From COVID-19 to a "new normal": could we support a "healthy renaissance" for our cities?

BACKGROUND: At the beginning of 2020, worldwide public debate focused on the fight against the climate crisis. Many challenges are ahead of us, from health emergencies, with the pandemics underway, to the exhaustion of natural resources, to major climate change. DISCUSSION: Many cities face health threats related to urban and land use planning, while infectious diseases thrive in overcrowded cities: living in unhealthy environments killed 12,6 million people in 2012 and air pollution killed 7 million people in 2016. Urbanization is one of the major global trends of the 21st century and has a significant impact on health. Over 55% of the world's population lives in urban areas, a percentage that is expected to increase to 68% by 2050. CONCLUSIONS: Developing new and more sustainable ways of living, moving, utilizing resources, and accessing services including healthcare and education, is crucial to preserve our future and the future of the next generations.

Healthy Municipalities, Cities, and Communities Movement of the Americas. Local Governance for Health and Well-being

This brochure presents the Movement of Healthy Municipalities, Cities and Communities (MCCS) of the Americas, a regional platform of local governments in the Region, committed to local governance for health and well-being. Aimed at mayors and women mayors, it shows how the MCCS Movement is organized, how to join, and what opportunities it offers.

Advancing Health Equity through 15-min Cities and Chrono-urbanism.

Implementing the 15-min city and chrono-urbanism aims to improve sustainability and quality of life by ensuring residents' proximity to essential services. The 15-min city model is gaining global traction, with localized adaptations to suit communities' needs. Beyond environmental motivations, 15-min cities can benefit public health through enhanced walkability, social cohesion, and universal accessibility. However, research examining the intersection of health and equity among chrono-urbanism and the 15-min city remains limited. This study aims to develop a framework to integrate health and equity into chrono-urbanism and 15-min city plans. We describe the potential benefits and risks of the 15-min approach for urban planning, daily behaviors, and health outcomes. Potential benefits of 15-min cities for health equity include proximity to destinations, increased physical activity, strengthened social capital, reduced emissions, and traffic calming. Risks that must be mitigated include gentrification, variable proximity definitions, infrastructure upgrades, and inadequate cultural sensitivity. Recommendations to integrate 15-min cities into planning activities include conducting comprehensive baseline assessments, aligning goals with sustainability, economic development, flexible zoning, inclusive public spaces, and diverse community engagement tactics. We recommend interventions targeting marginalized communities and developing standardized measurement tools for comparison, monitoring, and evaluation. A nuanced, equitable approach to implementing 15-min cities can help urban plans support health equity across diverse populations.

Policy impact pathways of climate-related urban health vulnerability - A retrospective analysis.

Climate change-related health risks are likely to become more prevalent in cities. Cities are also key actors in adaptation to these risks. Adaptation can take place through intentional measures to reduce vulnerability or exposure and unintentionally through other urban policy processes and outcomes. However, complex and dynamic relations between urban policy impacts and vulnerability development are an understudied phenomena. This limits the understanding of how urban climate-related health risks emerge and evolve. We examine urban policy pathways that influence vulnerability to climate-related health impacts with a most similar - most different case study. With a qualitative retrospective analysis of four urban areas in Finland we unveil the mechanism of how urban policy affects urban environment over time and how these impacts and changes shape vulnerability. Contrasting the most different cases, we show that urban policy impacts set differing preconditions to adaptation between local districts. We conclude by suggesting that to adapt to future challenges in cities with respect to social and ecological justice, it is necessary to mainstream adaptation into urban policies with continuous cross-sector and multi-level dialogue about the development of vulnerability.

Perinatal mortality in the municipality of Panchimalco, San Salvador: a case series. / Mortalidad perinatal en el municipio de Panchimalco, San Salvador: una serie de casos.

Perinatal mortality is an indicator that reflects the impact of maternal and infant care in a country. This study presents nine cases of perinatal mortality that occurred in the municipality of Panchimalco, El Salvador. The information was obtained from audit reports. The mothers of the deceased infants were aged between 17 and 43 years, did not use contraceptive methods, had incomplete prenatal controls and averaged a gestational age of 31 weeks. Three deliveries were attended in the community. Most perinatal deaths occurred before delivery due to unknown causes, and live births were preterm. We identified factors such as deficits in comprehensive care for women. Further studies are needed to determine the main factors influencing perinatal deaths in El Salvador. Motivation for the study. It is necessary to understand the maternal and infant characteristics of perinatal deaths. Additionally, it is required to generate evidence that contributes to a better understanding of these events. Main findings. Nine cases of perinatal deaths with maternal-fetal risk characteristics were identified. Most deaths occurred before delivery, with prematurity predominating in the neonates. Implications. Understanding the maternal and infant characteristics of perinatal deaths is essential for developing preventive strategies aimed at reducing risk factors related to perinatal mortality.

La mortalidad perinatal es un indicador que refleja el impacto de la atención materno-infantil de un país. Este estudio presenta nueve casos de la mortalidad perinatal ocurridos en el municipio de Panchimalco, El Salvador. La información se obtuvo de los informes de auditorías. Las madres de los fallecidos tenían edades entre 17 a 43 años, sin uso de anticonceptivos, con controles prenatales incompletos y un promedio de edad gestacional de 31 semanas, tres partos fueron atendidos en la comunidad. La mayoría de muertes perinatales ocurrieron antes del parto de causa desconocida y los nacidos vivos fueron prematuros. Se identificaron factores como el déficit en la atención integral a la mujer. Se requiere de nuevos estudios para determinar los principales factores que influyen en las muertes perinatales en El Salvador. Motivación para realizar el estudio. Es necesario conocer las características maternas e infantiles de las muertes perinatales. Además, es fundamental generar evidencia que contribuya a una mejor comprensión de estos eventos. Principales hallazgos. Se identificaron nueve casos de muertes perinatales y con características materno-fetales de riesgo. La mayoría de las muertes ocurrieron antes del parto y predominó la prematurez en los neonatos. Implicancias. El comprender las características materno-infantiles de las muertes perinatales, es esencial para desarrollar estrategias preventivas orientadas a disminuir los factores de riesgo relacionados con la mortalidad perinatal.

Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study.

Objective: To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life. Methods: Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated. Results: The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied. Conclusion: Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.

Effectiveness of hierarchical medical system and economic growth: based on China's urban vs. rural health perspectives.

Background: The hierarchical medical system is an important measure to promote equitable healthcare and sustain economic development. As the population's consumption level rises, the demand for healthcare services also increases. Based on urban and rural perspectives in China, this study aims to investigate the effectiveness of the hierarchical medical system and its relationship with economic development in China. Materials and methods: The study analyses panel data collected from Chinese government authorities, covering the period from 2009 to 2022. According to China's regional development policy, China is divided into the following regions: Eastern, Middle, Western, and Northeastern. Urban and rural component factors were downscaled using principal component analysis (PCA). The factor score formula combined with Urban-rural disparity rate (ΔD) were utilized to construct models for evaluating the effectiveness of the hierarchical medical system from an urban-rural perspective. A Vector Autoregression model is then constructed to analyze the dynamic relationship between the effects of the hierarchical medical system and economic growth, and to predict potential future changes. Results: Three principal factors were extracted. The contributions of the three principal factors were 38.132, 27.662, and 23.028%. In 2021, the hierarchical medical systems worked well in Henan (F = 47245.887), Shandong (F = 45999.640), and Guangdong (F = 42856.163). The Northeast (ΔDmax = 18.77%) and Eastern region (ΔDmax = 26.04%) had smaller disparities than the Middle (ΔDmax = 49.25%) and Western region (ΔDmax = 56.70%). Vector autoregression model reveals a long-term cointegration relationship between economic development and the healthcare burden for both urban and rural residents (ßurban = 3.09, ßrural = 3.66), as well as the number of individuals receiving health education (ß = -0.3492). Both the Granger causality test and impulse response analysis validate the existence of a substantial time lag between the impact of the hierarchical medical system and economic growth. Conclusion: Residents in urban areas are more affected by economic factors, while those in rural areas are more influenced by time considerations. The urban rural disparity in the hierarchical medical system is associated with the level of economic development of the region. When formulating policies for economically relevant hierarchical medical systems, it is important to consider the impact of longer lags.

HealthyPlan.City: A Web Tool to Support Urban Environmental Equity and Public Health in Canadian Communities.

Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low-income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions, and therefore, face greater health risks. Planning and advocating for equitable healthy urban environments requires systematic analysis of reliable spatial data to identify where vulnerable populations intersect with positive or negative urban/environmental characteristics. To facilitate this effort in Canada, we developed HealthyPlan.City ( https://healthyplan.city/ ), a freely available web mapping platform for users to visualize the spatial patterns of built environment indicators, vulnerable populations, and environmental inequity within over 125 Canadian cities. This tool helps users identify areas within Canadian cities where relatively higher proportions of vulnerable populations experience lower than average levels of beneficial environmental conditions, which we refer to as Equity priority areas. Using nationally standardized environmental data from satellite imagery and other large geospatial databases and demographic data from the Canadian Census, HealthyPlan.City provides a block-by-block snapshot of environmental inequities in Canadian cities. The tool aims to support urban planners, public health professionals, policy makers, and community organizers to identify neighborhoods where targeted investments and improvements to the local environment would simultaneously help communities address environmental inequities, promote public health, and adapt to climate change. In this paper, we report on the key considerations that informed our approach to developing this tool and describe the current web-based application.

The Urban Environment and Cardiometabolic Health.

Urban environments contribute substantially to the rising burden of cardiometabolic diseases worldwide. Cities are complex adaptive systems that continually exchange resources, shaping exposures relevant to human health such as air pollution, noise, and chemical exposures. In addition, urban infrastructure and provisioning systems influence multiple domains of health risk, including behaviors, psychological stress, pollution, and nutrition through various pathways (eg, physical inactivity, air pollution, noise, heat stress, food systems, the availability of green space, and contaminant exposures). Beyond cardiometabolic health, city design may also affect climate change through energy and material consumption that share many of the same drivers with cardiometabolic diseases. Integrated spatial planning focusing on developing sustainable compact cities could simultaneously create heart-healthy and environmentally healthy city designs. This article reviews current evidence on the associations between the urban exposome (totality of exposures a person experiences, including environmental, occupational, lifestyle, social, and psychological factors) and cardiometabolic diseases within a systems science framework, and examines urban planning principles (eg, connectivity, density, diversity of land use, destination accessibility, and distance to transit). We highlight critical knowledge gaps regarding built-environment feature thresholds for optimizing cardiometabolic health outcomes. Last, we discuss emerging models and metrics to align urban development with the dual goals of mitigating cardiometabolic diseases while reducing climate change through cross-sector collaboration, governance, and community engagement. This review demonstrates that cities represent crucial settings for implementing policies and interventions to simultaneously tackle the global epidemics of cardiovascular disease and climate change.

[Identification and sensitization to environmental fungal spores in Lima City, Peru]. / Identificación y sensibilización a hongos ambientales en Lima, Perú.

OBJECTIVE: To identify and registry the most important fungal spores trapped in our aerobiology station, as well as to report the prevalence of skin sensitization to these allergens. METHODS: The pollen counts were made according to standardized technique with a Burkard seven days spore trap, following the American Academy of Allergy, Asthma and Immunology (AAAAI) through National Allergy Bureau (NAB) recommendations. The trap was installed on the roof of Clinica SANNA, El GOLF, San Isidro, which is 20 m high, 12°5'54"S 77°3'6"W in the west-south of the Lima urban area. The sampling period was performed from September 2020 to October 2021. Skin prick tests were carried out according to the recommendations of the Spanish Society of Allergology and Clinical Immunology (SEAIC) in 200 patients (18 to 60 years old) with symptoms of rhinoconjunctivitis and/or asthma, who were evaluated in the Allergology Service of Clinica SANNA el Golf. Allergenic extracts were applied, dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), cat and dog danders, cockroach (Periplaneta americana), grass 6 mix, weed mix, molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Nigrospora spp.), INMUNOTEK-Spain provided the extracts. We also tested other fungal allergens such as Fusarium spp, Stemphylium spp, Curvularia spp, a mixture of Helmintosporum/Dreschlera spp. from the DIATER-Argentina laboratory. RESULTS: We identified spores of Alternaria alternata, Cladosporium spp., Nigrospora spp., Stemphylium spp., Fusarium spp., Curvularia spp., Dreschlera/Helmintosporum spp. The patients showed sensitization to Cladosporium herbarum (14%), Fusarium spp. (13,5%), Nigrospora spp. (8%), Alternaria Alternata (7%), Stemphylium (6%), Dreschlera/Helmintosporium spp. (5,5%), Curvularia spp. (3%), Aspergillus fumigatus (2,5%). CONCLUSIONS: The inhabitants of the south-western area of the urban city of Lima are exposed to different fungal spores with allergenic potential, with a higher concentration being identified during the summer/autumn months. Cutaneous sensitization is demonstrated in variable percentages to the fungal spores identified in this aerobiological sampling. The results of this study should be expanded and compared with data in the forthcoming years, identify seasonal and annual fluctuations and extend the traps to other locations in Lima.

OBJETIVO: Identificar y registrar las esporas de hongos más importantes captadas en nuestra estación de aerobiología, además reportar la prevalencia de sensibilización cutánea a estos alérgenos. MÉTODOS: La identificación y los conteos de esporas de hongos se realizaron según la técnica estandarizada con un equipo colector Burkard Spore Trap For Seven Days, siguiendo las recomendaciones de la National Allergy Bureau (NAB), de la American Academy Allergy Asthma and Immunology (AAAAI). El equipo se instaló a 20 m de altura desde el nivel del suelo, en la azotea de la Clínica SANNA El Golf, distrito de San Isidro, (12°5'54"S 77°3'6"O), en la zona sur-oeste del área urbana de Lima. El periodo de captación se llevó a cabo entre septiembre de 2020 y octubre de 2021. Se realizaron estudios de pruebas cutáneas (skin prick-test), según recomendaciones de la Sociedad Española de Alergología e Inmunología Clínica (SEAIC), en 200 pacientes (entre 18 y 60 años), con sintomatología de rinoconjuntivitis y/o asma. Fueron evaluados en el servicio de Alergología de la Clínica SANNA El Golf. Se aplicaron extractos alergénicos de ácaros del polvo (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), epitelios de gato y perro, Periplaneta americana, mezclas de seis gramíneas, mezclas de malezas, hongos ambientales (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Nigrospora spp.), extractos del laboratorio INMUNOTEK-España. Además, testeamos otros alérgenos fúngicos de Fusarium spp, Stemphylium spp, Curvularia spp, una mezcla de Helmintosporum/Dreschlera spp. del laboratorio DIATER-Argentina. RESULTADOS: Identificamos esporas de Alternaria alternata, Cladosporium spp., Nigrospora spp., Stemphylium spp., Fusarium spp., Curvularia spp., Dreschlera/Helmintosporum spp. Los pacientes mostraron sensibilización a Cladosporium herbarum (14%), Fusarium spp. (13,5%), Nigrospora spp. (8%), Alternaria Alternata (7%), Stemphylium (6%), Dreschlera/Helmintosporium spp. (5,5%), Curvularia spp. (3%) y Aspergillus fumigatus (2,5%). CONCLUSIONES: Los habitantes de la zona sur-oeste de la ciudad urbana de Lima están expuestos a distintas esporas de hongos con potencial alergénico, identificándose mayor concentración durante los meses de verano y otoño. Se demuestra sensibilización cutánea en porcentajes variables a las esporas fúngicas identificadas en este muestreo aerobiológico. Los resultados de este estudio deberían ampliarse y ser comparados con data en los años siguientes, identificar fluctuaciones estacionales y anuales y extender los captadores a otras locaciones en Lima.

Criterios para Municipios, Ciudades y Comunidades Saludables en la Región de las América

Los criterios regionales para Municipios, Ciudades y Comunidades Saludables (MCCS) de las Américas, adoptados en el Encuentro de Alcaldes y Alcaldesas por MCCS de la Región de las Américas del 2022, presentan un conjunto de lineamientos de referencia para fortalecer políticas públicas, planes y programas dirigidos a mejorar la salud y el bienestar de las poblaciones atendidas por los gobiernos locales. Se parte del reconocimiento del papel clave de los municipios en impulsar políticas públicas saludables, teniendo en cuenta que estas trascienden al sector de la salud y el papel que otros sectores tienen, dado el impacto en la salud de todas las políticas públicas. Estos criterios son resultado de un trabajo colaborativo e interdisciplinario con participación de distintas personas e instituciones de la Región, incluyendo gobiernos locales. Algunas consideraciones clave para la elaboración de estos criterios fueron las experiencias de las redes nacionales y subnacionales de municipios saludables, los criterios existentes en varios países de la Región y las orientaciones de la Organización Mundial de la Salud para ciudades saludables. Los criterios se agrupan en seis áreas de acción política y para la implementación de cada uno se incluye un grupo de acciones recomendadas, así como una propuesta de medios de verificación e indicadores de cumplimiento. Se dirigen a los equipos de gestión municipal, redes y asociaciones de municipios de la Región, y ministerios de Salud, como apoyo a las políticas que fortalezcan la inclusión de la promoción de la salud como una prioridad de la gestión local. Se reconoce expresamente la heterogeneidad existente entre los gobiernos locales, donde distintas formas organizativas, competencias y disponibilidad de recursos abordan realidades diversas. Por eso, los criterios están concebidos con carácter propositivo para su adecuación a esa diversidad y se deben contextualizar y priorizar en cada territorio. Indudablemente, la aplicación de estas orientaciones conducirá a la identificación de distintos retos y oportunidades que enriquecerán esta propuesta.

Assessment of urban ecosystem health and its influencing factors: a case study of Zibo City, China.

Urban ecosystem health is the foundation of sustainable urban development. It is important to know the health status of urban ecosystem and its influencing factors for formulating scientific urban development planning. Taking Zibo city as the study area, the indicators were selected from five aspects: ecosystem vigor, structure, resilience, service function and population health to establish an assessment index system of urban ecosystem health. The health level of urban ecosystem was assessed, and its changing trend was analyzed from 2006 to 2018 in Zibo. Furthermore, obstacle degree analysis and sensitivity analysis were used to quantitatively analyze the main obstacle factors and sensitivity factors affecting urban ecosystem health, so as to provide references for improving urban ecosystem health. The results showed that the health level of urban ecosystem in Zibo showed an upward trend from 2006 to 2018. The poor structure and ecological environment quality were the main obstacle factors to urban ecosystem health. The impact of changes in a single indicator on urban ecosystem health gradually decreased, but the sensitivity index of indicators had obvious differences. Urban ecosystem health was sensitive to changes in ecosystem structure and resilience. In the future, Zibo should strengthen ecological construction, optimize the industrial structure, and develop green economy to promote urban ecosystem healthy.

A Co-Created Assessment Framework to Measure Inclusive Health and Wellbeing in a Vulnerable Context in the South of Europe.

Rapid urbanisation exacerbates health and wellbeing disparities in vulnerable contexts and underscores the imperative need to develop innovative and participatory co-creation approaches to understand and address the specificities of these contexts. This paper presents a method to develop an assessment framework that integrates top-down dimensions with bottom-up perspectives to monitor the impact of inclusive health and wellbeing interventions tailored to the neighbourhood's needs in Las Palmeras, a vulnerable neighbourhood in Cordoba (Spain). Drawing upon studies in the literature examining urban health and wellbeing trends, it delineates a participatory and inclusive framework, emphasising the need for context-specific indicators and assessment tools. Involving diverse stakeholders, including residents and professionals, it enriches the process and identifies key indicators and assessment methods. This approach provides valuable insights for managing innovative solutions, aligning them with local expectations, and measuring their impact. It contributes to the discourse on inclusive urban health by advocating for participatory, context-specific strategies and interdisciplinary collaboration. While not universally applicable, the framework offers a model for health assessment in vulnerable contexts, encouraging further development of community-based tools for promoting inclusive wellbeing.

Multisectoral interventions for urban health in Africa: a mixed-methods systematic review.

Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa. To address this gap in research, we conducted a mixed-method systematic review of multisectoral interventions aimed at enhancing health, with a particular focus on non-communicable diseases in urban African settings. Africa is the world's fastest urbanising region, making it a critical context in which to examine the impact of multisectoral approaches to improve health. This systematic review provides a valuable overview of current knowledge on multisectoral urban health interventions and enables the identification of existing knowledge gaps, and consequently, avenues for future research. We searched four academic databases (PubMed, Scopus, Web of Science, Global Health) for evidence dated 1989-2019 and identified grey literature from expert input. We identified 53 articles (17 quantitative, 20 qualitative, 12 mixed methods) involving collaborations across 22 sectors and 16 African countries. The principle guiding the majority of the multisectoral interventions was community health equity (39.6%), followed by healthy cities and healthy urban governance principles (32.1%). Targeted health outcomes were diverse, spanning behaviour, environmental and active participation from communities. With only 2% of all studies focusing on health equity as an outcome and with 47% of studies published by first authors located outside Africa, this review underlines the need for future research to prioritise equity both in terms of research outcomes and processes. A synthesised framework of seven interconnected components showcases an ecosystem on multisectoral interventions for urban health that can be examined in the future research in African urban settings that can benefit the health of people and the planet.Paper ContextMain findings: Multisectoral interventions were identified in 27.8% of African countries in the African Union, targeted at major cities with five sectors present at all intervention stages: academia or research, agriculture, government, health, and non-governmental.Added knowledge: We propose a synthesised framework showcasing an ecosystem on multisectoral interventions for urban health that can guide future research in African urban settings.Global health impact for policy and action: This study reveals a crucial gap in evidence on evaluating the long-term impact of multisectoral interventions and calls for partnerships involving various sectors and robust community engagement to effectively deliver and sustain health-promoting policies and actions.

Exploring the role of smart cities in supporting ageing-in-place in Chongqing, China.

OBJECTIVE: Through interviews with older adults and professionals in Chongqing, China, this paper explores the challenges and opportunities faced by smart cities that undertake to better support ageing-in-place. METHODS: We undertook a qualitative multi-methods approach, engaging 46 professional stakeholders and 64 older people to examine the role of smart cities in enabling older people to age-in-place in Chongqing, China. RESULTS: With the development of smart cities, technology has the potential to facilitate ageing-in-place by creating opportunities for heathy and active ageing. This study identified specific priorities in delivering age-friendly smart cities, including the following: shaping smart environments around the everyday lives of older people, designing inclusive and equitable smart cities and ensuring strong forms of institutional governance, trust and relationship building with older people. CONCLUSIONS: The age-friendly city and communities movement (AFCC) and smart city policy instruments have potential for realising active ageing by supporting mobility, access to services and civic participation. However, there exists a disconnect between smart city policy and practice in delivering tangible well-being outcomes for older people. Addressing this requires greater cross-sectoral working, reconciling smart city policy priorities with AFCC domains and creating the institutional and governance framework to enable socially sustainable cities to support ageing-in-place.

Identifying childhood malaria hotspots and risk factors in a Nigerian city using geostatistical modelling approach.

Malaria ranks high among prevalent and ravaging infectious diseases in sub-Saharan Africa (SSA). The negative impacts, disease burden, and risk are higher among children and pregnant women as part of the most vulnerable groups to malaria in Nigeria. However, the burden of malaria is not even in space and time. This study explores the spatial variability of malaria prevalence among children under five years (U5) in medium-sized rapidly growing city of Akure, Nigeria using model-based geostatistical modeling (MBG) technique to predict U5 malaria burden at a 100 × 100 m grid, while the parameter estimation was done using Monte Carlo maximum likelihood method. The non-spatial logistic regression model shows that U5 malaria prevalence is significantly influenced by the usage of insecticide-treated nets-ITNs, window protection, and water source. Furthermore, the MBG model shows predicted U5 malaria prevalence in Akure is greater than 35% at certain locations while we were able to ascertain places with U5 prevalence > 10% (i.e. hotspots) using exceedance probability modelling which is a vital tool for policy development. The map provides place-based evidence on the spatial variation of U5 malaria in Akure, and direction on where intensified interventions are crucial for the reduction of U5 malaria burden and improvement of urban health in Akure, Nigeria.

Reimagining Urban Spaces: Green Spaces, Obesity, and Health Resilience in an Era of Extreme Heat.

Record-breaking heat waves intensified by climate change pose both environmental and health threats, necessitating a balance between urban sustainability and well-being. Extreme heat and limited green space access are drivers of obesity prevalence, with decreased proximity to green spaces correlating with higher rates of obesity in nearby communities. In contrast, access to such green spaces fosters physical activity, well-being, and community cohesion, especially crucial in marginalized communities facing health disparities due to historical policies like redlining and underinvestment in social gathering spaces. Despite challenges, green space investment offers healthcare savings and environmental gains, necessitating a shift in perception towards viewing green spaces as essential for urban living. As heat waves persist, integrating health and sustainability in urban planning is paramount. Health and medical communities must play an active role in advocating for equitable access to urban green spaces, as they possess influential positions to address climate-related health disparities through localized advocacy.