COST Action CA18218

Mark Nieuwenhuijsen - European Urban Burden of Disease project

Dr. Mark Nieuwenhuijsen, Research Professor in Environmental Epidemiology at the Barcelona Institute for Global Health, is in the burden-eu spotlight to discuss the European Urban Burden of Disease project


Cities have long been known to be society’s predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease  partly due to current urban and transport planning practices. The aims of the European Urban Burden of Disease (UBD) project is to:

  • Evaluate the health burden and its determinants related to current and future potential urban and transport planning practices and related exposures (e.g, air pollution, noise, islands, green space, physical activity) in European cities; 
  • Make this evidence available for policy and decision making for healthy and sustainable futures.

Cities provide good opportunities for policy change as city councils have direct local accountability and have more agile governance structures compared to national governments. However, they often lack the expertise and resources to conduct quantitative health impact assessments to quantify the health impacts of their current urban and transport planning practices, or alternative or future scenarios. The urban burden of disease project will provide exposure and health estimates for around 1000 cities in Europe and publish these on a publicly accessible website –

Appropriate and efficient urban planning and transport systems are essential for cities to thrive, but evidence suggests that current urban and transport planning practices can cause increased exposure to air pollution and noise, heat islands and a lack of green space and physical inactivity that have detrimental effects on health such as increasing morbidity and premature mortality. A recent health impact assessment study in Barcelona found that suboptimal urban and transport planning practices may be responsible for nearly 3,000 premature deaths annually or around 20% of the total of number of deaths.

The UBD project draws on an established comparative risk assessment methodology (i.e. Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool). The project has only recently become possible because of the availability of new data on city boundaries, exposures, and mortality data for such a large number of cities and new exposure response functions. Unfortunately, city specific morbidity data and data on other determinants of health such as physical activity or transport mode are lacking and/or not available in easy accessible format for most of the cities, but may become available in the future. Please contact the UBD project team if you know of good available data sources.

Furthermore, the UBD project will conduct an in-depth assessment of current status of urban and transport planning and develop alternative, sustainable and healthy scenarios for a number of cities (e.g. Barcelona, Paris, Utrecht, Kiev). It will conduct an in-depth evaluation of current land use and transport practices in the cities and linkages between urban and transport planning, environment, physical activity and health. It will assess the health burden of current and alternative urban and transport planning practices. The work will be conducted with local stakeholders.

So far the UBD project team conducted quantitative burden of disease assessments for the year 2015 to estimate the effect of air pollution exposure (PM2·5 and NO2) and lack of green space on natural-cause mortality for adult residents (aged ≥20 years) in 969 cities and 47 greater cities in Europe. We found that the reduction of air pollution to the lowest measured concentrations could prevent nearly 125,000 deaths per year for PM2·5 exposure and 80,000 deaths per year for NO2 exposure. Increasing green space in the cities could prevent around 40,000 premature deaths annually.

The UBD project will provide many European cities with burden of disease estimates that can be used to inform policies to reduce this burden. Improved urban and transport practices are needed to reduce the current related burden of disease. New urban models such as the Barcelona Superblocks, the Paris 15-minute city or the Car free city/neighbourhood such as Vauban Freiburg and/or a shift in private car use towards public and active transportation and greening of cities are urgently need to make our cities more sustainable, liveable and healthier.

Further information on the UBD project be found in the study protocol, below.

Nieuwenhuijsen MJ, Barrera-Gómez J, Basagaña X, Cirach M, Daher C, Pulido MF, Iungman T, Gasparrini A, Hoek G, de Hoogh K, Khomenko S, Khreis H, de Nazelle A, Ramos A, Rojas-Rueda D, Pereira Barboza E, Tainio M, Thondoo M, Tonne C, Woodcock J, Mueller N. Study protocol of the European Urban Burden of Disease Project: a health impact assessment study. BMJ Open. 2022;12:e054270. doi: 10.1136/bmjopen-2021-054270

The UBD project receives funding and support from SURREAL through the European Union’s Horizon 2020 research and innovation programme under grant agreement No 956780, GoGreenRoutes through the European Union’s Horizon 2020 research and innovation programme under grant agreement No 869764, EXPANSE through the European Union’s Horizon 2020 research and innovation programme under grant agreement No 874627 and a Fellowship from the Spanish Ministry of Science and Innovation through the ayudas para la formación de profesorado universitario 2020–24 doctoral funding.

Consortium members are: Mark Nieuwenhuijsen, Jose Barrera-Gomez, Xavier Basagaña, Marta Cirach, Carolyn Daher, Maria Foraster Pulido, Tamara Iungman, Antonio Gasparrini, Gerard Hoek, Kees de Hoogh, Sasha Khomenko, Haneen Khreis, Audrey de Nazelle, Ana Ramos, David Rojas-Rueda, Evelise Pereira Barboza, Marko Tainio, Meelan Thondoo, Cathryn Tonne, James Woodcock and Natalie Mueller.


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