Sustainability is more than a lofty goal: how cities can strengthen health and disaster resilience

Abstract

Urban resilience to extreme climate events depends not only on flood control measures or civil defense capacity but also on policies across various economic sectors such as transportation, land use, housing, food systems, waste management, and energy. These same policies can also help prevent leading causes of death, including noncommunicable and vector-borne diseases. However, there is limited awareness of the systemic links between urban policies and their combined benefits, resulting in unnecessary societal costs and inefficient urban investments. This paper reviews policies in the sectors mentioned above that have supported both disaster resilience and disease prevention in cities around the world. It also explores governance mechanisms that enable coordinated action across sectors and encourage broader participation in building safer and healthier urban environments. Recent floods in Porto Alegre and other cities in the Brazilian state of Rio Grande do Sul revealed the limitations of narrowly focused resilience strategies. This paper argues that adopting integrated, cross-sectoral decision-making can make cities such as Porto Alegre safer, healthier, and more livable, while also promoting health equity and more efficient resource use.