Introduction: Until now, estimates of the Global Burden of Disease have mainly been produced on national or regional levels. These estimates, however, are less useful for city governments who have to take decisions on local scales. We conducted a burden of disease (BoD) assessment and applied the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity by complying with international exposure recommendations for the performance of physical activity, exposure to air pollution, noise, heat and access to green spaces in Barcelona.
Methods: Exposure estimates and morbidity data were available for 1357361 Barcelona residents ?20 years. We compared recommended with current exposure levels. We quantified the associations between exposures and morbidity and calculated population attributable fractions to estimate the number of morbidity cases. We also quantified the BoD attributable to non-compliant exposure levels by calculating disability-adjusted life-years (DALYs).
Results: Our estimations show that a large morbidity burden is attributable to current urban and transport planning practices in Barcelona. Non-compliance of recommended exposure levels for physical activity, air pollution, noise, heat and access to green spaces were estimated to generate almost 40,000 DALYs annually. Almost 50% of the BoD was due to road traffic noise with especially sleep disturbance and annoyance contributing largely.
Conclusions: The estimated BoD could be modified by changes to urban and transport planning related practices. We emphasize the need for (1) the reduction of motorized traffic and (2) the provision of green infrastructure to provide mitigation of noise, air pollution and heat as well as opportunities for physical activity engagement.
