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Associate Professor Nevin Cohen and colleagues published a policy brief that examines how urbanization is reshaping global food systems and creating new health challenges for cities. This article is part of a WHO-commissioned collection of papers (“Making the Case for Urban Health: Defining Value and Relevance to Contemporary Challenges” examining contemporary urban health challenges.
The brief explains that urban populations are uniquely dependent on purchasing rather than producing food, making them highly vulnerable to the types of foods available and their relative prices. The authors identify four interconnected urban planning trends that are transforming urban food environments and health outcomes.
Housing development pressures are creating smaller living spaces with diminished kitchen functionality, limiting residents’ ability to store and prepare healthy foods at home. Urban sprawl is distancing food supplies from city centers while increasing car dependency and relegating vulnerable populations to areas with poor food access. Rising housing costs are forcing households to allocate larger portions of their budgets to rent, constraining food expenditures and pushing families toward cheaper, nutrient-poor options.
Digitalization has revolutionized urban food provisioning through e-commerce and delivery platforms, while creating a large workforce of precarious “food gig workers.” Digital marketing aggressively targets vulnerable populations with unhealthy processed foods. Though digital platforms can increase food access, they often promote unhealthy options and may undermine local food businesses through platform fees and market concentration.
Labor transitions in food systems provide employment opportunities but are characterized by low wages, job insecurity, and poor working conditions. The rise of gig economy work, particularly in food delivery, lacks traditional worker protections. Poor employment conditions directly impact workers’ own food security and can create food safety risks when sick workers handle food without adequate healthcare or sick leave.
Dietary transitions toward more diverse but increasingly processed diets are accelerated in urban environments with greater food marketing exposure and limited space for food production. Supermarket expansion has increased access to some nutritious foods but also to highly processed options, while often displacing local food businesses and creating “food deserts” and “food swamps” in underinvested neighborhoods.
The authors argue that these trends require integrated, multi-sectoral policy responses that address power imbalances, ensure policy coherence across scales and sectors, and anticipate trade-offs in urban food system transitions. They advocate for a “Food in All Policies” approach that recognizes food as central to achieving multiple urban health and sustainability goals. As Dr. Cohen argues, “Cities must stop treating food as separate from housing policy, labor policy, and digital equity policy. The trends reshaping urban food systems demand that we integrate food policy into all aspects of city planning and governance.”
