Doing nothing is not an option. The Diabetes Projection Model, which models the trajectory of diabetes prevalence over time, shows that the prevalence of diabetes will continue to climb and could reach almost 12% by 2045.6 Conservatively, this would result in 736 million people living with diabetes and more than 1,000 billion dollars in global healthcare expenditure.6
motorised transport, and widening distances between where people live and work all contribute to a decrease in physical activity.19,20 This, together with time constraints and an unhealthy food environment of cheap, processed foods, which too often are high in fat and sugar, can increase the risk of developing obesity and type 2 diabetes.21,22
CITIES ARE ON THE FRONT LINE IN THE FIGHT AGAINST DIABETES
Because of the scale and density of urban environments, the people who design, plan, build and govern cities exercise considerable influence over the basic ingredients of a healthy life: access to decent housing, nutritious food, safe transport and mobility, and opportunities for physical activity. Cities that offer these fundamentals can dramatically reduce the incidence and associated costs of a wide range of NCDs while improving health equity for those most often exposed to such risks – children, older people, women, people with disabilities and the poor.
More than half the world’s population (55%) lives in urban areas, and this statistic is expected to reach 68% by 2050.10 This surge in urbanisation presents a health challenge for many cities and their citizens.11–17 Already, two-thirds of people with diabetes live in urban areas, which is where the increase in prevalence is expected to occur.18 Urban environments influence how people live, move and, often, what they eat. Confined spaces, urban design optimised for
Rome, Italy
11.7% OR 736 MILLION PEOPLE WITH DIABETES
11.0%
10.1%
10.0%
9.9% 9.6%
10.0% OR 625 MILLION PEOPLE WITH DIABETES
2025
2030
2035
2040
2045
YEAR
* Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. BMI is defined as a person’s weight in kilograms divided by the square of their height in metres (kg/m2). For adults, obesity is defined as a BMI greater than or equal to 30. 5
