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Innovative actions for improving urban health and wellbeing - addressing environment, climate and socioeconomic factors

The natural and built[1] environment as well as the social fabric are critical determinants of health and well-being. Three quarters of the European population now live in cities and urbanisation continues at high speed, driven by economic growth and employment opportunities. The related environmental changes e.g. pollution of air and water, transportation problems, reduced social cohesion and stress affect physical as well as mental health. Although health has improved in the EU over the last decades, large differences in health still exist between and within all countries in the EU. These differences are caused by many factors such as living conditions, health-related behaviour, education, occupation and income, health care. Some of these inequalities are widening[2]. As European cities are growing, they are increasingly taking action and introducing policies to become more sustainable and liveable, adapting to climate change, investing in a range of smart and innovative solutions such as clean and sustainable transport, higher energy efficiency and stronger social cohesion. Similar initiatives are underway e.g. in Canada, USA as well as in Asia and Africa which could provide valuable knowledge.

At EU level, the Urban Agenda for the EU[3] focuses on improving the life of their citizens for example through the development of digital solutions, reducing urban poverty and better integration of migrants and refugees. The headline targets in the EU2020 strategy aim to turn the EU into a smart, sustainable and inclusive economy delivering high levels of employment, productivity and social cohesion[4].

Improving urban health and reducing health disparities can be achieved by changes in individual behaviour as well as policies such as urban design and sustainable transport, (re)creating green and blue space or improved housing standards. There is a need to address public policies across sectors to achieve health benefits, systematically taking into account the health implications of decisions, to seek synergies, and avoid harmful health impacts (health in all policies[5]).

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Implementation research for scaling up and transfer of innovative solutions involving digital tools for people-centred care

People-centred care is one of the main goals of health systems[1]. It relates to a stronger orientation towards the needs of people and their involvement in the treatment process and decision-making. This is expected to result in a better care as experienced by people, in less inequality, better health promotion, better disease prevention, and treatments better targeted to people’s needs. Health system transition to people-centred care requires empowering citizens[2] and integration of services[3].

The growing digital transformation of health and care offers great opportunity to achieve this transition. Innovative solutions[4] involving digital tools have the potential to improve people-centred care through self-management, goal orientation and shared decision-making. However, technical innovation is unlikely to achieve the anticipated improvements/impact if not accompanied by supportive organisational and policy innovations. Given the complexity and differences between health systems, cross-national comparative health services and systems research as well as implementation research are needed to better understand the contextual factors that impact the successful introduction, use and sustainability of innovative solutions. This will in turn facilitate their scalability[5] and their transferability to other settings.

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