Research & Innovation 2015-16 - Page 63



Thought leader
the impact on, and consequences of, the urbanisation
process on the multidimensional determinants of
health in order to intervene effectively.
The UN sustainable development goal (SDG) 3
aims to ensure healthy lives and promote wellbeing for all at all ages. While this is the only
explicit health goal, almost all of the other goals
relate or contribute to health. This includes the
targets of fostering healthier cities (SDG 11)
and preventing disease through safe water and
sanitation (SDG 6). This recognises that the health
sector is but one player in health and human
development; action that involves a number of
sectors and takes into account the needs of the
whole of society is therefore a key strategy to
addressing societal challenges that will improve
health and well-being.
South Africa is the most urbanised country
in sub-Saharan Africa, with 62% of the
population living in urban areas. Urban areas are
characterised by significant spatial inequities,
in which wealthy urban populations have better
access to health services on average, and are
associated with better health indicators overall;
while in the poorer, more informal areas we see
the co-existence of chronic communicable and
non-communicable diseases, and the paradox of
a high prevalence of obesity in communities that
are most food insecure.
Nine health goals
The National Development
Plan 2030 identifies nine
health goals for South
Africa, including raising
life expectancy to 70
years, reducing maternal,
infant and child mortality,
and significantly reducing
non-communicable
diseases (NCD), injuries and
violence. Addressing the social
determinants of health and
disease is identified as a key priority
required to achieve these goals.
These goals and priorities were taken into
account in the development of the South African
Department of Health Strategic Plan 2014 to 2019;
one of the key strategic goals is to prevent and
reduce the burden of disease and to promote
health. Although many of these factors lie outside
the expertise and reach of the health sector, it is
clear that they interrelate to health and well-being,
and signal the need to build health into all policies
when addressing societal challenges to improve
health and well-being.
Despite the pressing need for this approach, urban
health and urban health equity have not yet emerged
as major research and policy priorities in South Africa.
This represents a major gap, given South Africa’s high
and complex burden of disease, and high levels of
health inequity. In response to this gap, I established
the Research Initiative for Cities Health and Equity
(RICHE), an interdisciplinary collaboration of UCT
researchers from public health; anthropology; civil
engineering; architecture, planning and geomatics;
human biology; psychiatry and mental health;
medicine; pathology; and paediatrics.
The aims of RICHE include generating African
perspectives on urban health and urban health equity,
and identifying potential areas of research collaboration
across disciplines, and opportunities for joint supervision
of interdisciplinary postgraduate students.
Intersectoral collaboration
A workshop to tackle the urban health research
agenda in August 2015 was attended by 40 RICHE
members with extensive global and local urban health
experience, resulting in the publication of a paper
on urban health research priorities in Africa. Another
notable achievement was the organising of a Health
in All Policies workshop to bring together researchers
and senior representatives from the Western Cape
provincial government departments of Health,
Human Settlements, Environmental Affairs and
Development Planning, Transport and Public
Works, and the Department of the Premier.
The purpose of this workshop was to
identify joint priority areas across
these sectors that impact on health,
and potential opportunities for
intersectoral collaboration to codevelop a research agenda, as well as
to inform the application of a health
lens across non-health sectors in the
development of policy. This workshop
resulted in the development of research
between RICHE and the departments of
Human Settlements and Health.
For academia to contribute significantly to
achieving the health-related SDGs, there is a need to
re-think our approach to conducting research with a focus
of collaboration across disciplinary lines, closing the gap
between science and policymakers, with a focus on coproduction of knowledge, and the training of a new hybrid
of students. This change may be slow and sometimes
painful, but the potential to contribute meaningfully
to improving population health equitably will make it
worthwhile in the long run.
Dr Tolullah Oni is a senior lecturer in the division of Public
Health Medicine.
Good health and well-being 58

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