Assessing Health-Related Climate Resilience Using an Urbanization Index in Fast-Track Cities
1
Fast-Track Cities Institute, Washington, DC, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Urban centers face escalating climate-related health risks, including heat stress, flooding, and vector-borne diseases. Measuring resilience is critical for protecting populations. Fast-Track Cities, engaged in global health initiatives, provide a unique context for assessing how urbanization influences health-related climate resilience.
METHODS:
A composite Health–Climate Urban Resilience Index (HCURI) was developed comprised of four domains: environmental (green space, heat-island intensity), infrastructural (healthcare density, flood protection), social (poverty, density), and governance (disaster response, health investment). Data were drawn from municipal and national sources for Amsterdam, Netherlands; Paris, France; São Paulo, Brazil; Nairobi, Kenya; and Johannesburg, South Africa. Domains were standardized and aggregated, then correlated with heat-related hospitalizations and vector-borne disease incidence using regression models adjusted for socioeconomic variables.
RESULTS:
Amsterdam ranked highest (+1.75 SD), reflecting strong climate adaptation and health infrastructure, followed by Paris (+0.85 SD). São Paulo scored near average (+0.10 SD), balancing investments with persistent inequities. Nairobi (−0.50 SD) and Johannesburg (−1.20 SD) scored lowest, reflecting infrastructural and governance gaps despite ongoing public health initiatives. Higher HCURI values correlated strongly with lower heat-related hospitalizations (r = −0.82, p = 0.005) and moderately with lower vector-borne disease incidence (r = −0.65, p = 0.04). Adjusted models showed a one-unit increase in HCURI corresponded to a 30% reduction in heat-related admissions (95% CI: 15–45%) and a 20% reduction in vector-borne cases (95% CI: 5–35%).
CONCLUSIONS:
The HCURI provides a practical tool to quantify health-related climate resilience in urban contexts. Findings highlight how integrated planning – linking environmental, infrastructural, social, and governance factors – can mitigate climate-sensitive health outcomes. Policymakers should adopt cross-sectoral resilience strategies to safeguard health, with potential to scale the HCURI for broader monitoring and evaluation across the Fast-Track Cities network.
Urban centers face escalating climate-related health risks, including heat stress, flooding, and vector-borne diseases. Measuring resilience is critical for protecting populations. Fast-Track Cities, engaged in global health initiatives, provide a unique context for assessing how urbanization influences health-related climate resilience.
METHODS:
A composite Health–Climate Urban Resilience Index (HCURI) was developed comprised of four domains: environmental (green space, heat-island intensity), infrastructural (healthcare density, flood protection), social (poverty, density), and governance (disaster response, health investment). Data were drawn from municipal and national sources for Amsterdam, Netherlands; Paris, France; São Paulo, Brazil; Nairobi, Kenya; and Johannesburg, South Africa. Domains were standardized and aggregated, then correlated with heat-related hospitalizations and vector-borne disease incidence using regression models adjusted for socioeconomic variables.
RESULTS:
Amsterdam ranked highest (+1.75 SD), reflecting strong climate adaptation and health infrastructure, followed by Paris (+0.85 SD). São Paulo scored near average (+0.10 SD), balancing investments with persistent inequities. Nairobi (−0.50 SD) and Johannesburg (−1.20 SD) scored lowest, reflecting infrastructural and governance gaps despite ongoing public health initiatives. Higher HCURI values correlated strongly with lower heat-related hospitalizations (r = −0.82, p = 0.005) and moderately with lower vector-borne disease incidence (r = −0.65, p = 0.04). Adjusted models showed a one-unit increase in HCURI corresponded to a 30% reduction in heat-related admissions (95% CI: 15–45%) and a 20% reduction in vector-borne cases (95% CI: 5–35%).
CONCLUSIONS:
The HCURI provides a practical tool to quantify health-related climate resilience in urban contexts. Findings highlight how integrated planning – linking environmental, infrastructural, social, and governance factors – can mitigate climate-sensitive health outcomes. Policymakers should adopt cross-sectoral resilience strategies to safeguard health, with potential to scale the HCURI for broader monitoring and evaluation across the Fast-Track Cities network.
| eISSN: | 2654-1459 |
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