Re-designing cities with young people – collaborative action for healthier and safer urban settings

A systems view of health and wellbeing

Already in 2008, WHO’s influential Commission on Social Determinants of Health Report (Friel et al., 2023) mentioned that “where people live affect their health and chances of leading flourishing lives.” A body of literature has focused on the ‘determinants of health’, and the need to improve people’s daily living conditions, fostering healthy societies, i.e. societies that “support efforts to create the conditions in which people can grow, play, live, learn, and work to promote and protect their health and wellbeing, in harmony with a healthy planet” (Buse, 2022).

More recently, the WHO’s Urban Health Research Agenda (World Health Organization, 2022) has advocated for a systems perspective on health and wellbeing in the context of rapid worldwide urbanisation and acknowledged cities as spaces of profound social change. Noteworthily, WHO took an inclusive, multisector approach in developing this agenda by holding a consultative process with diverse stakeholders, including governments, civil society, funding bodies, foundations such as Fondation Botnar, as well as actors beyond the health sector such as urban planning, transport, and housing.

Aligned with this perspective, Fondation Botnar supports research and implementation of effective multisector interventions, promoting the engagement of citizens, in particular young people, as co-shapers of their urban settings. One of our focus areas is on urban safety in low- and middle-income countries where we support implementing partners and young people, to address this challenging problem through collaborative action.

One of our focus areas is on urban safety in low- and middle-income countries where we support implementing partners and young people, to address this challenging problem through collaborative action.

Inequality in urban spaces – safety and the wellbeing of young people

The world is rapidly urbanising, with over two-thirds of the global population projected to live in urban areas by 2050 (United Nations, 2018). This trend significantly impacts various dimensions of sustainable development, including the social, economic, and environmental spheres. Urban areas are also becoming increasingly youthful, with UN-Habitat reporting that 60% of the urban population will be under the age of 18 by 2030. Moreover, the world youth population aged 15 to 24 years is projected to rise to 1.3 billion by 2030 (UN-Habitat, 2020, 2022). In light of these trends, the creation of healthy, sustainable, and liveable urban environments is critical for the wellbeing of young people living in cities.

​Urban settings, marked by their dynamic growth and complex challenges, highlight safety as a factor of physical security and as a fundamental determinant of young people's overall health and wellbeing.

Urban settings, marked by their dynamic growth and complex challenges, highlight safety as a factor of physical security and as a fundamental determinant of young people's overall health and wellbeing. Safety in urban environments for young people represents a complex and multifaceted issue. There is a myriad of literature linking the built environment with health behaviours and outcomes of the population through interventions focusing on, e.g. road safety, green spaces, parks and playgrounds, active travel, and safe routes to schools (see e.g. Audrey & Batista-Ferrer, 2015, Pasanen et al., 2023). Studies like that of Lovasi and colleagues (2013) have shown how the lack of safety in neighbourhoods and the scarcity of green spaces can influence childhood obesity, highlighting the negative impact of stress and the reduction of physical activities such as walking or cycling. Similarly, Foster and Giles-Corti (2008) have investigated how the fear of crime affects mental health in urban areas, underlining the importance of safety for overall wellbeing.

Given the multidimensional nature of urban safety, it is essential to adopt a strategy that is both holistic and systemic, encompassing a multisector approach where all relevant stakeholders, including young people, have a say.

Urban areas are also becoming increasingly youthful, with UN-Habitat reporting that 60% of the urban population will be under the age of 18 by 2030.

Addressing safety through participation – re-designing cities with the next generation

Even though young people represent a vital and growing segment of the urban population, they often do not participate in the design of safe public spaces. Involving young people in the planning, implementation, and monitoring of safety initiatives ensures that the solutions are grounded in the actual experiences and needs of the youth. This approach not only makes the strategies more effective and sustainable but also empowers young individuals, giving them a sense of social and political responsibility for the wellbeing of their communities, as well as ownership.

For meaningful youth engagement to take place in programmes addressing safety, at least three elements are key: localisation, capacity and skills strengthening, and structured processes of implementation.

An example of this is the Fondation Botnar-supported S² Cities Programme (Safe and Sound Cities), led by the Global Infrastructure Basel (GIB) Foundation, which aims to create safer urban environments for young people through empowerment and innovation. The programme has engaged with young people in currently six cities across the Philippines, Indonesia, Colombia, and Ecuador.

This approach not only makes the strategies more effective and sustainable but also empowers young individuals, giving them a sense of social and political responsibility for the wellbeing of their communities, as well as ownership.

At the heart is a participatory, flexible, and adaptative design which allows for meaningful localisation. This approach acknowledges that each urban area has its unique challenges and opportunities. Importantly, the programme does not pre-define safety issues in the respective cities but enables a collaborative identification of safety issues and engages local governments, civil society organisations, academic institutions, the private sector, youth-led organisations, community actors and other key stakeholders. Therefore, projects within the same programme do not merely replicate a predetermined model but are shaped to respond to local realities.

To establish structures for meaningful youth engagement, young people and other key actors require the necessary capacities and skills to facilitate collaborations between local organisations and public and private institutions. In addition to negotiation skills as are necessary for successful interactions with institutions and project partners, the programme supports young people with skills to identify, analyse, and comprehend safety-related issues and to develop potential solutions. Achieving this involves participatory training and a collaborative environment nurtured through interactions and connections with various stakeholders.

In addition to negotiation skills as are necessary for successful interactions with institutions and project partners, the programme supports young people with skills to identify, analyse, and comprehend safety-related issues and to develop potential solutions.

In the S² Cities programme, the process of implementation is structured, e.g. through city-wide calls for ideas responding to the previously identified safety issues, collaborative development of the ideas with experts and mentors, and selecting initiatives to be jointly implemented in close collaboration with the public sector and with other partners from the private sector, academia, media, and civil society.

The same three elements are key in the second example, the Tanga City Observatory in Tanzania. The process leading to reaching out to young people started with a collaboration between the Tanga City Council and the NGO Tanzania Data Lab, which was mandated to support the municipality in data-driven decision-making for service delivery in the city of Tanga. To solve substantial data gaps, the NGO proposed a citizen-science approach by training young people in mapping critical infrastructure and performing data analytics.

Fondation Botnar supported this approach and provided funding for training young people, implemented by the Ardhi University of Dar es Salaam in partnership with Tanzania Data Lab and Tanga City Council. The engagement and leadership of the young people led to the Tanga City Observatory, now officially recognised as one of five UN-Habitat urban observatories in Sub-Saharan Africa, for urban data collection and analysis. As of today, the Tanga City Observatory is hosted by the Tanga City Council and supports data and analytics for specific needs identified by the municipality, such as the use of data and maps for improving waste management. The work of the Tanga City Observatory is now fully led by a group of young people trained under the project. In addition, they now have an important role in building capacities of municipal staff in data governance and the use of data for local decision-making. The services of the Tanga City Observatory are offered to other agencies, such as the World Bank.

The engagement and leadership of the young people led to the Tanga City Observatory, now officially recognised as one of five UN-Habitat urban observatories in Sub-Saharan Africa, for urban data collection and analysis.

From grant-making to change-making – supporting collaborative approaches

Addressing health determinants in a sustainable way requires local ownership, which recognises the importance of tailoring interventions to the specific needs and context of the community, and fosters a sense of responsibility, commitment, and control over the processes and outcomes. Active involvement, participation, and leadership of local communities, institutions, and stakeholders in the planning, implementation, and management of initiatives requires an implementation-research model that focuses on structures and processes, the interaction between causes, emergent outcomes, and unexpected consequences. Fondation Botnar, in partnership with the Melbourne Centre for Cities, has developed the Evidence to Action (E2A) framework (Das et al. 2023), which provides guidance for participatory approaches of evidence-generation and learning for adapting interventions and using evidence in policy work, at local, national, and global levels.

In sum, tackling health determinants, as illustrated in this article on urban safety, requires an increased focus on context-specific structures, mechanisms, and dynamics that extend well beyond the health sector. Collaborative approaches require time, sustained effort and commitment from all the stakeholders, including funding bodies. This calls for flexibility in funding and long-term partnerships. Philanthropic organisations such as Fondation Botnar can play a crucial role as a bridge, convenor, and facilitator, encouraging community participation and fostering connections between stakeholders that reinforce cross-sector partnerships by investing in trust-building, capacity and skills development and supporting flexible and adaptable interventions.

Addressing health determinants in a sustainable way requires local ownership, which recognises the importance of tailoring interventions to the specific needs and context of the community, and fosters a sense of responsibility, commitment, and control over the processes and outcomes.

References

• Audrey, S., & Batista-Ferrer, H. (2015). Healthy urban environments for children and young people: A systematic review of intervention studies. Health & Place, 36, 97–117. https://doi.org/10.1016/j.healthplace.2015.09.004
• Buse, K. (2022). Tedros calls for a paradigm shift—what next on this political agenda? BMJ, o2529. https://doi.org/10.1136/bmj.o2529
• Das, J., Butcher, S., & Dam, J. (2020). Evidence to action framework: a participatory approach to action learning. Connected Cities - Lab.
• Foster, S., & Giles-Corti, B. (2008). The built environment, neighborhood crime and constrained physical activity: An exploration of inconsistent findings. Preventive Medicine, 47(3), 241–251. https://doi.org/10.1016/j.ypmed.2008.03.017
• Friel, S., Marmot, M., Bell, R., Houweling, T. A., & Taylor, S. (2023). WHO Commission on Social Determinants of Health: closing the gap in a generation. Institute of Health Equity.
• Lovasi, G. S., Schwartz-Soicher, O., Quinn, J. W., Berger, D. K., Neckerman, K. M., Jaslow, R., Lee, K. K., & Rundle, A. (2013). Neighborhood safety and green space as predictors of obesity among preschool children from low-income families in New York City. Preventive Medicine, 57(3), 189–193. https://doi.org/10.1016/j.ypmed.2013.05.012
• Pasanen, T. P., White, M. P., Elliott, L. R., van den Bosch, M., Bratman, G. N., Ojala, A., Korpela, K., & Fleming, L. E. (2023). Urban green space and mental health among people living alone: The mediating roles of relational and collective restoration in an 18-country sample. Environmental Research, 232, 116324. https://doi.org/10.1016/j.envres.2023.116324
• UN-Habitat. 2020.World cities report 2020: The value of sustainable urbanization. Nairobi: UN-Habitat.
• UN-Habitat. 2022.World cities report 2022: Envisaging the Future of Cities. Nairobi: UN-Habitat.
• United Nations, Department of Economic and Social Affairs, Population Division (2018). World Urbanization Prospects: The 2018 Revision, custom data acquired via website. https://population.un.org/wup/DataQuery/.
• World Health Organization (2022). Setting global research priorities for urban health. World Health Organization. https://www.who.int/publications/i/item/9789240041...