Nearly 56% of the global population lives in cities, with this number expected to increase to 6.6 billion or >70% of the world’s population by 2050. Given that cardiometabolic diseases are the leading causes of morbidity and mortality in people living in urban areas, transforming cities and urban provisioning systems (or urban systems) toward health, equity, and economic productivity can enable the dual attainment of climate and health goals. Seven urban provisioning systems that provide food, energy, mobility-connectivity, housing, green infrastructure, water management, and waste management lie at the core of human health, well-being, and sustainability. These provisioning systems transcend city boundaries (eg, demand for food, water, or energy is met by transboundary supply); thus, transforming the entire system is a larger construct than local urban environments. Poorly designed urban provisioning systems are starkly evident worldwide, resulting in unprecedented exposures to adverse cardiometabolic risk factors, including limited physical activity, lack of access to heart-healthy diets, and reduced access to greenery and beneficial social interactions. Transforming urban systems with a cardiometabolic health–first approach could be accomplished through integrated spatial planning, along with addressing current gaps in key urban provisioning systems. Such an approach will help mitigate undesirable environmental exposures and improve cardiovascular and metabolic health while improving planetary health. The purposes of this American Heart Association policy statement are to present a conceptual framework, summarize the evidence base, and outline policy principles for transforming key urban provisioning systems to heart-health and sustainability outcomes.

中文翻译：

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迈向心脏健康和可持续发展的城市：美国心脏协会的政策声明

全球近 56% 的人口居住在城市，预计到 2050 年，这一数字将增至 66 亿，占世界人口的 70% 以上。鉴于心脏代谢疾病是城市地区居民发病和死亡的主要原因，将城市和城市供给系统（或城市系统）转变为健康、公平和经济生产力，可以实现气候和健康目标的双重目标。提供食品、能源、交通连接、住房、绿色基础设施、水管理和废物管理的七个城市供应系统是人类健康、福祉和可持续发展的核心。这些供给系统超越了城市边界（例如，对食物、水或能源的需求通过跨境供应来满足）；因此，改造整个系统是一个比当地城市环境更大的工程。设计不良的城市供应系统在全世界范围内都很明显，导致人们前所未有地暴露于不利的心脏代谢风险因素，包括体力活动有限、缺乏对心脏健康的饮食、以及减少接触绿色植物和有益的社会互动。通过综合空间规划以及解决关键城市供应系统中当前的差距，可以通过心脏代谢健康优先的方法来改造城市系统。这种方法将有助于减轻不良环境暴露，改善心血管和代谢健康，同时改善地球健康。美国心脏协会政策声明的目的是提出一个概念框架，总结证据基础，并概述将关键城市供应系统转变为心脏健康和可持续性成果的政策原则。