Clean air Clean water Comfortabletemperatures Housing Green andblue space Transportation Managedurban growth > Clean air Clean water Waste management Comfortabletemperatures Quiet Housing Green andblue space Transportation Managedurban growth Goodgovernance Drag slider to show particular challenges for dry cities Dry cities can have problems with dust and other pollutants, which increase the risk of cardiopulmonary and other diseases Water scarcity in dry cities can lead to infectious disease, mental health challenges, and impaired child development Scarcity of green and blue spacecan cause problems with mental health and lead to lower levels of physical inactivity Many dry cities are exposed toextreme heat, which can lead to heat related illness as well as aggression and violence Dry cities often have problemsproviding needed services, especially reliable water supplies Walking and cycling can be difficult in very hot cities, which can lead to increased risk of sedentary lifestyles Migration from dry rural areas can cause unpredictable influxes of people, putting strain on existing infrastructure Healthy cities require acceptable levelsof particulate matter and other pollution, reducing cardiopulmonary and other risks, particularly for people with underlying conditions such as asthma Ample supplies of clean water are required for drinking and washing. This is essential for good hygiene and disease containment Parks and other green spaces, as well as bodies of water, provide opportunities for recreation and exercise Healthy cities have the ability to deal appropriately with waste generated by human activities Good management of healthy cities requires inclusive, equitable, transparent governance, as well as cross sectoral coordination Protection from extremely hot or cold weather helps residents avoid a wide range of poor health outcomes, from mild symptoms to heat stroke and respiratory and neurologic difficulties Cities without too much noise promote better mental and physical health, and productivity People need to move around cities easily. Active transport such as walking and cycling isespecially beneficial It is important for expansion of cities to be well managed, to ensure adequate infrastructure is available to support new development Healthy cities have sufficient, affordable, and safe housing Policy plays a critical role in ensuring both that cities do not suffer from being dry and that the health of their residents is promoted. Select the six policy areas to the right to highlight which of the characteristics above they aim to address Promoting health in dry cities © 2020 BMJ Publishing Group Ltd. Health systems in dry cities can be strengthened by investment in service provision and management. Health infrastructure, equipment, indicators, and training should be adapted to drier and hotter conditions 1 Healthsector Successful governance features collaborative, cross sectoral planning and implementation. Decentralization is key, giving autonomy to cities, so they can raise their own resources and plan and implement policies 2 Governance Improving water supply involves reducing demand, diversifying available water sources, and managing the water cycle using integrated, flexible, and adaptive systems 3 Water Assessments and diagnostics that identify hotspots of high vulnerability to water shortage and disease can be important for decision makers in prioritizing measures towards better management of healthy dry cities 4 Assessment Water scarcity and extreme heat both require adaptive behavior change by urban publics, including avoiding exertion, keeping hydrated, and conserving water. Social marketing can help to drive behavior change 5 Behavior Solutions based on ecosystem functions provide benefits for both biodiversity and human wellbeing. For example, urban vegetation can cool urban microclimates through shading and evapotranspiration 6 Naturebased Towards healthy dry cities Particular challenges require innovative thinking Interactive Today’s global population is increasingly urban, and arid regions of the world are expanding, creating a growing challenge of dry cities. Some health challenges are common to all cities, but others are unique to dry ones, as climate change, water scarcity, and heat interact to threaten health in diverse ways. This graphic shows some characteristics of healthy cities, and the slider can be used to show which of these are particular challenges for dry cities. The policies summarized at the bottom are described in more detail in the full paper below this graphic DRAFT