urban renewal and retrofitting program by the Government of India with a mission to develop 100 cities (the target has been revised to 109 cities) all over the country making them citizen friendly and sustainable.

The Union Ministry of Urban Development is responsible for implementing the mission in collaboration with the state governments of the respective cities

Smart Cities Awas Yojna Mission was launched by Prime Minister Narendra Modi in June 2015.

1. SOLAR/GREEN CITIES:

Development of Solar Cities” programme is designed to support/encourage Urban Local Bodies to prepare a Road Map to guide their cities in becoming ‘renewable energy cities’ or ‘solar cities’.

Sanctions have been given to 31 cities.

These cities are: Agra, Moradabad, Rajkot, Gandhinagar, Nagpur, Kalyan-Dombiwali,

Kohima, Dehradun, Chandigarh, Gurgaon, Faridabad, Thane, Panaji City & Environs, Bilaspur, Raipur, Imphal, Itanagar, Jodhpur, Jorhat, Guwahati, Agartala, Ludhiana, Amritsar, Shimla, Hamirpur, Haridawar & Rishikesh, Vijaywada, Aizawl, Mysore, Hubli and Gwalior.

SUSTAINABLE DEVELOPMENT THROUGH MINISTRY OF NEW &

RENEWABLE ENERGY:

2. GREEN BUILDINGS:

A building which can function using an optimum amount of energy, consume less water, conserve natural resources, generate less waste and create spaces for healthy and comfortable living, as compared to conventional buildings, is a green building.

3. SOLAR ENERGY SYSTEMS:

Solar lanterns

Solar Cooker

Solar power plants

Solar water heating systems

4. GRID CONNECTED POWER:

Established by State Electricity Regulatory Commissions (SERC),

Wind Power

Bio-power: through - Biomass power / bagasse cogeneration - Non-bagasse cogeneration - Biomass gasifier - Urban & Industrial wastes

Small Hydro Power - Upto 25 MW station capacity Solar Power - Aims to generate competitively Solar Thermal and Solar Photovoltaic Power.

5. OFF GRID RENEWABLE ENERGY/POWER:

Biomass based heat and power projects and industrial waste to-energy projects for meeting captive needs

Biomass gasifiers for rural and industrial energy applications Watermills/micro hydro projects – for meeting electricity requirement of

remote villages Small Wind Energy & Hybrid Systems - for mechanical and electrical

applications, mainly where grid electricity is not available. Solar PV Roof-top Systems for abatement of diesel for power generation in

urban areas

SUMMARY: In the broadest sense, the strategy for sustainable development aims to promote harmony

among human beings and between humanity and nature. In essence, it is a process of change in which the exploitation of resources, the direction of

investments, the orientation of technological development and institutional change are all in harmony and enhance both current and future potential to meet human needs and aspirations.

As the natural resources are meant for all, the future generations have every right to use those to meet their own demands and hence it is our duty to achieve sustainable development in a rightful way.

Health being center of the concern for sustainable development, it is need of the hour to

have sustainable transport, sustainable energy, sustainable houses and sustainable cities for a healthy life.

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