During the Covid-19 pandemic, the role of cities in protecting health suddenly took on all its importance. Being areas of high population density, cities were at the front line of decisions and regulatory responses, and the world began to see how important local actions were to contain the spread of a virus. However, the role of a city in the field of health is by no means limited to pandemics.
During my time at the Wellcome Trust and in my current role as Chief Scientific Officer of the World Health Organization, I have focused on global health. However, my first years of professional activity took place at the local level, so I have first-hand experience about the crucial role that municipal authorities play in protecting health at all times, not only during global health emergencies.
Between 1996 and 2013 I lived in Ho Chi Minh City, where I worked as Director of the Clinical Research Unit of the Vietnam Hospital for Tropical Diseases. During that time he witnessed not only the incredible development of the city, but also a notable improvement in road safety. More crosswalks were added to city streets so pedestrians could cross safely instead of juggling traffic. Inclusive street design, mandatory helmet use by motorcyclists and policies to improve road safety began to protect pedestrians, motorcyclists and the growing number of car drivers.
These types of laws are not always considered public health policies, but they are vitally important to protect us all in our daily lives. They are also essential to protect the health of the next generation: injuries from traffic accidents are the leading cause of death among children and young people aged five to 29.
The risk of death for pedestrians hit by a car traveling at 65 kilometers per hour is 4.5 times greater than if the car is traveling at 50.
My stay in Ho Chi Minh City came to an end, but the city's efforts to improve road safety did not. The city has continued its work and is now part of several programs supported by WHO: the Alliance for Healthy Cities network and the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS). With the support of international experts and counterparts, the city has enforced local regulations on speeding and drink-driving, improved infrastructure around schools to reduce speeding, and strengthened the collection of data to help inform policy. In addition, it periodically organizes media campaigns to encourage people to comply with traffic regulations, such as respecting speed limits or not driving under the influence of alcohol. This is important because we know that, for every kilometer that speed increases, the risk and severity of an accident also increases. The risk of death for pedestrians hit by a car traveling at 65 kilometers per hour is 4.5 times greater than if the car is traveling at 50.
In 2022, the city saw a nearly 23% decrease in traffic fatalities compared to 2016. Statistics like these show the power of local policies and programs based on solid scientific evidence. The success observed in the cities has been translated to a national scale: Vietnam has become one of the countries that has reduced the number of fatalities the most, with a decrease of 40% between 2010 and 2021.
More bike lanes
Even during the COVID-19 pandemic itself, road safety continued to be a priority for many cities. During the different phases of confinement, road traffic in urban environments was reduced, and many cities opened more bicycle lanes and pedestrian routes so that people had more opportunities to move around safely and actively. In some cases, these initiatives have become permanent changes, creating safe spaces for better health and a more sustainable future.
In Accra, Ghana, safety is being improved at several multi-lane intersections in and around the city to reduce speeds and prevent injuries and fatalities in the area. Among the measures adopted, it is worth highlighting the placement of speed limit signs, the marking with paint on the ground to mark directions and the placement of fixed painted bollards at pedestrian crossings to discourage motorcyclists from entering. in them. More than half of traffic deaths affect vulnerable users, such as pedestrians, cyclists and motorcyclists.
In Mexico City, a new policy was recently adopted to increase penalties for motorcyclists who do not have a license or wear a helmet. Correct use of a helmet can reduce the risk of death in the event of an accident by more than six times and the risk of brain injuries by up to 74%. However, its importance as a health issue is often underestimated. Through the Alliance for Healthy Cities, Mexico City now shares its experiences with other cities in the region that hope to promote local policies on the same issue.
The number of people living in cities is increasing, and by 2050 it is expected that almost two-thirds of the world's population will live in an urban settlement. Cities have a great burden of responsibility when it comes to establishing the appropriate environments and policies to protect the health of their inhabitants.
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