Urbanisation, climate change and health equity: how can health promotion contribute?

We live in a world that is constantly changing and is challenging established approaches to managing human and ecological health. Two key drivers of change are urbanisation and global climate change. This commentary is concerned with the interrelationship of these drivers with human and ecological health, proposing that health promotion practitioners need to actively seek a new role in the process of creating urban environments that support social and ecological well-being. It provides practitioners with an up-to-date synthesis of climate change science and future projections, the literature around the health impacts of climate change and potential health challenges to urban communities. We argue that health promotion cannot respond to the challenges created by climate change and urbanisation, nor can it meet its own mandate without shifting from an anthropogenic-focussed approach toward embracing a multi-scale, collaborative approach outside the health sector. We suggest that the underlying principles of health promotion, which include equity and community engagement at all scales, are critical to the evolution of thriving urban environments. Food security is given as an example to demonstrate the proposed shift away from an anthropogenic and urban focus toward a socio-ecological approach (i.e. resilience thinking) that provides a framework for collaboration between sectors working with unpredictable global systems. In so doing, the commentary provides practitioners with guidance on the complex science of climate change and its impact on health in urban settings, as well as highlighting the skills that they can bring to creating resilient urban settlements in these times of change.