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The COVID-19 pandemic has required health protection responses with far-reaching consequences for society, livelihoods, and the wider economy. Future enquiries will in time evaluate the success of responses at all scales. But emerging lessons highlight immediate implications for addressing the growing climate crisis through a recovery from COVID-19 that advances population health, economic regeneration and climate action. Cities are where many of the most critical actions for health, greenhouse gas (GHG) emissions reduction, resilience and risk reduction must be taken, supported by national governments, multi-lateral agencies and other stakeholders. Rapid decarbonisation across all sectors of society is needed over this decade—further delay will seriously reduce the possibility of achieving the targets set out in the Paris Agreement. Now is therefore an especially important juncture for cities to act for both the near-term imperatives of the post-COVID recovery and the long-term welfare of their residents and the planet.

Networks are increasingly important for advancing urban science, policy and practice. The complexity that cities present to stakeholders of all kinds demands systems-based and networked approaches to solving sustainability challenges. This article analyses the contemporary rise of global networks of urban science, policy, and practice. We provide an overview of urban science, policy, and practice networks followed by a detailed case study of the emerging Future Earth Urban Knowledge Action Network (Urban KAN), highlighting its vision, initial activities and impacts, and challenges and remaining tasks. Findings from the case study reveal that a network across science, policy and practice can make significant contribution in cutting-edge knowledge generation, global research agenda setting, timely contribution to global policy processes, catalyzing the formation of new national and thematic research-action networks, among others. In contrast, such a network also faces challenges, in terms of attraction and representation of the composition, maintaining initial momentum, turning the science-policy integration and collaboration into reality, and obtaining strong and continued financial and institutional support. We conclude that networks across the boundaries of science-policy-practice are still in their infancy, and deeper collaborations across sector, scale, and networks that enable the implementation of effective new actions will be key indicator in measuring the success of these networks.

Background Localisation is a pervasive challenge in achieving sustainable development. Contextual particularities may render generalized strategies to achieve the Sustainable Development Goals (SDGs) unfeasible, impractical, or ineffective. Furthermore, many localities are resource- and data-poor, limiting applicability of the global SDG indicator framework. Tools to enable local actors to make sense of complex problems, communicate this understanding, and act accordingly hold promise in their ability to improve results. Aim Systems approaches can help characterise local causal systems, identify useful leverage points, and foster participation needed to localise and catalyse development action. Critically, such efforts must be deeply rooted in place, involving local actors in mapping decision-processes and causation within local physical, social and policy environments. Given that each place has a unique geographical or spatial extent and therein lies its unique characters and problems, we term these activities “placially explicit.” We describe and reflect on a process used to develop placially explicit, systems-based (PESB) case studies on issues that intersect with and impact urban health and wellbeing, addressing the perspectives of various actors to produce place-based models and insights that are useful for SDG localisation. Methods Seven case studies were co-produced by one or more Partners with place-based knowledge of the case study issue and a Systems Thinker. In each case, joint delineation of an appropriate framing was followed by iterative dialogue cycles to uncover key contextual factors, with attention to institutional and societal structures and paradigms and the motivations and constraints of other actors. Casual loop diagrams (CLDs) were iteratively developed to capture complex narratives in a simple visual way. Results Case study development facilitated transfer of local knowledge and development of systems thinking capacity. Partners reported new insights, including a shifting of problem frames and corresponding solution spaces to higher systems levels. Such changes led partners to re-evaluate their roles and goals, and thence to new actions and strategies. CLD-based narratives also proved useful in ongoing communications. Conclusion Co-production of PESB case studies are a useful component of transdisciplinary toolsets for local SDG implementation, building the capacity of local actors to explore complex problems, identify new solutions and indicators, and understand the systemic linkages inherent in SDG actions across sectors and scales.

Complexity is the hallmark of our habitats, our livelihoods and our health. These objects of analysis, understanding and intervention extend from our homes to our streets and neighbourhoods...

The sustainable development of cities is increasingly recognized as crucial to meeting collectively agreed sustainability goals at local, regional and global scales, and more broadly to securing hu ...

Executive summary: Over the past four decades, rapid urbanisation in China has brought unprecedented health benefits to its urban population, but has also created new challenges for protection of and promotion of health in cities. With the shift from rural to urban living, more people than ever enjoy the health advantages that cities can provide, such as better access to health services and improved sanitation. For example, the average life expectancy of male urban residents in 2010 was estimated to be 7·09 years longer than that of of their counterparts in rural China; urban females lived 6·64 years longer.1 Other changes associated with rapid urbanisation– including large-scale migration, ageing, pollution, shifts in diet and lifestyle, and social inequality–have created new health challenges.2 For example, about 52% of people over 60 years old lived in urban areas in 2015 compared with 34% in 2000,3 thus increasing the burden of senior care in Chinese cities. Non-communicable diseases have replaced infectious diseases as the leading cause of death among urban residents; the percentage of years of life lost because of such diseases as a fraction of all-cause years of life lost increased from 50·0% (95% CI 48·5–53·0) in 1990 to 77·3% (76·5–78·1) in 2015.4 Health inequality also increased in urban areas.5 China has acted to address urban health challenges by passing strict environmental regulations and investing heavily in urban infrastructure. Major reforms have been passed to increase the transparency of environmental governance to control pollution over the short term, while moving to reform whole industries and thus provide long-term solutions. Programmes like the Hygienic Cities movement have invested heavily in urban infrastructure to promote health, including major improvements in urban sanitation.6 China has also increased coverage of and accessibility to health services in urban areas. In 2016, around 93·8% of the urban population was covered by urban medical insurance programmes, a substantial increase from 4·1% in 1998 when the programmes started.7,8 Meanwhile, cities in China are also testing new strategies for urban health management, such as China’s pilot Healthy Cities project.9 Management of chronic diseases and mental disorders in cities has improved dramatically and major progress has been made regarding access to preventive and primary health services. All these efforts have contributed to the reduction of exposure to health risks and health improvement in urban China. However, despite these successes, major gaps remain, including but not limited to an over-reliance on a top-down-approach to environmental management, a narrow focus on health care in urban health management, and a scarcity of intersectoral action. Given that the urbanisation rate in China is predicted to reach 71% by 2030,10 urban health challenges will continue to emerge and expand. If innovative strategies are not used to address these issues, they will become major obstacles to the achievement of improved health and development for millions of people. It has also become clear that the health sector alone, with its traditional piecemeal approach, cannot effectively resolve the modern challenges to urban health in China. The country is now in a transitional period in which the pursuit of economic growth at any cost is being replaced by sustainable development. In 2013, President Xi Jinping declared China’s intention to develop a so-called ecological civilisation (ecocivilisation), the core principles of which involve balancing the relationship between humanity and nature. During this transition, health is recognised as the centrepiece of sustainable development in China, as highlighted in the Healthy China 2030 plan that was adopted in 2016.11 As a result, people-centred and health-oriented urban development will hopefully prevail in China; however, major efforts, political will, and investments will be needed to put this vision into practice. The Tsinghua–Lancet Commission on Healthy Cities in China aimed to characterise, understand, and address urban health challenges in the unique context of China’s rapid and dynamic urban development. Experts from a wide range of disciplines examined environmental and social determinants of health, identified key stakeholders,and assessed actions for the prevention, management, and control of adverse health outcomes associated with the country’s urban experience. We conclude that key efforts are needed to combat urban health challenges in China and these should be unified with the Healthy Cities movement, which uses a systems approach to urban health management and provides a clear path to the realisation of the Healthy China 2030 plan. Actions taken to build healthy cities in China have contributed to global knowledge on the development of healthy cities in other parts of the world. China’s strategic, simultaneous rollout of diverse trials in different cities— in areas such as health education and promotion—and its rapid adoption of effective approaches at the national scale is a valuable lesson for other countries facing rapid urbanisation. Despite such successes, we believe that there is room for substantial improvement and make the following five key recommendations. Integrate health into all policies China should take advantage of new, human-centred urbanisation strategies. For example, cities should integrate health into urban planning and design as a first step towards the integration of health into all policies. Increase participation Cities should increase participation by residents, the private sector, non-governmental organisations (NGOs), and community groups in health management. This increase can be achieved through investment in community capacity building and engagement with the private sector. Promote intersectoral action To motivate and sustain intersectoral action in the design, building, and management of healthy cities, cities should develop ways to assess the health effects of urban management by use of measures that span multiple and diverse sectors. Set local goals for 2030 and assess progress periodically Cities should view the health goals specified in the Healthy China 2030 plan as long-term goals that are achieved through the building of healthy cities. Indicator systems should be put in place to assess progress and inform the public. Enhance research and education on healthy cities To develop new theories and practical solutions, cities should increase investment and form partnerships with universities, research institutes, and the private sector to support research and education on the best ways to create healthy cities.

Dependence on air-conditioning (AC) for residential cooling and ventilation is a health and sustainability challenge. In hot temperatures, climate-sensitive buildings (CSB) can complement and/or substitute for AC usage in achieving thermal comfort. Many countries facing such conditions—particularly in tropical climates—are developing quickly, with rising populations and income creating demand for new housing and AC. This presents a window for adoption of CSB but could also result in long term lock-in of AC-dependent buildings. Here, a simple system dynamics model is used to explore the potential and limitations of subsidies to affect futures of housing stock and night-time AC usage in Malaysia. The effectiveness of subsidies in achieving high uptake of CSB and resulting health benefits is highly dependent on homebuyer willingness to pay (WTP). A detailed understanding of WTP in the Malaysian context and factors that can shift WTP is necessary to determine if CSB subsidies can be a good policy mechanism for achieving CSB uptake.

When we think of "climate change," we think of man-made global warming, caused by greenhouse gas emissions. But natural climate change has occurred throughout human history, and populations have had to adapt to the climate's vicissitudes. Anthony J. McMichael, a renowned epidemiologist and a pioneer in the field of how human health relates to climate change, is the ideal person to tell this story. Climate Change and the Health of Nations shows how the natural environment has vast direct and indirect repercussions for human health and welfare. McMichael takes us on a tour of human history through the lens of major transformations in climate. From the very beginning of our species some five million years ago, human biology has evolved in response to cooling temperatures, new food sources, and changing geography. As societies began to form, they too adapted in relation to their environments, most notably with the development of agriculture eleven thousand years ago. Agricultural civilization was a Faustian bargain, however: the prosperity and comfort that an agrarian society provides relies on the assumption that the environment will largely remain stable. Indeed, for agriculture to succeed, environmental conditions must be just right, which McMichael refers to as the "Goldilocks phenomenon." Global warming is disrupting this balance, just as other climate-related upheavals have tested human societies throughout history. As McMichael shows, the break-up of the Roman Empire, the bubonic Plague of Justinian, and the mysterious collapse of Mayan civilization all have roots in climate change. Why devote so much analysis to the past, when the daunting future of climate change is already here? Because the story of mankindâs previous survival in the face of an unpredictable and unstable climate, and of the terrible toll that climate change can take, could not be more important as we face the realities of a warming planet. This sweeping magnum opus is not only a rigorous, innovative, and fascinating exploration of how the climate affects the human condition, but also an urgent call to recognize our species' utter reliance on the earth as it is.

It has become evident that our planetary ecosystem is changing rapidly in response to human activities. This has led scientists to recognize the present-day era as a new geological epoch, the Anthropocene, in recognition of the substantial effect of man on the Earth’s systems. Human health is better today than at any other time in history. Yet the flourishing of civilization has come at the cost of an unsustainable exploitation of nature’s resources. As we look toward the future, it has become clear that we now face substantial health risks from the degradation of the natural life support systems which is critical for human survival. Global environmental change, including climatic change, ocean acidification, land degradation, water scarcity, overexploitation of fisheries, and biodiversity loss, poses serious challenges to the global health gains of the past several decades.

Extreme events, both natural and anthropogenic, increasingly affect cities in terms of economic losses and impacts on health and well-being. Most people now live in cities, and Asian cities, in particular, are experiencing growth on unprecedented scales. Meanwhile, the economic and health consequences of climate-related events are worsening, a trend projected to continue. Urbanization, climate change and other geophysical and social forces interact with urban systems in ways that give rise to complex and in many cases synergistic relationships. Such effects may be mediated by location, scale, density, or connectivity, and also involve feedbacks and cascading outcomes. In this context, traditional, siloed, reductionist approaches to understanding and dealing with extreme events are unlikely to be adequate. Systems approaches to mitigation, management and response for extreme events offer a more effective way forward. Well-managed urban systems can decrease risk and increase resilience in the face of such events.

Background As human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them. These challenges may take on unique aspects in cities with different cultures, political and institutional frameworks, and at different levels of development, but they frequently have in common an origin in the interaction of human and environmental systems and the feedback relationships that govern their dynamic evolution. Accordingly, systems approaches are becoming recognized as critical to understanding and addressing such complex problems, including those related to human health and wellbeing. Management of water resources in and for cities is one area where such approaches hold real promise. Results This paper seeks to summarize links between water and health in cities and outline four main elements of systems approaches: analytic methods to deal with complexity, interdisciplinarity, transdisciplinarity, and multi-scale thinking. Using case studies from a range of urban socioeconomic and regional contexts (Maputo, Mozambique; Surat and Kolkata, India; and Vienna, Austria). Conclusion We show how the inclusion of these elements can lead to better research design, more effective policy and better outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12940-016-0107-2) contains supplementary material, which is available to authorized users.