Air pollution does not affect everyone equally. In many cities, those with fewer resources are more exposed to pollutants, more vulnerable to their effects, and ultimately suffer worse health outcomes. This is one of the main conclusions of the report Cities Facing Climate Change: Reducing Emissions to Improve Health, published today by Salud por Derecho.
Air pollution and climate change are closely linked. They share common causes—mainly the burning of fossil fuels in transport, energy (most of which is consumed in households), and industry—and many of their solutions. In the report, we analyze how this environmental inequality translates into what we call a “triple vulnerability.” In many cities, lower-income neighborhoods are often located near major traffic corridors or areas with a higher pollution burden. In these environments, pollutant concentrations can be up to a third higher.
But exposure is only part of the problem. Other social factors amplify health risks: housing conditions, type of employment, and access to healthcare services directly influence people’s ability to protect themselves from pollution or reduce their exposure.
Air pollution is not only an environmental issue, but also a matter of public health and social justice. If urban policies take into account those who are most exposed, cities can reduce emissions while improving the wellbeing of the entire population.
A major public health challenge
Poor air quality is one of the main environmental risks to health in Europe. Every year it causes more than 253,000 premature deaths in the European Union and can reduce life expectancy by up to two years. Furthermore, 97% of the urban population breathes air with levels of fine particulate matter above those recommended to protect health.
The impact also has an economic dimension. In European cities, air pollution represents an average cost of more than €1,200 per inhabitant per year, due to healthcare expenditure, productivity losses, and other associated effects.
Scientific evidence is clear: long-term exposure to pollutants such as fine particulate matter (PM2.5) and nitrogen dioxide (NO2) is linked to respiratory, cardiovascular, and metabolic diseases, as well as impaired child development, increased risk of preterm birth, and effects on mental health.
Rethinking cities to improve health
In cities, motorized traffic is the main source of pollutant emissions. Although freight and passenger vehicles represent only around 13% of the fleet, they are responsible for 51% of nitrogen oxide emissions in the European Union.
In our report, we analyze different urban interventions that are already demonstrating their capacity to reduce emissions and improve health. These include low-emission zones, traffic-free school streets, and neighborhood redesigns to favor active mobility. Evidence shows that these policies can have significant impacts. School streets have achieved reductions of between 23% and 33% in nitrogen dioxide ($NO_2$) levels in areas surrounding schools.
Another example is Barcelona’s superblock model. According to estimates by the Barcelona Institute for Global Health (ISGlobal), its full implementation could prevent up to 667 premature deaths a year thanks to the reduction of pollution, noise, and urban heat.
Beyond the electric car
The report also warns that focusing the solution solely on replacing combustion cars with electric vehicles is insufficient. Although electric vehicles eliminate tailpipe emissions, they do not address other problems associated with the current urban mobility model. A traffic jam of electric cars is still a traffic jam: it occupies space, generates particles from brake and tire wear, and maintains congestion in cities.
For this reason, we argue that the priority must be reducing dependence on private cars and reclaiming urban space for people. To achieve this, it is fundamental to strengthen public transport, facilitate walking and cycling, and renature public spaces. These alternatives not only reduce emissions but also have direct health benefits, as they encourage physical activity and help prevent cardiovascular disease and other chronic conditions.
Reducing pollution without increasing inequality
Climate and urban policies can also produce unintended effects if they are not designed with social equity in mind. Some interventions aimed at improving the urban environment can lead to rising housing costs and the displacement of vulnerable residents.
That is why we argue that mobility and urban planning policies must incorporate affordable and accessible transport alternatives for all, and ensure that the benefits of environmental improvements are distributed equitably. Designing cities with health and equity at the center allows policies aimed at reducing emissions to also become tools for improving quality of life and reducing social gaps. The cost of transforming cities is high, but the cost of inaction is even greater. Inaction translates into more disease, more inequality, and a worsening of the climate crisis.
