We are delighted to publish our report “Urban health research in Latin America”, from our workshop with the National Academy of Medicine of Brazil and the Brazilian Academy of Sciences in March 2020.
By 2030, more than 90% of the population of Latin America is likely to be living in cities. Such rapid urbanisation leads to many health challenges, which are exacerbated by high levels of inequality. Today [15th July 2020], the Academy of Medical Sciences, the National Academy of Medicine of Brazil and the Brazilian Academy of Sciences launch their workshop report on Urban health research in Latin America. The workshop, held in March 2020, explored the major health issues facing the region, the priority research questions, and the potential ways to advance urban health research. We asked Professor Frank Kelly FMedSci, co-chair of the report, to answer four questions about the key messages that came out of the workshop.
- Why is urban health in Latin America an important issue?
Latin American cities experience a wide range of health hazards, including poor air quality, limited access to safe drinking water and effective sanitation services, limited access to green space, and high levels of violence. Most cities also have many densely populated areas and unhygienic living environments, which favour the spread of infectious diseases.
Commonly the socially disadvantaged are exposed to these health hazards to a greater degree. This means these groups will have a lower life expectation and experience a greater burden of both non-communicable and infectious diseases.
- In your opinion, what are the most important themes identified in the report?
The most important theme that came out for me was the issue of socioeconomic inequality. Whilst cities have advantages in terms of wealth creation, that wealth is often unevenly shared. This is particularly true in Latin America. Eight countries in Latin America are in the top 20 most unequal countries globally. Although inequalities had been falling in the last decade, progress has now ground to a halt. In 2018 an estimated 30% of the population, that’s 185 million people, were living in poverty, with 10% living in extreme poverty. It is important to consider all of the factors that affect health and wellbeing, as together these have a tremendous impact on the lower socioeconomic classes in Latin American cities.
- How can urban health research be better coordinated across Latin America?
During the workshop, we learnt that South American cities are facing common challenges. Participants agreed that sharing both successful and unsuccessful experiences provides a framework and foundation for collaboration, alignment and political engagement.
It is important that we identify and better understand the many factors that affect peoples’ health and wellbeing in urban areas. Understanding the key influences on urban health would also help us identify and address the drivers of health inequalities.
Collaboration between researchers is also going to be important to support the development and evaluation of interventions aimed at improving urban health and reducing inequalities. But stronger links are also needed between researchers and policy makers to make sure there is a stronger emphasis on policy-relevant research and evidence-based decision making.
- What are the next steps that you would like to see being taken as a result of the project?
Participants identified a number of important next steps during the workshop. We need to see the creation and strengthening of urban research networks across Latin America to support collaboration, the collection of existing evidence on urban health and to establish a regional urban health research agenda. It will be essential to strengthen the links with national policy makers to promote commitment to evidence-based decision making. As well as establishing South-South networks, there was also much enthusiasm to establish North-South networks involving collaborations with colleagues in Europe, including the UK.
Despite all the enormous challenges facing Latin American cities we heard about during the workshop, we also heard examples of tremendous accomplishments, such as the Cyclovía in Bogotá, Colombia, where the streets are closed every Sunday and every public holiday to provide space for the citizens to exercise safely and undertake family events to increase their level of enjoyment. It was clear that this brought the city and its population together and I think that’s a wonderful example of good citizenship and good city administration, and it’s something that we need to look to bring to cities in the UK and across Europe.
To mark the launch of the report, Brazilian steering committee member on behalf of the National Academy of Medicine of Brazil and the Brazilian Academy of Sciences, Acad. Paulo Buss, also added:
“National and international studies have shown that the quality of urban health in Latin America is dependent on the deep socioeconomic, environmental and health inequalities that are present in all countries in the region.
In our cities, the environment is decisive: bad housing, lack of basic sanitation (water and sewage), garbage collection and inadequate urban drainage. It is in these conditions, not by their choice but to an ‘imperative of needs’, that the poor, the low-income families, the unemployed and the self-employed workers live. Adult and child malnutrition is much higher than that of the average population, the educational level and the offer of schools is low, the supply of health services is insufficient, the number of unemployed and desperate young people is high and the violence, including police actions, is endemic.
It does not come as a surprise that it is precisely in these regions of Latin American cities that the present Covid-19 pandemic is producing the higher number of cases and deaths.
Only public policies deeply dedicated to overcoming these inequalities and implementing socioeconomic, health and environmental equity can overcome the worst urban health conditions in the region.”
Watch our short animation which summarises the discussion and proposed actions to address Urban health research in Latin America: