Aimed at a broad audience, including practitioners, policymakers, philanthropic funders, researchers, activists, community organisers, and non-profit leaders across myriad sectors, the report, ‘Global trend sensing for health equity’, identifies global innovations that promote more equitable health outcomes.

Six trends provide the key focus for the report:

• Growing calls for more equitable care work;
• Greater longevity;
• Surge in digital health information impacting wellbeing;
• A compounding housing crisis;
• Increasing risks to nutrition security; and
• Growing demands for health public spaces.

For each trend, the report highlights two to three key connections with other trends, in an effort to encourage different audiences to forge new links – for example, between housing and longevity; or between food and nutrition and public spaces.

‘Multisolving’ solutions

The report also acknowledges two key cross-cutting themes affecting all trends: accelerating climate change and the rise of artificial intelligence. On the first of these areas, the report argues that there are opportunities to weave health equity and climate resilience together in ‘multisolving’ solutions – a term that describes when a single solution, policy or investment can address multiple problems across sectors.

This can be seen in how the historic links between environmental and health issues have shaped key environmental policies. The Montreal Protocol, for example, limited chemicals that both cause ozone depletion and increase cancer risk. The report therefore explores how tracking nuanced health information related to climate change might enable better climate advocacy.

Housing is another interlinked issue. While all across the world, new houses need to be built to cater to an increasing population, many construction processes are emission-intensive. How to ensure that new housing developments, particularly for affordable housing, do not further exacerbate the climate crisis is a key question.

A third way in which climate change is interlinked with health equity is through its impact on older adults, especially in low-income communities, who are highly affected by extreme weather events. How might older adults be supported to cope with, respond to, and build resilience to the effects of climate change is a further discussion point.

In addition to climate change, the report also explores questions on how best to capitalise on AI tools for improved health equity, again considering each of the six trends. The more that AI is integrated into systems around the world, the more risks to health equity must be monitored and managed. AI tools, for example, are often built off large language models (LLMs), which, owing to the underlying data on which they’re trained, are known to have gender, racial, and other biases.

More positively, there will also be opportunities for AI to open doors for more equitable solutions to health challenges. AI-powered “virtual healthcare workers”, for instance, can provide free advice in multiple languages on a range of topics, from Covid-19, to mental health, to quitting smoking.

Among the key questions the report considers are how can the US ensure AI analyses of health data are representative of all populations? How might AI tools further empower older adults to have greater independence in daily life? And how might AI be used throughout the nutrition system to stabilise consistent nutrition flows, preventing and managing shocks?

Wider health determinants

Several policy solutions are discussed that have successfully altered cities’ or countries’ approaches to social determinants of health.

Vienna’s housing policies, for instance, are seen as a global paragon. In 2021, a subsidised housing development in the Austrian capital focused on upgrading existing buildings to integrate 12 pockets of high-density greenery to provide leisure space, filter fine dust particles, and reduce noise for residents. Vienna’s social housing also incorporates many climate-resilient aspects. One housing development, for example, recycles rainwater to flush toilets and irrigate gardens. Another housing project is car-free, replacing what would typically be car parking spaces with a bicycle repair shop and a children’s play area.

In Bogotá, Colombia, the TransmiCable cable car allows residents of the elevated neighbourhood of Ciudad Bolivar to access the rest of the city in just 19 minutes. For care workers, in particular, it’s been a godsend. The cable car system has reduced commute times for many caregivers, making it easier for them to access services, not only at a Care Block – which uses public spaces to provide free services for caregivers – but also in the rest of the city. The cable car system is also fully accessible for individuals with limited mobility and for wheelchair users. This improves inclusivity for elders who may also have physical disabilities, helping them integrate into their community.

Japan’s experience of an earthquake and tsunami in 2011 led to the first Ibasho project – an elder-run cafe in Ōfunato designed to foster community resilience. The Ibasho model creates public spaces for community members of all ages to build social capital through informal gathering spaces open to all. Through elder-led disaster risk management sessions, Ibasho also helps prepare and equip elders to be resilient when faced with climate crises.

“Equipped with information like this, we can build on our own efforts to advance health equity in the US, leveraging what we know about global trends and, more specifically, what’s worked in other countries,” said Karabi Acharya, senior director – global ideas for US solutions at the Robert Wood Johnson Foundation, in an introduction to the report.

“After reading this report, I’m dreaming about cable cars flying over Los Angeles, grandmothers counselling people on park benches, and intergenerational housing communities. These ideas aren’t so far-fetched – after all, they’re already being done somewhere else.”

The report can be downloaded here.