It's official: New Yorkers are living longer. The average Big Apple resident can now expect to make it to the ripe old age of 80.6 years – eight years more than in 1990. No other US city has seen such a leap.

Why the spike? The Institute for Health Metrics and Evaluation, which conducted the research, is reluctant to draw explicit conclusions. For one, the population of New York isn't the same today as in 1990 given the millions of migrants that come and go every year. And back in 1990, high levels of HIV/AIDS and murders were skewing the city's mortality figures.

That said, most deaths (87%) are caused by non-communicable diseases – cancer, heart disease, strokes, diabetes and the like – and it's reductions in these that most clearly explain New Yorkers living longer lives. Deaths from heart disease, for instance, are down a whopping 25% from a decade ago.

Mounting evidence

For Johanna Ralston, chief executive of the World Heart Federation (WHF), the example of New York provides a stellar case of "retrofitting" a city to make it more heart-healthy. She points to numerous public health interventions introduced under Mayor Michael Bloomberg: a ban on smoking in public places, new bicycle routes, calorie labels on restaurant menus, advertising campaigns around the benefits of taking exercise, to name just a few. "This all helps build the body of evidence about what an important platform cities can be", she states.

Ralston is right to be enthused. This time last year, WHF released a report highlighting the link between urbanisation and cardiovascular disease. The report spelt out a five-step approach based on mitigating risks, such as exposure to tobacco and poor diets, and increasing preventative measures, such as taking exercise and educating children about healthy living.

Since the report's publication, more evidence has come to light. A recent study by the London School of Economics finds that people are likely to live longer in cities like Tokyo, Singapore and Hong Kong, where public transport and walking are favoured over private car use. Furthermore, differences of life expectancy can be found within cities too. West Londoners, for example, are likely to live seven years longer than their East London counterparts.

The findings suggest urban form is a "contributing factor" to human health, says Ricky Burdett, director of the LSE Cities programme: "One can begin at least to speculate that these correlations are not just to do with where people of different education or income come from, but that their physical conditions will affect their wellbeing and health."

City planning

Policy makers are increasingly beginning to take note. Susan Thompson, who heads the Healthy Built Environment Programme at the University of New South Wales, points to a "groundswell of interest" among planners and health officials in recent years. She points to explicit health and wellbeing provision in the city plans of metropolitan centres such as Portland, USA, and Vancouver, Canada, as well as London.

One of the big advances over the past 12 months is the uptake of cardiovascular health in key policy circles. The World Health Organisation, for instance, is dedicating this year's World Health Day to the issue of hypertension, a major cause of heart-related illness. The Clinton Global Initiative is also pushing for many of the World Heart Federation's recommendations to be adopted. The reconstruction of New York after Hurricane Sandy marks a prime opportunity.

In a similar vein, advocates of cardiovascular health succeeded in including specific language around chronic non-communicable diseases in the Rio +20 summit last summer. The WHF is currently preparing a document for the UN secretary general that calls for cardiovascular health to be factored into the post-2015 Sustainable Development Goals. "The place where sustainable development and health merge most elegantly is the development of cities and addressing urbanisation", Ralston says.

The big challenge centres on applying this thinking in the mega-cities of the developing world, where unregulated urban growth is driving up heart problems at unprecedented rates. As Ralston notes: "You can sit back and say, 'Gee, aren't organic gardens great. But, guess what? They don't have them in Shenzhen. They just have 18 million people who weren't there 30 years ago." Mumbai, Mexico City, Lagos or any number of other examples would fit just as well.

Employers' responsibility

What can the private sector be doing? House builders, infrastructure providers and architects are clearly best placed to take direct action in how our cities are designed. More joined-up thinking is required, says Martin Hunt, head of networks and partnerships for Forum for the Future.

Take London, he says. The UK capital is currently suffering a housing shortage. "We want to build homes, but we want to build them in the right way. That requires green space, the ability to exercise and move around freely and safely, and being in an environment that's well-lit, car-free and with good access to public transport", he states.

Heart-healthy cities depend not just on urban design, of course. You can have green corridors linking parks, or calorie-marked menus, but individual residents still need to don their running shoes or opt for the low-fat option. Companies, especially those with large workforces, can play an active role here, says Jenny Hawker, a health management expert at UK consultancy Mercer. Sports clubs, wellness programmes, flexible working options and bike-to-work schemes are just some of the initiatives responsible employers might consider.

As public health budgets tighten, the private sector can expect more pressure from government to promote cardiovascular health, Hawker adds: "You can't exclude the employer in all this. They do have responsibility because they are part of the city environment."

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