Health benefits of sustainable urban and transport policies: evidence from the UBD Policy project

Suboptimal urban and transport planning is linked to adverse health effects due to environmental stressors and physical inactivity. In response, cities are implementing policies to promote healthier environments. The UBD Policy project estimated the health benefits of such measures to support their implementation across 10 European cities: Amsterdam, Barcelona, Basel, Bradford, Brussels, Copenhagen, Manchester, Sofia, Warsaw and Utrecht. Assessed policies included sustainable mobility, low-emission zones (LEZ), air quality and green space measures, heat adaptation, public space design and noise regulation. Stakeholder engagement ensured context-specific policy prioritisation and was conducted via workshops or direct consultation with municipal representatives. Health impacts were quantified using comparative risk assessment and, in some cases, more advanced methods such as proportional multistate life tables, microsimulation and agent-based models. Cities showed marked baseline differences in 2018: PM2.5 ranged from 8.9 µg/m3 in Bradford to 22 in Warsaw, NO2 from 20.3 in Bradford to 35.4 in Barcelona, and green space from 14% in Brussels to 30.6% in Sofia. Utrecht was highest in cycling (56%), Barcelona in walking (46%) and Warsaw in public transport (47%). Policies were associated with substantial health gains. In Barcelona, the LEZ reduced NO2 by 5.7 µg/m3, estimated to prevent 4,092 asthma cases and 7,501 premature deaths by 2100. In Bradford, the LEZ reduced NO2 by 3.7 µg/m3, linked to 42 avoided deaths annually. In Sofia, shifting from car use to sustainable mobility was estimated to prevent 12,100 premature deaths between 2021 and 2050. Our results support the implementation of sustainable urban and transport policies. Quantified health impacts can strengthen communication with citizens, public support and policy uptake, while differences between cities highlight the importance of context-specific interventions to maximise health benefits.

Key messages

• Sustainable urban and transport policies across 10 European cities yield substantial health benefits, mainly through reduced air pollution and increased physical activity.

• Context-specific differences between cities highlight the need for local-level analyses and interventions to maximise health gains and support policy uptake.