How an integrated approach to urban planning is creating healthier environments for all inhabitants
Imagine a city where park designs consider both human recreation and wildlife habitats, where waste management systems protect both public health and environmental quality, and where urban planning decisions are made with equal consideration for people, animals, and ecosystems. This holistic vision is becoming reality through the emerging approach of One Health in urban environments.
The One Health approach recognizes the fundamental interdependence between the health of humans, animals, plants, and the environment 1 4 . While this concept has traditionally been applied in rural contexts to manage zoonotic diseases and food security, cities worldwide are now embracing it as a powerful framework for tackling complex urban challenges 1 . In today's era of rapid urbanization, climate change, and emerging diseases, the One Health framework offers cities a transformative pathway toward creating healthier environments for all inhabitants.
One Health is more than just a concept—it's a practical framework for creating healthier urban environments.
One Health is a collaborative, transdisciplinary approach that recognizes that the health of humans, animals, plants, and the environment are deeply interconnected 1 4 . It emphasizes that we cannot protect human health without also considering the health of animals and our shared environment.
The COVID-19 pandemic served as a powerful reminder of these connections, highlighting how quickly diseases can jump between species and spread through densely populated urban areas 4 . As the World Health Organization notes, "cities are central actors for the implementation of One Health thanks to their characteristics of action" 4 .
| Dimension | Components | Urban Applications |
|---|---|---|
| Human Health | Physical health, mental well-being, social equity | Healthcare access, green spaces for recreation, healthy urban planning |
| Animal Health | Domestic animals, wildlife, livestock | Managing human-animal interactions, zoonotic disease prevention, wildlife corridors |
| Environmental Health | Air, water, soil quality, biodiversity, climate | Pollution control, green infrastructure, sustainable waste management, nature-based solutions |
Focuses on physical, mental, and social well-being of urban residents through accessible healthcare, recreational spaces, and equitable planning.
Addresses health of domestic animals, wildlife, and livestock in urban settings, managing interactions and preventing disease transmission.
Ensures quality of air, water, and soil while preserving biodiversity and mitigating climate impacts through sustainable urban design.
Urban environments present unique challenges that make the One Health approach particularly necessary for creating sustainable, healthy cities.
Close proximity between humans and animals in urban environments, ranging from pets to urban wildlife to rodents, increases opportunities for disease spread 4 .
Pollution, habitat loss, and heat islands affect all living beings in cities 4 . These challenges require integrated solutions that address multiple environmental factors simultaneously.
Comprising nine European cities including Lyon, Lahti, and Munich, this network exemplifies how the One Health approach is being translated into urban policy and practice 4 6 . These cities serve as living laboratories for testing and implementing integrated health solutions.
European Cities Collaborating
Investigating One Health challenges in marginalized communities across four international cities.
To understand how One Health principles apply in some of the most challenging urban environments, researchers conducted a crucial study investigating One Health challenges in urban slums across four cities: Jaipur (India), Jakarta (Indonesia), Antofagasta (Chile), and Istanbul (Turkey) 8 .
This research, published in 2024, employed a Patient and Public Involvement (PPI) approach, engaging community members directly in the research process to ensure culturally relevant insights into the social, environmental, and animal health factors contributing to health challenges, particularly antimicrobial resistance (AMR) 8 .
Researchers accompanied by community members walked predetermined routes through neighborhoods, documenting environmental health risks including water sources, waste management practices, and human-animal interactions 8 .
Community members created visual representations of their neighborhoods, identifying resource distribution and risks while highlighting key community leaders and organizations 8 .
Researchers conducted interviews with community members, local leaders, and healthcare providers to understand perceptions of health risks and potential solutions 8 .
| City | Human Health Challenges | Animal Health Factors | Environmental Issues |
|---|---|---|---|
| Jaipur, India | Frequent diarrheal outbreaks often self-treated with non-prescribed antibiotics | High presence of stray animals, particularly dogs, contributing to zoonotic risks | Significant environmental contamination near stagnant water bodies used for waste dumping |
| Jakarta, Indonesia | High reliance on informal healthcare providers exacerbating improper antibiotic use | Animal-human proximity in dense living conditions | No formal waste disposal system, leading to widespread pollution and exposure to untreated wastewater |
| Antofagasta, Chile | Respiratory diseases exacerbated by poor air quality | Limited veterinary services for domestic animals | Proximity to industrial areas exposing residents to heavy pollution |
| Istanbul, Turkey | Concerns about diseases transmitted from animals | Close proximity to unvaccinated livestock in informal settlements | Inadequate sanitation infrastructure increasing contamination risks |
The study revealed striking interconnections between human, animal, and environmental health factors. The data collection methods revealed that environmental contamination was consistently linked with disease patterns in humans and animals across all study sites. For instance, transect walks in Jaipur identified specific areas where stagnant water and waste accumulation correlated with higher reports of diarrheal diseases and increased presence of disease vectors 8 .
Similarly, social mapping exercises in Antofagasta highlighted disparities in healthcare access, with certain slum sections having no direct access to clinics, leaving residents dependent on local pharmacies for antibiotics without prescriptions 8 . This practice contributes directly to the global challenge of antimicrobial resistance.
Essential approaches and tools for capturing complex interactions between human, animal, and environmental health in urban settings.
Social mapping and transect walks involve community members as guides and co-researchers, ensuring that findings reflect local contexts and knowledge 8 .
Semi-structured interviews and focus group discussions with diverse stakeholders provide insights into perceptions, practices, and potential solutions 8 .
Observing and analyzing naturally occurring interventions such as park renovations or new transit lines can provide valuable insights into cause-effect relationships 3 .
Emerging tools like the novel 3 Healths Impact Assessment help evaluate how urban policies and projects simultaneously affect human, animal, and environmental health 6 .
Engaging residents in monitoring local biodiversity and environmental health parameters builds community ownership while generating valuable data .
Combining health, environmental, and animal data in unified platforms enables comprehensive analysis of interconnected urban health challenges.
The key is employing strong research designs that approximate random assignment through what researchers call the "LARD principle" - Legal Assignment that preserves an as-if Random Distribution of confounders 3 .
Strategies for successfully implementing One Health based on lessons from pioneering cities.
"To truly embrace One Health, cities must convene diverse experts across disciplines to ensure that decisions consider human, animal, and environmental impacts comprehensively" 1 6 . Too often, animal health is omitted from urban planning conversations as an afterthought rather than an equal consideration 1 .
"Implementing One Health does not need to be perfect from the first try. The urgency lies in accelerating experimentation and testing new ideas across various domains" 1 6 . Cities like those in the One Health 4 Cities Network are testing approaches ranging from "Health Forests" to green prescribing programs 6 .
The One Health approach represents more than just an academic concept - it offers a fundamental shift in how we design, manage, and inhabit urban spaces.
By recognizing the intricate connections between human, animal, and environmental health, cities can develop more effective, equitable, and sustainable solutions to pressing challenges ranging from pandemic prevention to climate adaptation.
As cities continue to grow and evolve, embracing this holistic perspective becomes increasingly urgent. The pioneering work of networks like One Health 4 Cities demonstrates that while the path forward requires breaking traditional disciplinary boundaries and trying new approaches, the potential rewards are profound: urban environments that actively promote the health and wellbeing of all their inhabitants, human and non-human alike.
The journey toward truly "One Healthy Cities" is just beginning, but it promises a future where urban living enhances rather than diminishes the health of people, animals, and the planet we all share.