From climate hazards to diet and physical activity pathways: Investigating policy intersections for health in five global South Cities - 29/10/26

Doi : 10.1016/j.joclim.2026.100766

Meelan Thondoo ^a, Nina Abrahams ^a, Elise Borde ^b, Lidia Morais ^b, Erin Mathieu ^a, Damilola Odekunle ^c,^⁎ , Clarisse Mapa-Tassou ^d, Nfondoh Blanche ^d, Edwin Ngwa ^d, Awah Kum Tchouaffi ^d, Victor Onifade ^c, Vide Adedayo ^c, Darshen Naidoo ^e, Elizabeth Thomas ^e, Mikateko Mafuyeka ^f, Felix Assah ^d, Taibat Lawanson ^c, Waleska Caiaffa ^b, Tolullah Oni ^a, Maylene Shung-King ^g

^a MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0SL, UK

^b Observatory for Urban Health in Belo Horizonte, Federal University of Minas Gerais (OSUBH/UFMG), Belo Horizonte, 31270-901, Brazil

^c Centre for Housing and Sustainable Development, University of Lagos, Lagos, 101245, Nigeria

^d Health of Population in Transition Research Group, University of Yaoundé I, Yaoundé, BP337, Cameroon

^e The South African Medical Research Council/Wits Centre for Health Economics and Decision Science (PRICELESS SA), Wits School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa

^f Global Health Advocacy Incubator, Johannesburg Metropolitan Area, South Africa

^g Health Policy and Systems Division, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa

^⁎ Corresponding author.

Abstract

Introduction

Climate change, rapid urbanization, and non-communicable diseases (NCDs) pose intersecting threats to public health in low- and middle-income countries. While evidence supports integrating health into climate policy, limited attention has been paid to how climate change and urban resilience policies address key NCD-related pathways, particularly diet and physical activity.

Methods

As part of the Global Diet and Activity Research (GDAR) Network, this study analyzed 34 climate change and urban resilience policies (2012–2022) across five Global South cities: Belo Horizonte, Yaoundé, Lagos, Johannesburg and Cape Town. The analysis focused on three lenses: climate hazards, pathways to health (diet and physical activity), and social vulnerability considerations.

Results

Policies frequently incorporated climate mitigation and adaptation strategies, but explicit consideration of diet, physical activity, and NCD prevention and management was limited. Of 34 policies, 26 addressed diet primarily through food security (n = 19) and agriculture (n = 15), while only two linked food systems to NCDs. Physical activity received limited attention and was mainly framed through active transport goals. Health considerations focused predominantly on immediate climate and disaster-related impacts, with less attention to longer-term NCD-related pathways.

Conclusion

Findings highlight important gaps and opportunities for more integrated climate-health policy approaches.

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Keywords : Climate change, Diet, Non-communicable diseases, Equity, Physical activity, Multi level policy analysis, Urbanization, Low- and middle-income countries, Urban health