The Lancet Global Health 2022 Series on Urban Design, Transport and Health

About the Series

Good city planning produces co-benefits for individual and planetary health and wellbeing. In 2016, a Series on Urban Design, Transport and Health was published in The Lancet, drawing attention to the importance of integrated upstream city planning policies as a pathway to creating healthy and sustainable cities. City planning policies determine the local built environment and transport features that influence transportation choices and affect exposures to health risk and protective factors. The 2016 Lancet Series proposed a set of city planning indicators that could be used to benchmark and monitor cities.

The Lancet Global Health Series on Urban Design, Transport, and Health, published in May 2022, follows up on the 2016 Series in The Lancet. In this new Series, we demonstrate how those indicators can be used to measure urban design and transport policies and features in cities.

We present the results of a 3.5 year case study in 25 cities in 19 lower-middle and high-income countries where we conducted policy analysis and assessed built environment and transport features using geospatial indicators. We also identified thresholds for built environment interventions that could help achieve the World Health Organization’s target for increasing physical activity by 15% by 2030. Through this new Series in The Lancet Global Health, we show how the indicators can guide decisions about what must change in order to create healthy and sustainable cities; how research can be used to guide urban policy to achieve urban and population health; create tools so that cities can replicate our indicators, and explore ‘what next’ is needed to create healthy and sustainable cities, particularly in light of the COVID-19 pandemic and climate change.

Series articles

Giles-Corti, B., Moudon, A. V., Lowe, M., Adlakha, D., Cerin, E., Boeing, G., Higgs, C., Arundel, J., Liu, S., Hinckson, E., Salvo, D., Adam, M. A., Badland, H., Florindo, A. A., Gebel, K., Hunter, R. F., Mitáš, J., Oyeyemi, A. L., Puig-Ribera, A., Queralt, A., Santos, M. P., Schipperijn, J., Stevenson, M., van Dyck, D., Callejo, G. V., & Sallis, J. F. (2022). Creating healthy and sustainable cities: what gets measured, gets done. The Lancet Global Health, May 2022. https://doi.org/10.1016/S2214-109X(22)00070-5
Lowe, M., Adlakha, D., Sallis, J. F., Salvo, D., Cerin, E., Moudon, A. V., Higgs, C., Hinckson, E., Arundel, J., Boeing, G., Liu, S., Mansour, P., Gebel, K., Puig-Ribera, A., Mishra, P. B., Bozovic, T., Carson, J., Dygrýn, J., Florindo, A. A., Ho, T. P., Hook, H., Hunter, R. F., Lai, P. C., Molina-García, J., Nitvimol, K., Oyeyemi, A. L., Ramos, C. D. G., Resendiz, E., Troelsen, J., Witlox, F., & Giles-Corti, B. (2022). City planning policies to support health and sustainability: an international comparison of policy indicators for 25 cities. The Lancet Global Health, May 2022. https://doi.org/10.1016/S2214-109X(22)00069-9
Cerin, E., Sallis, J. F., Salvo, D., Hinckson, E., Conway, T. L., Owen, N., van Dyck, D., Lowe, M., Higgs, C., Moudon, A. V., Adam, M. A., Cain, K. L., Christiansen, L. B., Davey, R., Dygrýn, J., Frank, L. D., Reis, R., Sarmiento, O. L., Adlakha, D., Boeing, G., Liu, S., & Giles-Corti, B. (2022). Determining thresholds for spatial urban design and transport features to create healthy and sustainable cities: findings from the IPEN Adult study. The Lancet Global Health, Accepted May 2022. https://doi.org/10.1016/S2214-109X(22)00068-7
Boeing, G., Higgs, C., Liu, S., Giles-Corti, B., Sallis, J. F., Cerin, E., Lowe, M., Adlakha, D., Hinckson, E., Moudon, A. V., Salvo, D., Adams, M. A., Barrozo, L. V., Bozovic, T., Callejo, G. V., Delclòs-Alió, X., Dygrýn, J., Ferguson, S., Gebel, K., Ho, T. P., Lai, P., Martori, J. C., Nitvimol, K., Queralt, A., Roberts, J. D., Sambo, G. H., Schipperijn, J., Vale, D., Van de Weghe, N., & J, A. (2022). Using Open Data and Open-Source Software to Develop Spatial Indicators of Urban Design and Transport Features for Achieving Healthy and Sustainable Cities. The Lancet Global Health, May 2022. https://doi.org/10.1016/S2214-109X(22)00072-9
Giles-Corti, B., Moudon, A. V., Lowe, M., Cerin, E., Boeing, G., Frumkin, H., Salvo, D., Foster, S., Kleeman, A., Bekessy, S., Hérick de Sá, T., Nieuwenhuijsen, M., Higgs, C., Hinckson, E., Adlakha, D., Arundel, J., Liu, S., Oyeyemi, A. L., Nitvimol, K., & Sallis, J. F. (2022). What next? Expanding our view of city planning and global health, and implementing and monitoring evidence-informed policy. The Lancet Global Health, May 2022. https://doi.org/10.1016/S2214-109X(22)00066-3

Click here to download an infographic summarizing the key findings of the 2022 series of urban planning, transport and health in The Lancet Global Health.

Series launch events

The Lancet Global Health Series on Urban Design, Transport and Health launches on May 10, 2022. Two webinars will take place as part of the launch activities, and are open to the public. If you are interested in attending, please register here (May 10) or here (May 12).

In addition to the official Series launch by The Lancet Global Health, a series of local events to disseminate the methods and findings presented in this new Series will take place across the globe, as follows:




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*More local events to be confirmed

Local launch event videos

Other publications

Adlakha, D., Resendiz, E., Vernez Moudon, A., Sallis, J., Higgs, C., Giles Corti, B., Salvo, D., Cerin, E., Boeing, G., Liu, S., and Lowe, M. (2024). The Global Observatory of Healthy and Sustainable Cities: Indicators to Inform Urban Planning Worldwide. (El Observatorio Global de Ciudades Saludables y Sostenibles: Indicadores para informar la planificación urbana a nivel mundial). NotasCPAU(A publication of Consejo Profesional de Arquitectura y Urbanismo/Professional Council of Architecture and Urbanism). Open access (Spanish and English): https://revistanotas.org/revistas/55/2738-el-observatorio-global-de-ciudades-saludables-y-sostenibles

Featured in: World Bank. 2023. Chapter 2: How Inclusive Are Cities Today? in Enablers of Inclusive Cities: Enhancing Access to Services and Opportunities. Washington, DC: World Bank. http://hdl.handle.net/10986/40642

山田拓実, 竹内萌恵, 成澤拓実, 福島渓太, 塩崎洸, 高橋哲也, … & 樋野公宏. (2023). 日本の基礎自治体における身体活動を促進する都市計画政策の現状 1000 Cities Challenge の指標を用いた試行的評価. 都市計画報告集, 21(4), 486-491.

Lowe, M., Sallis, J. F., Salvo, D., et al. (2022). A pathway to prioritizing and delivering healthy and sustainable cities. Journal of City Climate Policy and Economy, 1(1), 111-123. https://doi.org/10.3138/jccpe-2022.1.1.0008

Liu, S., Higgs, C., Arundel, J., Boeing, G., et al. (2022). A generalized framework for measuring pedestrian accessibility around the world using open data. Geographical Analysis54(3), 559-582. https://doi.org/10.1111/gean.12290


Plan periodic reassessments to monitor progress

Your team can continue to work together to advocate for progress and serve as a resource for city leaders.

Repeating the calculation of indicators every few years provides occasions to celebrate progress, identify continuing, and update goals.


Present results to city leaders & build consensus for an improvement plan

You are now ready to organize one or more meetings or events to present results to city leaders and encourage their use in setting goals to improve policies and environments in your cities.

It is useful to have people from multiple sectors involved in the presentations.There are recordings of local events in which indicators are presented to city leaders on the website.


Submit your data, Scorecard, and Report for inclusion on the Global Observatory of Healthy and Sustainable Cities website

Send your city’s finalised Scorecard and/or Report to info@healthysustainablecities.org, for upload to the Global Observatorywebsite.

Your city will officially be included in the 1000 Cities Challenge, and city teams will become part of our Global Healthy and Sustainable City-Indicators Collaboration.


Compute spatial and policy indicators using the Global Healthy & Sustainable City Indicators (GHSCI) Software

Check your data and indicator results to ensure they are as accurate as possible. Validation checklists and the Global Observatory team will assist with validation.

Please contact our team for support: info@healthysustainablecities.org


Compute spatial and policy indicators using the Global Healthy & Sustainable City Indicators (GHSCI) Software

Use the GHSCI Software to:

  • Configure and analyze spatial data
  • Upload the Policy Checklist for analysis
  • Generate indicator outputs (e.g., maps, summary reports for validation and comparison)
  • Please contact our team if you require support using the GHSCI Software

Policy indicators include:

Metropolitan transport policy with health-focused actions

Air pollution policies for transport and land-use planning

Requirements for public transport access to employment and services

Employment distribution requirements

Parking restrictions to discourage car use

Minimum public open space access requirements

Street connectivity requirements

Provision of pedestrian infrastructure and targets for walking participation

Provision of cycling infrastructure and targets for cycling participation

Housing density requirements

Minimum requirements for public transport access and targets for public transport use

Publicly available information on government expenditure for different transport modes

Spatial indicators include:

Population with access to fresh food market or supermarket

Population living in neighbourhoods above minimum density threshold for WHO physical activity target

Population with access to regularly running formal public transport (<20 mins)

Population living in neighbourhoods above the median walkability across cities

Population living in neighbourhoods above minimum connectivity threshold for WHO physical activity target

Population with access to any public open space


Collect data

Policy data

  1. Identify the relevant level(s) of government for your analysis, and the government sectors responsible for the policy areas covered in the Policy Checklist.
  2. Conduct a search of government or public websites and repositories to identify relevant policy documents.
  3. Find and enter relevant policy details into the 1000 Cities Challenge Policy Checklist.

Spatial data

  1. Confirm the existence of the required spatial data.
  2. Download data for analysis of your urban area.
OpenStreetMapOpenStreetMap .pbf file with coverage of the region (and time) of interest; this could be an historical planet file, or a region-specific excerptYes
Population GridsPopulation distribution raster grid or vector data with coverage of urban region of interest. GHS population grid (R2023) is recommendedYes
Region BoundaryVector boundary for identifying study region (e.g. geopackage, geojson or shp).Conditional
Urban RegionGlobal Human Settlements Layer Urban Centres database and/or administrative boundary for urban region of interestConditional
Transit FeedsCollections of zipped GTFS feeds to represent public transport service frequencyNo
OtherOther custom data, such as points of interestNo

Further information and guidance on how to collect policy and spatial data is available on the Global Observatory website, Resources tab


Seek advice from country/regional mentor

The Global Observatory team, including country/regional coordinators can act as mentors or guides and will be able to answer questions related to the data collection plan, policy and spatial indicators computation, and generation of the Scorecard and Report.


Generate a Data Collection and Analysis Plan

  • Download and familiarize yourself with the Policy Checklist.
  • Review the steps for the Indicators Software available from the Global Observatory website, Resources tab.
  • Develop a policy data collection plan and identify who will collect the data.


Attend or watch an information and/or training session