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Publications

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Magazine publication cover

Increases In Women’s Political Representation Associated With Reductions In Child Mortality In Brazil

SALURBAL researchers assessed the effects of female political representation on mortality among children younger than age five in Brazil and the extent to which this effect operates through coverage with conditional cash transfers and primary care services.


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Pandemics, cities and Public Health

Published in the Revista Ambiente & Sociedade, SALURBAL researchers examined changes in air pollution in São Paulo, Brazil during the COVID-19 pandemic. The team found that in São Paulo, reduced economic activity and a reduction in vehicle circulation contributed to a reduction by over 10% in environmental PM2.5 (fine particulate matter) in April 2020 compared to previous years.


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Bicycle safety in Bogotá: A seven-year analysis of bicyclists’ collisions and fatalities

Road safety research in low- and middle-income countries is limited, even though ninety percent of global road traffic fatalities are concentrated in these locations. In Colombia, road traffic injuries are the second leading source of mortality by external causes and constitute a significant public health concern in the city of Bogotá. Bogotá is among the top 10 most bike-friendly cities in the world. However, bicyclists are one of the most vulnerable road-users in the city. This study aims to determine the spatiotemporal trends in fatal and nonfatal collision rates and to identify the individual and contextual factors associated with fatal outcomes.


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Building a Methodological Foundation for Impactful Urban Planetary Health Science

Anthropogenic environmental change will heavily impact cities, yet associated health risks will depend significantly on decisions made by urban leaders across a wide range of non-health sectors, including transport, energy, housing, basic urban services, and others. A subset of planetary health researchers focus on understanding the urban health impacts of global environmental change, and how these vary globally and within cities.This report presents observations from a participatory workshop focused on challenges and opportunities for urban planetary health research.


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Evaluating the health effects of place-based slum upgrading physical environment interventions: A systematic review (2012-2018)

Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and economic conditions linked to health outcomes. Summarizing and assessing evidence of the impact of prior interventions is critical to motivating and selecting the most effective upgrading strategies moving forward. Scientific and grey literature were systematically reviewed to identify evaluations of physical environment slum upgrading interventions in LMICs published between 2012 and 2018.


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Traffic stress publication cover

Level of traffic stress-based classification: A clustering approach for Bogotá, Colombia

The Level of Traffic Stress (LTS) is an indicator that quantifies the stress experienced by a cyclist on the segments of a road network. This publication proposes an LTS-based classification with two components: a clustering component and an interpretative component. The methodology is a useful tool for policy-making, as it identifies suitable areas for interventions; and can estimate their impact on the LTS classification, according to probable changes to the input variables.


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Health as driver for urban policy in Latin America: a scoping review of literature from international organizations

Understanding how health drives urban policies is critical for highlighting knowledge gaps and communicating evidence about health impacts to policymakers. This scoping review of grey literature examined the use of multiple health arguments and corresponding scientific evidence as justification for urban policies in Latin America. Generally, health arguments were generic, underdeveloped, healthcare-focused, and/or unfounded in scientific evidence. These findings highlight the need to more effectively communicate scientific evidence on the health impacts of urban policy.


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Revisión rápida: probabilidad de contagio por infecciones respiratorias agudas en el transporte público y medidas para mitigarlo

La publicación determina el nivel de evidencia sobre la probabilidad de transmisión de enfermedades respiratorias agudas en el transporte público, incluyendo transporte activo, identificando medidas en el uso del transporte público que pueden reducir la probabilidad de contagio por SARS-CoV-2 u otra infección respiratoria aguda de etiología viral.


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A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions

Urban transportation is an important determinant of health and environmental outcomes, and therefore essential to achieving the United Nation's Sustainable Development Goals. To better understand the health impacts of transportation initiatives, we conducted a systematic review of longitudinal health evaluations involving: a) bus rapid transit (BRT); b) bicycle lanes; c) Open Streets programs; and d) aerial trams/cable cars. We also synthesized systems-based simulation studies of the health-related consequences of walking, bicycling, aerial tram, bus and BRT use.


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TransMiCable Paper Cover

Urban Transformations and Health: Methods for TrUST—a Natural Experiment Evaluating the Impacts of a Mass Transit Cable Car in Bogotá, Colombia

TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. 


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Knowledge to Policy Translation for Urban Health

How can urban health research drive the development of evidence-based policies? Knowledge to Policy Translation for Urban Health: Lessons from Latin American Cities explores how knowledge about the links between urban environments and health can inform action to promote urban health and health equity and contribute to environmental sustainability. The document reviews challenges and opportunities related to knowledge to policy translation for urban health in Latin America and presents concrete actions for improving how the research community engages with policymakers and other actors. (February 2020)


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Assessing Google Street View Image Availability in Latin American Cities

This study identifies patterns of Street View image availability, image age, and image age variance across cities in Latin America and assesses relationships between these measures and measures of resident socioeconomic conditions.


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Inequalities in Life Expectancy in Six Large Latin American Cities

This study reveals important differences in life expectancy within ​six Latin American cities. The findings highlight the importance of developing urban policies focused on reducing social inequalities and improving social and environmental conditions in the poorest neighborhoods in the region.


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Commute patterns and depression: Evidence from eleven Latin American cities

Although travel behavior is expected to influence personal health, few studies have examined associations with mental health. This study examines associations between commute patterns and mental health using survey data in 11 Latin American cities. The findings provide preliminary evidence that better access to mass transit systems and less congestion may be linked to better mental health among urban residents.


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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases

Rising obesity and increasing recognition of the food environment's role in creating and addressing this challenge has led to increased attention on this topic within scientific literature in recent years. This study reviews literature describing the food environment in Latin America and policies targeting the food environment (FEP), as well as analytic studies that investigate associations between the FEP and dietary behaviors, overweight/obesity and obesity related chronic diseases. Findings suggest that health claims on food packaging are prevalent and mostly misleading; there is widespread use of marketing strategies for unhealthy foods aimed at children; and food prices are lower for processed relative to fresh foods. More work is needed to better understand policy impacts over time and the impacts of food prices and digital marketing on diet and health.


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Using community-based system dynamics modeling to understand the complex systems that influence health in cities: The SALURBAL study

This article describes the design, implementation, and results of a collaborative process designed to elucidate the complex systems that drive food behaviors, transport, and health in Latin American cities and to build capacity for systems thinking and community-based system dynamics (CBSD) methods among diverse research team members and stakeholders. During three CBSD workshops, 62 stakeholders from 10 Latin American countries identified 98 variables and a series of feedback loops that shape food behaviors, transportation and health, along with 52 policy levers. Our findings suggest that CBSD can engage local stakeholders, help them view problems through the lens of complex systems and use their insights to prioritize research efforts and identify novel solutions that consider mechanisms of complexity.


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A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC-Urban Health and SALURBAL

This article describes the origins and characteristics of an interdisciplinary multinational collaboration aimed at promoting and disseminating actionable evidence on the drivers of health in cities in Latin America and the Caribbean: The Network for Urban Health in Latin America and the Caribbean and the Wellcome Trust funded SALURBAL (Salud Urbana en América Latina, or Urban Health in Latin America) Project. Both initiatives have the goals of supporting urban policies that promote health and health equity in cities of the region while at the same time generating generalizable knowledge for urban areas across the globe. The processes, challenges, as well as the lessons learned to date in launching and implementing these collaborations, are described. By leveraging the unique features of the Latin American region (one of the most urbanized areas of the world with some of the most innovative urban policies), the aim is to produce generalizable knowledge about the links between urbanization, health, and environments and to identify effective ways to organize, design, and govern cities to improve health, reduce health inequalities, and maximize environmental sustainability in cities all over the world.


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Complex Systems Approaches to Diet: A Systematic Review

Complex systems approaches can help to elucidate mechanisms that shape population-level patterns in diet and inform policy approaches. This study reports results of a structured review of key design elements and methods used by existing complex systems models of diet.


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Cover page of the data brief

Data in the SALURBAL Project

Data in the SALURBAL Project provides an overview of the process of selecting cities, compiling data, and the types of questions the dataset may help to answer. The document was developed to inform future SALURBAL studies and to receive feedback from stakeholder working in urban health in the region regarding how SALURBAL research can support their efforts.


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Building a Data Platform for Cross-Country Urban Health Studies: the SALURBAL Study

Studies examining urban health and the environment must ensure comparability of measures across cities and countries. We describe a data platform and process that integrates health outcomes together with physical and social environment data to examine multilevel aspects of health across cities in 11 Latin American countries. We used two complementary sources to identify cities with ≥ 100,000 inhabitants as of 2010 in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. We defined cities in three ways: administratively, quantitatively from satellite imagery, and based on country-defined metropolitan areas. In addition to "cities," we identified sub-city units and smaller neighborhoods within them using census hierarchies. Selected physical environment (e.g., urban form, air pollution and transport) and social environment (e.g., income, education, safety) data were compiled for cities, sub-city units, and neighborhoods whenever possible using a range of sources. Harmonized mortality and health survey data were linked to city and sub-city units. Finer georeferencing is underway. We identified 371 cities and 1436 sub-city units in the 11 countries. The median city population was 234,553 inhabitants (IQR 141,942; 500,398). The systematic organization of cities, the initial task of this platform, was accomplished and further ongoing developments include the harmonization of mortality and survey measures using available sources for between country comparisons. A range of physical and social environment indicators can be created using available data. The flexible multilevel data structure accommodates heterogeneity in the data available and allows for varied multilevel research questions related to the associations of physical and social environment variables with variability in health outcomes within and across cities. The creation of such data platforms holds great promise to support researching with greater granularity the field of urban health in Latin America as well as serving as a resource for the evaluation of policies oriented to improve the health and environmental sustainability of cities.


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Health in All Urban Policies cover

Health in All Urban Policies

Health in All Urban Policies: Lessons from Latin American Cities outlines the core principles of a Health in All Policies (HiAP) approach to understanding how urban environments affect health, and how urban policies and interventions across sectors can impact the health of people living in cities. This policy brief was co-produced by the SALURBAL project in collaboration with the Pan American Health Organization (PAHO) and describes initiatives by each organization to advance HiAP implementation. The 12-page booklet provides an introduction to key concepts related to HiAP, research and evidence to support this approach, and recommendations for policymakers and for the academic community for leveraging action across sectors to promote health, equity, and environmental sustainability. 


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Cover page of the SALURBAL mortality and life expectancy data brief

Mortality and Life Expectancy in Latin American Cities

Life expectancy and causes of death vary greatly across urban areas in Latin America, and global and regional summaries of life expectancy and causes of death can hide significant variability across cities. Urban environments that differ across neighborhoods, cities, and countries can have a major impact on life expectancy and causes of death. Mortality and Life Expectancy in Latin American Cities presents the experiences of the SALURBAL project in harmonizing and describing mortality data across 366 cities in 10 countries.


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Planning Health Evaluations of Housing and Neighborhood Interventions

Planning Health Evaluations of Housing and Neighborhood Interventions: Lessons from Latin America​ discusses opportunities to integrate health evaluations into the design and implementation of urban policies. Housing and neighborhood interventions can be important interventions that deliver packaged benefits to improve urban health and well-being, but more evidence is needed regarding their effects under different conditions and the pathways underlying these effects to inform policy changes. The policy brief details potential health effects and evaluation designs, recommendations for intersectoral planning, and shares three case studies of current evaluations from the SALURBAL project.


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Cover image of Food and Urban Health brief

Food and Urban Health

Food and Urban Health: Lessons from Latin America presents leading challenges in urban nutrition in the context of demographic changes, poverty, and markets and regulations. The policy brief describes mechanisms that can be implemented to affect food-related behaviors and consumption, and highlights innovative policies, laws, and programs from the region. Recommendations build upon best regional practices and suggest integrated and intersectoral responses.


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Photo of the cover page of the sustainable transport policy brief

Sustainable Transport and Urban Health

Sustainable Transport and Urban Health: Lessons from Latin American Cities explores strategies and interventions from throughout the region that support active transport and mobility in cities. The policy brief gives an overview of the key areas of transportation policies, regional trends, case studies of policies in major cities, and discusses the contributions of Latin America to global efforts in urban policies and health. 


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