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Research, Urban Planning, Environment and Health

Cities Can Avoid 20% of Premature Deaths With Better Urban and Transport Planning

Researchers estimated that almost 3,000 premature deaths could be prevented in Barcelona each year by following international exposure recommendations


By 2050, almost 70% of people globally are projected to live in urban areas. As the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. A recent study published in Environmental Health Perspectives led by researchers at CREAL, an ISGlobal allied center, estimated that almost 3,000 deaths in Barcelona are premature and preventable under compliance with international exposure recommendations for physical activity, air pollution, noise, heat, and access to green spaces.

The researchers from CREAL developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona. Exposure estimates and mortality data were available for 1.357.361 Barcelona residents older than 20 years. “We compared recommended with current exposure levels. We quantified the associations between exposures and mortality, and calculated population attributable fractions to estimate the number of preventable premature deaths. We also modeled life-expectancy and economic impacts”, explains Natalie Mueller, first author of the study and researcher at CREAL.

The researchers estimated that annually almost 20% of natural all-cause mortality (i.e. almost 3,000 deaths) could be postponed each year if international recommendations for performance of physical activity, exposure to air pollution, noise, heat, and access to green space were complied with. Estimations showed that the biggest share in preventable premature deaths was attributable to increases in physical activity, followed by exposure reductions in air pollution, traffic noise and heat. Access to green spaces had smaller direct effects on mortality. “Compliance was estimated to increase the average life expectancy by 360 days and result in economic savings of 9.3 billion € per year”, says Mueller.

According to the researchers, solutions to the physical inactivity and environmental exposure burden on mortality can be found in changes to urban and transport planning. Insufficient physical activity was associated with the largest excess mortality in Barcelona. “This highlights the urgency of integrating physical activity into daily life. Cycling, walking and public transport provide a great opportunity to do so, as these forms of transport provide coincidental health gains by increases in daily physical activity in an easy way” explains David Rojas-Rueda co-author of the study. The researchers further suggest that key strategies for air pollution, noise and heat mitigation are the reduction of motorized traffic through the replacement by zero and low-emitting modes of transport (i.e. active and public transport) and the provision of urban greening. “Despite suggested minor direct effects of green spaces on mortality, green spaces are an important urban and transport management tool. Green spaces can facilitate physical activity engagement and vegetation can act as a passive control of air pollution, is a natural noise barrier and provides shading and cooling of the surroundings”, specifies Mueller.

The researchers support the implementation of the proposed superblocks (superilles) as a measure to reduce private motor traffic and encourage active and public transport. Also the proposed expansions and improvements of the bicycle network and pedestrian areas as defined in Barcelona’s Urban Mobility Plan 2013-2018 are favored. Moreover, the Green Infrastructure and Biodiversity Plan 2020 proposed by the Barcelona City Council with the goals of preserving the city’s natural heritage and reinforcing its green infrastructure and biodiversity appears as a promising strategy to increase Barcelona’s greenery. “But more drastic actions may be needed such as replacing entire roads with green space. For example Via Laietana that currently separates the old neighborhoods of Gòtic and El Born, could be turned into a park”, says Mark Nieuwenhuijsen, coordinator of the study.

“We appeal to further consider the health impacts when designing cities and emphasize the need for the reduction of motorized traffic through the promotion of active and public transport and the provision of green infrastructure, as both are suggested to provide co-benefits of physical activity engagement and mitigation of air pollution, noise, and heat”, concludes Nieuwenhuijsen.


Natalie Mueller, David Rojas-Rueda, Xavier Basagaña, Marta Cirach, Tom Cole-Hunter, Payam Dadvand, David Donaire-Gonzalez, Maria Foraster, Mireia Gascon, David Martinez, Cathryn Tonne, Margarita Triguero-Mas, Antònia Valentín, Mark Nieuwenhuijsen. Urban and transport planning related exposures and mortality: a health impact assessment for cities. Environmental Health Perspectives, June 2016.

More information:

Green Infrastructure and Biodiversity Plan 2020

Program of Superblocks in Barcelona (Spanish version)

Barcelona’s Urban Mobility Plan 2013-2018