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The Association of Mental Health Providers’ evidence observatory
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35,847 claims
Cities need targeted interventions to improve health risk factors such as smoking, obesity, and air pollution in areas of high deprivation.
Government, both national and local, as well as the NHS, should consider further targeted interventions to improve these well-known risk factors in concentrated urban areas
Policy · Policy statement · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 13
Cities should facilitate active travel and access to green spaces to improve physical activity levels.
Making walking and cycling more practical and safer, and access to green space easier and more equitable, would go a long way toward removing barriers to improving physical activity levels
Policy · Policy statement · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 11
Air pollution is a major issue in cities, particularly affecting transport and space heating.
Transport and space heating are areas that need particular action to reduce air pollution.
Operational · Policy statement · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 10
Improving the built environment in cities can significantly improve public health for millions of people.
This presents an opportunity to significantly improve health for millions of people.
Strategic · Policy statement · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 10
Cities benefit from ethnically diverse populations but face health inequalities among ethnic minorities due to higher concentrations of deprivation.
Cities benefit by having highly ethnically diverse populations. Ethnic diversity in England is country-wide but is much more highly concentrated in cities. People from ethnic minority backgrounds often experience particular health inequalities.
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 9
London has lower mortality rates than other built-up areas, especially in more deprived deciles.
It is noteworthy that London, the UK’s wealthiest city, shows significantly lower mortality rates than the other built-up areas, particularly in the more deprived deciles.
Metric · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 8
Reducing city deprivation can improve health outcomes.
This demonstrates the gains in health which could be made by reducing the health effects of city deprivation.
Strategic · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 8
Cities offer opportunities for diverse cultural and leisure activities.
A high proportion of the English population live in cities throughout their lives whilst others come to cities early in their adult lives for work or study before moving out, often after they start a family
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities have unique qualities that affect health and wellbeing.
It was striking in getting evidence for this report that many cities feel like a conglomeration of multiple villages next door to one another and with each community often not engaged in the health challenges of the neighbouring communities
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities provide opportunities for diverse cultural and leisure activities.
A high proportion of the English population live in cities throughout their lives whilst others come to cities early in their adult lives for work or study before moving out, often after they start a family
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities face challenges in providing equitable healthcare due to concentrated deprivation.
The risk factors for ill health, such as smoking and living with obesity, are also often concentrated in urban deprived areas. These combine to reduce life expectancy and years lived in good health in those neighbourhoods
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 7
Cities have large teaching hospitals and areas of health and scientific specialisation.
They tend to be home to the large teaching hospitals and other areas of health and scientific specialisation
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities provide opportunities for diverse communities to live in close proximity.
This includes wide ranges of poverty and affluence, ethnic mix, and cultural experience all living within short distances
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities offer a wealth of resources that can promote good health and wellbeing.
They can also have high concentrations of deprivation and poverty, often very close to areas of affluence, with the health effects of deprivation being very apparent
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 5
Deprivation is highly concentrated in specific areas within cities.
This concentration brings challenges for health improvement and health protection, but also opportunities as the areas to concentrate most on because they have the worst health outcomes in high density
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 7
Cities face challenges in maintaining public health interventions due to population mobility.
Many interventions such as screening or immunisation are harder to maintain in such mobile populations and rates of take-up of immunisation, screening and other public health interventions are often lower than in the rest of the country
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 7
Cities provide unique opportunities for health improvement through urban planning.
The evidence base is there to achieve this. None of these come without some cost in money or political capital but given the density of the population and the degree of need, the impact of pro-health decisions can be substantial and usually long lasting
Policy · Policy statement · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 4
Cities have high concentrations of deprivation and poverty, often very close to affluent areas.
This report explores both, with examples from many of England’s cities. I am very grateful to the many authors from around the country and those who contributed to this report
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 5
Cities are home to diverse communities with wide ranges of poverty and affluence.
They are home to an extensive variety of often distinct communities living very close together. This includes wide ranges of poverty and affluence, ethnic mix, and cultural experience all living within short distances
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 3
Cities are younger than rural areas with a larger working-age population.
Cities are younger than rural areas and smaller towns. This means that cities have an advantage in terms of having a large working-age population
Context · Observational claim · From Chief Medical Officer’s annual report 2024: health in cities — Executive summary and recommendations, page 5