Infrastructure investment and urban health: Why breaking the cycle of crises is so difficult

Abstract

AbstractInfrastructure and health, the theme of this journal, are responsible for a major share of GDP. However, GDP alone does not define well-being. Disaggregating the components of GDP, changes over time and variations within countries and social groups, the OECD’s 2013 Better Living Initiative focused on jobs, earning, housing and work–life balance as well as educational attainment, health status and subjective well-being. These indicators took on greater importance as evidence of growing disparities accumulated in the 2010s (OECD, 2013). Under Pressure: The Squeezed Middle Class was not the title of a popular work for the general public, but of a 2019 OECD report for policy- makers. Too often we take the positive, mutual reinforcement of policies and programmes that contribute to well-being for granted. Sectoral silos, which favoured the expansion of public services earlier in the 20th century, now interfere with their delivery [26, 28]. Better policy linkages across sectors remains the holy grail of sound, evidence-based decision-making. It remains aspirational, just out of reach.