Nearly 30,000 people fall ill or die from environmental causes in Spain each year.

Sanitas and the University of Navarra, through its Chair Sanitas de Salud y Medioambiente, have prepared the report "Influencia del medioambiente urbano en la salud de las personas"(Influence of the urban environment on people's health). The study was carried out by the Biodiversity and Environment Institute (BIOMA) of the University of Navarra in partnership with Sanitas, to analyze how the different environmental parameters of Spanish cities influence people's health. 

Based on the One Health concept, which establishes that the health of people and the planet are linked, the study identifies the most relevant and urgent factors that must be taken into account and applied in urban planning policies. It is also expected that these results will contribute to promoting the healthy and sustainable design of cities, since, according to WHO data , 23% of global mortality is already a consequence of environmental factors, especially in urban environments.

"Any external factor is likely to affect people's health in fundamental areas such as cardiovascular, pulmonary or mental health. For this reason, it is essential to carry out preventive practices not only at the individual level, adopting healthy habits, but also through general policies to protect the environment," says Sonia Gutiérrez, director of Clinical Governance and teaching at Sanitas Hospitals and Bupa Peru.

"The study analyzed the impact of eight urban environmental parameters on the health of the population: air quality, extreme temperatures, green areas, urban mobility , water, noise pollution, light pollution and urban safety. And both the risks and the potential for improvement have been evaluated," according to Ana Sánchez-Ostiz, researcher at the BIOMA Institute and professor at the University of Navarra. Of these, the main conclusions were drawn from the so-called main parameters:

- Air quality. In Spain, air pollution is estimated to be the urban factor that has the greatest impact on health, and is manifested in diseases such as lung cancer, heart attacks and strokes.

- High temperatures and heat waves. In the summer of 2022 there were 11,000 deaths due to extreme heat in Spain. These figures are especially significant in the most vulnerable populations, the elderly, minors and the chronically ill.

-Green spaces. The lack of green spaces in cities generates problems such as stress, anxiety and obesity, and also has an impact on the mental and physical health of the inhabitants. For this reason, increasing the presence of trees in urban areas by 30% could prevent more than 2,600 deaths per year in Europe.

- urban mobility . promote the use of bicycles and walking in European cities not only reduces traffic, but could prevent up to 11% of deaths from cardiovascular disease. In addition, these measures have also been shown to help reduce pollution, improve sleep quality and reduce noise.

"As a health company, we work to promote a healthier society. To achieve this, it is essential that the environment in which we live is also healthy. For this reason, we have been working for years to reduce greenhouse gas emissions, improve our waste management and promote the health of people and the environment through various actions. The conclusions of this study, which has analyzed more than 200 scientific studies, remind us why it is important to continue on this path. The main finding is to prove, once again, that our health is at stake," explained Yolanda Erburu, Chief Sustainability & Corporate Affairs Officer of Sanitas and Bupa Europe and Latin America.

Harmony Index

The report "Influence of the urban environment on people's health" highlights that, in order to analyze the influence of the urban environment on people's health, it is important to consider several factors at the same time.

"It's not just about looking at air quality or the presence of green spaces. What we have identified is that these factors are mixed and affect health. Therefore, it is essential to work in an integral context," explained Jesús Miguel Santamaría, director of the BIOMA Institute and Full Professor at the University of Navarra.

To achieve this approach, researchers at the Biodiversity and Environment Institute BIOMA of the University of Navarra have created the Harmony index(Health and Risk Monitoring of Urban Environments), a monitoring system through which the weighted impact of the four main aggregate factors can be determined. It is estimated that air pollution, extreme temperatures, lack of green areas and unsustainable urban mobility could be associated with more than 28,200 cases of death and disease in Spain. Among the factors analyzed, air pollution stands out as the main contributor, with 89% of the average weight when calculating the Harmony index.

In second place are heat waves, with an impact on morbidity and mortality of 9.1%. If only morbidity is taken into account, in Spain, the weight of the factors air quality and heat waves reaches 44% and 47% respectively, which underlines the importance of addressing both factors in urban planning.

The report also outlines possible strategies to reduce the impact of each of these factors to make cities healthier and more sustainable.