411© The Au ho (s) 2019
M. R. Ma selle e al. (eds.), Biodi e si y and Heal h in he Face o Clima e
Change, h ps://doi.o g/10.1007/978-3-030-02318-8_18
Chap e 18
Resilience Managemen o Heal hy Ci ies
inaChanging Clima e
ThomasElmq is , F anzGa zweile , Elisabe Lindg en, andJielingLiu
Abs ac Ci ies a e expe iencing mul iple impac s om global en i onmen al
change, and he deg ee o which hey will need o cope wi h and adap o hese chal-
lenges will con inue o inc ease. We a gue ha a ‘complex sys ems and esilience
managemen ’ iew may signi ican ly help guide u u e u ban de elopmen h ough
inno a i e in eg a ion o , o example, g ey, blue and g een in as uc u e embedded
in lexible ins i u ions (bo h o mal and in o mal) o mul i- unc ionali y and
imp o ed heal h. Fo ins ance, he u ban hea island e ec will u he inc ease ci y-
cen e empe a u es du ing p ojec ed mo e equen and in ense hea wa es. The
elde ly and people wi h ch onic ca dio ascula and espi a o y diseases a e pa icu-
la ly ulne able o hea . In eg a ing ege a ion and especially ees in he u ban
in as uc u e helps educe empe a u es by shading and e apo anspi a ion. G ea
complexi y and unce ain y o u ban social-ecological sys ems a e behind his
hea wa e- heal h nexus, and hey need o be add essed in a mo e comp ehensi e
manne . We a gue ha a sys ems pe spec i e can lead o inno a i e designs o new
u ban in as uc u e and he edesign o exis ing s uc u es. Pa icula ly o p omo -
ing he in eg a ion o g ey, g een and blue in as uc u e in u ban planning h ough
ins i u ional inno a ion and s uc u al eo ganiza ion o knowledge-ac ion sys ems
may signi ican ly enhance p ospec s o imp o ed u ban heal h and g ea e esil-
ience unde a ious scena ios o clima e change.
Keywo ds Resilience managemen · Na u e-based solu ions · U ban heal h ·
Clima e change · U ban complexi y · Knowledge-ac ion sys ems
T. Elmq is (*) · E. Lindg en
S ockholm Resilience Cen e , S ockholm Uni e si y, S ockholm, Sweden
e-mail: [email p o ec ed]; [email p o ec ed]
F. Ga zweile
Ins i u e o U ban En i onmen (IUE), Chinese Academy o Sciences (CAS), Xiamen, China
e-mail: [email p o ec ed]
J. Liu
Ins i u e o Social Sciences (ICS), Uni e si y o Lisbon, Lisbon, Po ugal
e-mail: [email p o ec ed]
412
Highligh s
• Ci ies a e expe iencing mul iple impac s om global en i onmen al change.
• A sys ems pe spec i e can lead o inno a i e designs o new u ban in as uc u e
and he edesign o exis ing s uc u es o add ess complex u ban heal h
challenges.
• The in eg a ion o g ey, g een and blue in as uc u e in u ban planning h ough
ins i u ional inno a ion and s uc u al eo ganiza ion o knowledge-ac ion sys-
ems may esul in la ge heal h imp o emen s and inc ease u ban esilience.
18.1 In oduc ion
U ban heal h and well-being is an ou come o u ban complexi y. In his chap e we
a gue ha ci ies a e complex adap i e social-ecological- echnological sys ems, a
pe spec i e needed in o de o un angle his complexi y and de ine he ypes o
p oblems we a e con on ed wi h (Albe i e al. 2018). By aming complexi y con-
cep ually we sugges pa hways o u ban go e nance o u ban heal h and well-
being, pa hways ha add ess p oblems o g ea scien i ic and economic complexi y
and adical unce ain y, o which clima e change is a p ime example. One example
o such a pa hway is using mul iple ecosys em se ices as a means o c ea e esil-
ience o clima e change in ci ies and hus educe nega i e impac s onheal h and
well-being, o so-called ‘na u e-based solu ions’ (NBSs) (Sec e a ia o he
Con en ion on Biological Di e si y 2009), such as he ‘Sponge Ci y’ ini ia i e o
lood wa e ea men cu en ly aking place in China and he g een oo design
h i ing ac oss many Eu opean ci ies. Whe eas echnology can be help ul o sol -
ing complica ed enginee ing p oblems by seeking solu ions o op ima and equilib-
ia, complex o inexac p oblems equi e he ecogni ion o deep unce ain y and
non-linea i y.
18.1.1 U ban Sys ems asComplex Adap i e Sys ems
A social- echnological app oach has, up un il now, been he adi ional way o ana-
lyzing u ban complexi y (e.g. Geels 2011; Hodson and Ma in 2010), and in his
con ex , many ha e s uggled o de ine exac ly wha is mean by a ci y. He e we
expand on an eme ging amewo k o ci ies as complex social-ecological-
echnological sys ems, as ci ies include much mo e han a pa icula densi y o peo-
ple o a ea co e ed by human-made s uc u es (Bai e al. 2016; Albe i e al. 2018).
Ci ies a e places whe e social, ecological and echnological sys ems connec
and in eg a e; whe e a ious ypes o capi al and in as uc u es in e sec in
mul i- dimensional spaces; and whe e connec i i y, in e ac ion, exchange and com-
munica ion accele a e in ime. U ban socio-ecological- echnological sys ems a e
T. Elmq is e al.
413
complex and dynamic because mul iple agen s om a ious ypes o ne wo ks
in e ac wi h each o he and hei en i onmen s, and on mul iple scales (Table18.1).
The heal h and well-being ou comes ha eme ge om hese complex adap i e sys-
ems a e no en i ely plannable (Albe i e al. 2018).
U ban sys ems (which include social, echnological and ecological dimensions)
p o ide unc ions (Table18.1) ha a e simila bu no iden ical o hose p o ided by
ecosys ems (Ga zweile e al. 2016, 2018).
A key di e ence be ween u ban and na u al ecosys ems is ha mos goods and
se ices in u ban sys ems a e p oduced by people and a e a esul o seconda y
p oduc ion, while na u al ecosys ems consis o p ima y (au o oph) and seconda y
p oduce s. Ne e heless, ecognizing ci ies as complex adap i e sys ems ha p o-
ide nume ous ca ego ies o unc ions (Table18.1) is he basis o esilience man-
agemen o heal hy ci ies in he con ex o clima e change.
Table 18.1 Func ions o u ban sys ems
Func ion Desc ip ion
Suppo ing Bene i s p o ided by physical space (habi a ) and in as uc u e o basic li e
suppo unc ions such as was e managemen , wa e ea men and sani a ion, and
ene gy p o ision (elec ici y). Enables he low o ene gy (cap u ed in he o m o
low-en opy goods) and in o ma ion. They a e necessa y o all o he unc ions o
be p oduced. Ma ke s some imes equi e physical space o exchange, bu ma ke
exchange can also ake place in i ual spaces
P o isioning Bene i s de i ed om p o iding manu ac u ed goods and knowledge, and
p o iding in as uc u e o access o wa e , ene gy, ood, anspo a ion, social
in e ac ion and ma ke exchange o main ain he popula ion’s heal h, in e nal
s uc u e, p ocedu es and p ocesses; e.g. (p ocessed) ood, (pu i ied) d inking
wa e , cons uc ion ma e ials, machines, a i ac s (e.g. u ni u e, bicycles),
educa ion and knowledge in as uc u e (uni e si ies)a
Regula ing Bene i s de i ed om p o iding ules and egula ion mechanisms o keep he
in as uc u e unning; e.g. egula ing access o social space, legal sys ems and
ma ke s (al hough no exclusi e o u ban a eas, hei signi icance may o en be
highe he e because o highe ins i u ional densi y and economic ac i i y in u ban
a eas).The means a e laws, no ms, coope a i es, law en o cemen , disease and
disas e managemen and eme gency esponse sys ems, hospi als and heal h
se ice sys ems, and en i onmen al p o ec ion agencies
Cul u al Bene i s p o ided o humans in ci ies ha a e c ea ed in socio-cul u al spaces
(again no exclusi e o ci ies). Social space and libe ies o economic and
poli ical exchange, exchange o ideas, social exchange, ec ea ion and leisu e,
space o spi i ual en ichmen , a and cogni i e de elopmen ; e.g. cul u al e en s,
“Heima ” (sense o belonging), exhibi ions, lib a ies, cul u al he i age alues (e.g.
his o ical places), cul u al di e si y
aNo e: The aw ma e ials and na u al esou ces, like oil, gas and wood, a e also used di ec ly in
ci ies; howe e , ha is a he a p o isioning unc ion o na u al ecosys ems
18 Resilience Managemen o Heal hy Ci ies inaChanging Clima e
414
18.1.2 U ban Complexi y, Sus ainabili y andGo e nance
The complexi y o u ban sys ems poses eno mous challenges o sus ainabili y in
iden i ying causal mechanisms because o he many con ounding a iables ha
exis . A he same ime, scien i ic indings om empi ical s udies a e di icul o
gene alize due o a ia ions in socio-economic and biophysical con ex s, and he
g ea he e ogenei y ha cha ac e izes u ban egions (G imm e al. 2008). Key chal-
lenges a e scale misma ches, c oss-scale in e ac ions and limi ed ans e abili y
ac oss scales (Cumming e al. 2012). Fu he mo e, he limi ed p edic abili y o sys-
em beha iou o e he long e m equi es a new conside a ion o unce ain y
(Polasky e al. 2011).
The esea ch and applica ion o u ban sus ainabili y p inciples ha e un il now
a ely been applied beyond ci y bounda ies and a e o en cons ained o ei he single
o na owly de ined issues (e.g. popula ion, clima e, ene gy, wa e ) (Ma co ullio
and McG anahan 2007; Sei zinge e al. 2012). Al hough local go e nmen s o en
aim o op imize esou ce use in ci ies, inc ease e iciency and minimize was e, ci ies
can ne e become ully sel -su icien . The e o e, indi idual ci ies canno be con-
side ed ‘sus ainable’ wi hou acknowledging and accoun ing o hei dependence
on he na u al ecosys ems, esou ces and popula ions om o he egions a ound he
wo ld (Folke e al. 1997; Sei zinge e al. 2012). Consequen ly, he e is a need o
e isi he concep o sus ainabili y, as i s na ow de ini ion and applica ion may no
only be insu icien bu can also esul in unin ended consequences, such as he
‘lock-in’ o undesi able u ban de elopmen ajec o ies (E ns son e al. 2010).
Go e nance ailu es and hei nega i e ou comes can a leas pa ly be unde -
s ood as he esul o a cons ained abili y and willingness o unde s and he dynam-
ics o u ban complexi y. Go e ning dynamic complex u ban sys ems o imp o ing
u ban heal h and well-being, he e o e, equi es a be e unde s anding o u ban
sys em complexi y and he ins i u ions ha inhibi o enable solu ion-o ien ed
ac ions (c . Dui and Galaz 2008).
The dynamics and empo ali y o changes o a sys em de e mine adap i e go e -
nance s yles. Unde sho - e m shocks o longe - e m s esses he s yles o ac ion
can be con ol-o ien ed o adap i e (Fig.18.1). Con ol-o ien ed s yles o go e nance
Fig. 18.1 Go e nance
s yles a e de e mined by
con ol and adap i e s yles
o ac ion and how he
empo ali y o sys em
changes is pe cei ed.
(Modi ied om Leach
e al. 2010)
T. Elmq is e al.
415
assume less unce ain y and mo e calculable isks. Unde such go e nance, s abili y
(agains shocks) o endu ance (agains s esses) o a sys em a e belie ed o be main-
ained o es o ed by ac ions o con ol and o de . Recognizing he inhe en unce -
ain y o complexi y also acknowledges limi s o a con ol-s yle o go e nance.
Managing he esilience o an u ban sys em o heal h depends on how sys em
changes a e pe cei ed and on whe he con olled o adap i e, lexible ac ions a e
pe o med (Fig.18.1). The co-p oduc ion o knowledge o u ban heal h esilience
managemen and in eg a ed sys ems o lexible go e nance o u ban heal h a e
esponses o u ban complexi y and an a emp o ha ness i o sus ainabili y.
The Wo ld Heal h O ganiza ion’s Global Ou b eak Ale and Response Ne wo k1
is an example o go e nance s a egies o esilience. I is se up o espond o unp e-
dic able ex e nal shocks (ou b eaks) wi h a lexible esponse ne wo k ha can be
mobilised when needed. Ano he example o esilience managemen o heal h is
he Epidemic In elligence and ou b eak esponses p o ided by he Eu opean Cen e
o Disease P e en ion and Con ol (ECDC) o he EU Membe S a es. ECDC con-
inuously moni o s and assesses epidemic ou b eaks in he EU egion. In case o
eme gencies and esponse needs, ECDC p o ides bo h assessmen missions and
di e en le els o epidemic esponse ac ions. An example o in eg a ed, lexible
sys ems go e nance o u ban heal h in he con ex o clima e change a e he u ban
Knowledge-Ac ion Sys ems (KAS) analysed by Muñoz-E ickson e  al. (2017).
KAS a e social ne wo ks o ac o s in ol ed in he p oduc ion, sha ing and use o
knowledge o ac ion and all o he ypes o in as uc u e, acili a ing he low o
esou ces, including da a and knowledge, and he eby enabling eedback, esponse
and lea ning o ac ion. Such KAS, once ins i u ionalised as an o ganisa ional en i y,
could be e e ed o as he collec i e mind o a ci y, o he ‘u ban b ain’. An example
is he Sou heas Flo ida Regional Clima e Compac ,2 which came oge he o
upg ade hei esilience knowledge sys ems o clima e adap a ion.
18.1.3 U ban Complexi y andResilience
When people hink o u ban esilience, i is gene ally in he con ex o esponse o
sudden impac s, such as a haza d o disas e eco e y (see Albe i e al. 2003; Albe i
and Ma zlu 2004; Vale and Campanella 2005; Cu e e al. 2008; Wallace and
Wallace 2008). Howe e , he esilience concep goes a beyond eco e y om sin-
gle dis u bances, as demons a ed by he abo e example o knowledge-ac ion
sys ems. Resilience is a mul i-disciplina y concep ha explo es pe sis ence, eco -
e y, and adap i e and ans o ma i e capaci ies o in e linked social and ecological
sys ems and subsys ems (Holling 2001; Folke e al. 2002; Walke e al. 2004; Biggs
e al. 2012).
1 h ps://ex ane .who.in /goa n/
2 h p://www.sou heas lo idaclima ecompac .o g/abou -us/wha -is- he-compac /
18 Resilience Managemen o Heal hy Ci ies inaChanging Clima e

416
Resilience hinking is pa o sys ems hinking in complexi y science, and has
wo cen al oci: one is o s eng hen he cu en social-ecological- echnological
sys em o li e wi h change by enhancing he abili y o adap o po en ial ex e nal
p essu es, in o de o e ain i s essen ial unc ions and iden i y; he o he is he abil-
i y o shi de elopmen pa hways om hose ha a e less desi able o unsus ainable
o ones ha a e mo e desi able o sus ainable –also e e ed o as ans o mabili y
(Walke e al. 2004; Folke e al. 2010).
A dis inc ion is o en made be ween gene al esilience and speci ied esilience
(Walke and Sal 2006). Gene al esilience e e s o he esilience o a sys em o all
kinds o shocks, including no el ones, whe eas speci ied esilience e e s o he
esilience ‘o wha , o wha ’– in o he wo ds, esilience o some pa icula pa o a
sys em ( ela ed o a pa icula con ol a iable) o one o mo e iden i ied kinds o
shocks (Walke and Sal 2006; Folke e al. 2010). While sus ainable de elopmen is
inhe en ly no ma i e and posi i e, his is no necessa ily ue o he esilience con-
cep (Picke e al. 2013). Fo example, de elopmen may lead o aps ha a e e y
esilien and di icul o b eak ou o . The desi abili y o speci ied esilience, in
pa icula , depends on ca e ul analysis o esilience ‘o wha , o wha ’ (Ca pen e
e al. 2001) since many examples can be ound o highly esilien sys ems (e.g.
opp essi e poli ical sys ems) locked in o an undesi able sys em con igu a ion o
s a e. I also may e e ‘ o whom’ as a ecogni ion o en i onmen al inequi y (e.g.
Picke e al. 2011).
In gene al, bo h he sus ainabili y and he esilience concep s (pa icula ly gen-
e al esilience) a e no easily applicable o he ci y scale (Elmq is e al. 2013a).
Ci ies a e cen es o p oduc ion and consump ion, and u ban inhabi an s a e elian
on esou ces and ecosys em se ices– including e e y hing om ood, wa e and
cons uc ion ma e ials o was e assimila ion– secu ed om loca ions ou side o ci -
ies. Al hough ci ies can op imize hei esou ce use, inc ease hei e iciency and
minimize was e, hey can ne e become ully sel -su icien (G o e 2009). Fo ha
eason, i is no su icien o de-couple ci ies om esou ce use (UNEP 2013), a he ,
ci ies need o be e-coupled wi h he egional and global ecosys ems in which hey
a e con ained (Zhu e al. 2017). The e o e, indi idual ci ies canno be conside ed
“sus ainable” wi hou acknowledging and accoun ing o hei eleconnec ions
(Se o e al. 2012)– in o he wo ds, he long-dis ance dependence and impac on
ecosys ems, esou ces and popula ions in o he egions a ound he wo ld (Folke
e al. 1997).
Vi ually all li ing sys ems om he local o he global scale a e open and in e -
connec ed ne wo ks. To achie e esilience o u ban heal h, he e is a need o be e
unde s and he heal h and well-being e ec s o in e en ions a mul iple scales o
complex u ban sys ems (B els o d e al. 2017). Fu he , as Ma kelo a and Mwangi
(2012) poin ou , e e ing o Cash and Mose (2000), i is necessa y o asce ain he
app op ia e scale o e alua ing bene i s om complex sys ems, and choosing he
app op ia e scale depends on nume ous ac o s such as he speci ic objec i es o a
s udy, he le el o accu acy, and he alue sys em chosen by he e alua o . In addi-
ion, in e en ions will no be e ec i e “when a pa icula p oblem issue is managed
T. Elmq is e al.
417
a an ins i u ional scale whose au ho i a i e each does no co espond wi h he geo-
g aphical scale o pa icula spa ial dynamics o a (…) p oblem”.
Howe e , despi e he complex na u e o u ban sys ems, he e exis ela i ely
simple uni e sal laws ha a e use ul o be awa e o when designing sys ems o go -
e nance o u ban heal h esilience. One e e s o he u ban scaling e ec and simi-
la ly coun s o li ing o ganisms. I says ha he bigge he o ganisa ion becomes,
he less ene gy pe capi a is needed. Fo ci ies, his means ha wi h a doubling o
popula ion size, ene gy supply, o example, inc eases sublinea ly by 85% (one pe -
ol s a ion can se e mo e people), implying an economy o scale sa ings e ec o
15% o ene gy and in as uc u e. Wi h ega d o a e age wages, he amoun o
c ime and incidence o in ec ious diseases, he numbe o pa en s p oduced, o he
numbe o es au an s, he e is a supe linea scaling e ec o 1.15, mani es ing sys-
ema ic inc easing e u ns o scale (Wes 2017, Be encou e al. 2010).
18.2 Clima e Change Agg a a ing Exis ing U ban
Complexi y
Demog aphic and echnological changes ha e esul ed in an h opogenic o ces on
he clima e sys em, g ea ly exace ba ing he low o ene gy and ma e ials wi hin
u ban sys ems, inc easing he complexi y le els o u ban sys ems and hei unc-
ions. In addi ion, clima e change agg a a es he complexi y o u ban sys ems by
imposing di ec and indi ec impac s on he u ban sys em a iables and hei unc-
ions. Clima e change e ec s include inc eased in ensi ies and equency o ain all,
d ough s, s o ms and hea wa es, due o wa me sea and land su ace empe a u es,
ising sea le els and educ ion o albedo, which u he exace ba es he wa ming,
and a ange o clima e unce ain y. These e ec s challenge he sensi i i y o each
a iable o he u ban social-ecological sys ems and subsys ems (da Sil a e al.
2012). The geo-demog aphical change shows an o e all end o inc easing popula-
ion in inc easingly mul i- and in e cul u al u ban a eas, which challenges he
al eady p eca ious concep o sus ainabili y o u ban sys ems. The di e en magni-
udes o clima e change, he e o e, accele a e and complica e bo h he gene al and
speci ied esilience o u ban sys ems o mul iple scales.
Resilience as a concep has been a gued equen ly o he case o clima e change
o he easons p esen ed abo e. I is also p ima ily e e ed o as he adap a ion o
clima e change impac s. As u ban sys ems a e composed o complex en i onmen s
in which ecological, social, cul u al and economic ac o s in e ac on mul iple scales
and ac oss di e en subsys ems, clima e change imposes no only di ec impac s on
he g ey, g een and blue in as uc u e in u ban sys ems, basic li e suppo unc ions
and manu ac u ed goods, such as ood, wa e , ene gy, anspo a ion and hei man-
agemen and p o ision, bu also indi ec impac s on he heal h and well-being o
u ban dwelle s. The e o e, we a gue ha heal h should be an end goal o clima e
change adap a ion and a p oxy o examine he le el o esilience o complex u ban
18 Resilience Managemen o Heal hy Ci ies inaChanging Clima e
418
social-ecological- echnological sys ems. Comp ehensi ely acknowledging he
alue o ecosys em se ices, inco po a ing hem in o u ban planning p ac ices o
clima e change impac s, and ins i u ionalizing his p ocess can help us achie e his
end goal.
18.3 Clima e Change, U ban Ecosys ems andHeal h
Despi e he ac ha “…human heal h is be e now han a any ime in his o y…”
(Haines 2018), his p og ess has come a social and en i onmen al cos s such as
inc easing inequali y, inc easing ene gy use and ela ed g eenhouse gas emissions,
soil deg ada ion, biodi e si y loss and se e e wa e s ess. Toge he wi h inc easing
u ban popula ion p essu es, his mix u e can become a backlash o wha we may
pe cei e as p og ess in human de elopmen . In 2012 app oxima ely 7million peo-
ple died p ema u ely as a esul o exposu e o ai pollu ion, making ai pollu ion he
wo ld’s la ges single en i onmen al heal h isk. Despi e imp o ed a ailabili y o
heal h sys ems and o he public se ices, u ban heal h isks emain: exposu e o
noise, wa e and ai pollu ion, diseases ela ed o u ban li es yle, con agious dis-
eases connec ed wi h c owding (e.g. ube culosis, sexually ansmi ed diseases,
in luenza, and ce ain oden - and ec o -bo ne diseases such as dengue e e , e c.),
and isks associa ed wi h homelessness, iolence and inequali y. Unde s anding he
complex in e ac ions o clima e change, u ban sys em unc ions and heal h has been
iden i ied as a esea ch p io i y o ci ies in he u u e (Bai e al. 2018).
Clima e change will ha e nume ous impac s on human heal h and well-being in
u ban en i onmen s depending on local condi ions and ulne abili ies. The isk o
dea hs, inju ies and epidemics (especially wa e -, ood-, oden - and ec o -bo ne
diseases) om s o ms, coas al s o m su ges and loods will inc ease in disas e -
p one a eas, exace ba ed by damages o impo an in as uc u e and socie al se -
ices. Ci ies a e pa icula ly ulne able o hea wa es since empe a u es in ce ain
pa s o a ci y can each se e al deg ees highe han in su ounding pe i-u ban and
u al a eas, due o he so-called u ban hea island e ec (Zhang e al. 2017). I has
been shown ha he isk bo h o dea h and o acu e episodes o ch onic diseases,
such as acu e espi a o y illness, hea a acks and s oke, inc eases ma kedly in
ela ion o hea wa e e en s (Michelozzi e al. 2009). The elde ly, pe sons wi h
ch onic ca dio- ascula and espi a o y diseases, and indi iduals who ha e di icul-
ies implemen ing hea - educing ac ions du ing a hea wa e a e pa icula ly ulne -
able, and so a e ou doo wo ke s in ci ies whe e empe a u es may soa du ing
wo king hou s (IPCC 2014; Ko a s and Haja 2008). I is well known ha ai pollu-
ion inc eases he isks associa ed wi h hea , and ice e sa, which u he inc eases
heal h isks om hea wa es in ci ies.
The u ban ecosys em se ice and u ban social-ecological- echnological app oach
ha e ecen ly de eloped in o se e al p og ams explo ing he scope and po en ial o
T. Elmq is e al.
419
na u e-based solu ions (Kabisch e al. 2016). Na u e-based solu ions a e ac ions ha
a e inspi ed by, suppo ed by o copied om na u e, and o en wi h he po en ial o
add ess a a ie y o socie al challenges in sus ainable ways, and con ibu e o g een
g ow h (EU DG Resea ch and Inno a ion 2015). Na u e-based solu ions o sus ain-
able u baniza ion ely in la ge pa on na u al a eas and ea u es in and a ound ci ies
o pe o m essen ial ecosys em se ices. This concep may also be used in clima e
change adap a ion o educe clima e change- ela ed impac s on heal h (Gill e al.
2007), o o gain heal h co-bene i s om clima e change adap a ion wi hin o he
sec o s o socie y.
U ban g een a eas and ege a ion can educe some o he en i onmen al heal h
isks wi hin he u ban sys ems (Elmq is e al. 2013b). U ban g een and wa e a eas,
such as ci y ga dens and ponds, and nea by o es s, lakes and sea, ha e a s ong
po en ial o locally bu e hea ex emes (Ha din and Jensen 2007). In summe ime,
high empe a u es a e abso bed by wa e a eas. G eene y, in pa icula ees, e lec s
sola adia ion and lowe empe a u es locally h ough e apo anspi a ion and shad-
ing (Bowle e al. 2010). By inc easing u ban ege a ion h ough he plan ing o
ees, c ea ing pa klands, g een oo ops, g een walls, and so on, local empe a u es
in ci ies can be be e egula ed and main ained. U ban g eene y has also been
shown o be e ec i e in educing ai pollu an s such as pa icles and ni ogen and
sulphu oxides (Ha ig e al. 2014).
No only do u ban g een and blue a eas educe heal h isks associa ed wi h high
empe a u es and ai pollu an s, bu u ban ege a ion also con ibu es o educe
lood- ela ed heal h isks. Vege a ion s abilizes he soil and educes su ace uno
ollowing p ecipi a ion e en s. Keeping o adding ege a ion will dec ease he isk
o landslides, as well as he p essu e on d ainage sys ems a ound human se le-
men s. By inc easing he ege a ion co e and educing he impe meable su ace
a ea in buil en i onmen s, he olumes o su ace s o m-wa e uno can dec ease,
hus inc easing he esilience o looding. Inc eased u ban g een space will hus
inc ease pe meabili y and wa e uno mi iga ion, as well as dec ease lood isk by
in e cep ing ainwa e (Pa aki e al. 2011).
In addi ion, u ban ege a ion has o he bene icial heal h e ec s. Se e al s udies
ha e shown ha ege a ion con ibu es o educing noise pollu ion and c ea ing
anquil en i onmen s o conduci e o men al heal h (González-O eja e al. 2010).
U ban g een a eas and ege a ion suppo and acili a e human heal h and well-
being by alle ia ing s ess and allowing space o physical ac i i y and communi y
in e ac ion, which sus ain men al heal h, physical i ness and cogni i e and immune
unc ions (WHO 2017).
As he undamen al ecological base o u ban social-ecological sys ems, biodi e -
si y and ecosys em se ices play a signi ican ole in educing he nega i e impac s
o clima e change on heal h, bo h a p esen and in he u u e, he e o e educing
ulne abili y and s eng hening esilience o he u ban sys ems and subsys ems.
18 Resilience Managemen o Heal hy Ci ies inaChanging Clima e