Complex Urban Systems for Sustainability and Health: A structured approach to support the development and implementation of city policies for population and planetary health

Context: The multi-disciplinary and multi-partner CUSSH project (Complex Urban Systems for Sustainability and Health) seeks to support cities to take transformative action towards population and planetary health goals. Rationale: As all cities are complex systems with unique contexts and priorities, our approach is to engage with partner cities in a participatory process to build a shared understanding of relevant systems that will inform the development and implementation of new city policies. Description: Six partner cities were selected to represent larger and smaller cities from across the global spectrum of income: London (UK) and Rennes (France) in Europe, Nairobi and Kisumu in Kenya, and Beijing and Ningbo in China. In each setting we are engaging stakeholders in a broadly similar structured approach that integrates evidence gathering and modelling, participatory engagement framework, and ongoing tracking and evaluation. In addition, we are developing a working theory of change in each setting to explain how and why the chosen policies may work. Achievements: Our city engagement to date has focused on indoor air pollution (Nairobi), green infrastructure (London) and GHG emissions (Rennes), where findings highlighted not only multiple pathways by which policy interventions could affect health, but also potential counter-intuitive influences and tensions, and synergistic opportunities for solving both sustainability and health problems.