The second International Forum on Urban-Rural Linkages (IFURL 2)

The NUA makes numerous specific references to conditions in both urban and rural areas, simultaneous urban and rural development, interactions and connectivity, and the need to support territorial systems that integrate both urban and rural functions across the urban-rural continuum. This global strategy has addressed the fundamental linkages between health and the sustainable development of human settlements. It has clarified the importance of those linkages and that health is not only about the provision of health care services. The successful implementation of the NUA hinges on a clear understanding of how health of both ecosystems and human communities  can act as a driver of inclusive, sustainable development and on the identification and pursuit of practical steps for improving the health and wellbeing of all people.

Among the 17 Sustainable Development Goals (SDGs) set in the 2030 Agenda for Sustainable Development, SDG 11 is dedicated to making human settlements inclusive, safe, sustainable and resilient. Targets key to achieving this goal such as housing, air quality, transport and ecosystem services including food and water are important determinants of people’s health. Improving health will remain a global priority with SDG 3 focused on ensuring healthy lives and promoting well-being for all at all ages. Healthy environments and populations are essential to realizing human potential as well as the objective of equitable, inclusive and economically vibrant human settlements.

While health and urban agendas are becoming more comprehensive, they do not yet fully appreciate the importance of the urban-rural continuum and often maintain a rural-urban dichotomy in their analysis and prescription. The spread of outbreaks such as COVID-19 has brought attention to reverse migration from urban areas to rural areas and the territorial inequities of health systems including the lack of access to health facilities, poor nutrition, hunger, and disproportionate impacts on vulnerable groups along the urban-rural continuum. Health agendas do not yet extend that analysis to a more integrated understanding of spatial systems and territories.

Health is influenced by many factors beyond the health sector. Both the built environment and natural environment can directly or indirectly affect human health and livelihoods. Re-examining health through the lens of urban-rural linkages can play a key role in addressing the rise of two global phenomena that may bring not only unprecedented challenges but also opportunities to human settlements. First, climate change affects the social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter. WHO has estimated that between 2030 and 2050, climate change is expected to cause approximate 250,000 additional deaths per year, from malnutrition, malaria, diarrhea and heat stress. Second, ecosystem and biodiversity loss can have significant direct human health impacts. Changes in ecosystem services can also indirectly affect local migration and livelihoods of people. National, subnational and local policies, strategies and plans can create or exacerbate major health risks for populations or they can foster healthier environments, lifestyles and create healthy and resilient human settlements along the urban-rural continuum. Besides the environmental dimensions, the social determinants of health must be taken into account. The unbalanced urban-rural investment patterns have widened the inequities in health between urban and rural areas. It is vital to place health and health equity at the heart of urban governance and integrated territorial planning.

The above-mentioned health issues are highly complex and often linked through the social determinants of health. This requires a collaborative approach to improve the health of all people by incorporating health considerations into decision-making across sectors and policy areas. Health in All Policies [1]in an approach to public policies across sectors that systematically takes into account the health implications of decisions, seek synergies and avoids harmful health impacts in order to improve population health and health equity. It provides a means to identify and avoid those unintended impacts of public policy that can be detrimental to the health of populations or subgroups of the population, thus reducing risk.

With this background, IFURL2 aims to serve as a platform to promote urban rural linkages for sustainable development and wellbeing for all  across the urban-rural continuum. It also provides all participants with the opportunity to showcase country-specific case studies, innovative approaches and tools, emerging knowledge on rural development and health issues, and to learn from each other.

[1] Health in all policies: Helsinki statement. Framework for country action. World Health Organization, 2014.