Rethinking health: Multi-city networks to tackle future health challenges


21 May, 2023

Cities are places of high diversity but also extreme inequality and the disproportionate effect of the pandemic on low-income residents brought the fatal relationship to the forefront.

The situation of the rural poor is challenging because of inadequate access to public services, infrastructure and social protection. COVID-19 compounded this vulnerability by reducing incomes, limiting mobility and disrupting food security. However, despite persistent disadvantage faced by rural dwellers, poverty is declining faster in rural than in urban areas.

It is important to understand the intersection between diversity and inequality as a way to improve health outcomes for future cities.

Stockton, California's Universal Basic Income experiment provided unconditional cash assistance to low-income residents. The money was primarily spent by recipients on basic needs, including food and utilities. Among the key findings of the study, unconditional cash reduced monthly fluctuations faced by households and increased full-time employment whilst also decreasing feelings of anxiety and depression, and improving overall wellbeing.

“The cash was completely unconditional, with no strings attached and no work requirements.”

Stockton Economic Empowerment Demonstration (SEED)

By alleviating financial hardship, residents were better able to create new opportunities as a result of the guaranteed income. Notably, it extended households abilities to cover unexpected expenses which was of importance given the start of the pandemic. The study proved successful and catalysed a coalition of mayors to launch guaranteed income pilots in a further 29 cities across the US.

Cities are effective drivers of change. They often harbour organisations capable of facilitating diverse partnerships that can rally around a shared purpose to create neighbourhood and local-level strategies for healthier places and people. These can serve as lesson capable of being applied across city, national and international networks. Aging populations, chronic diseases and health inequities are a threat and building multi-city coalitions for health equity can be a resilience multiplier for both people's health and the economy.