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Abstract Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.

Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.

Participating in the social and civic life of communities is protectively associated with the onset and course of physical and mental disorders, and is considered important in achieving health promotion goals. Despite its importance in health research, there is no systematically developed measure of community participation. Our aim was to undertake the preliminary development of a community participation questionnaire, including validating it against an external reference, general psychological distress. Participants were 963 randomly selected community members, aged 19-97, from coastal New South Wales, Australia, who completed an anonymous postal survey. There were 14 types of community participation, most of which were characterised by personal involvement, initiative and effort. Frequency of participation varied across types and between women and men. Based on multiple linear regression analyses, controlling for socio-demographic factors, nine types of participation were independently and significantly associated with general psychological distress. Unexpectedly, for two of these, "expressing opinions publicly" and "political protest", higher levels of participation were associated with higher levels of distress. The other seven were: contact with immediate household, extended family, friends, and neighbours; participating in organised community activities; taking an active interest in current affairs; and religious observance. We called these the "Big 7". Higher levels of participation in the Big 7 were associated with lower levels of distress. Participating in an increasing number of the Big 7 types of participation was strongly associated in linear fashion with decreasing distress.

Participating in the social and civic life of communities is protectively associated with the onset and course of physical and mental disorders, and is considered important in achieving health promotion goals. Despite its importance in health research, there is no systematically developed measure of community participation. Our aim was to undertake the preliminary development of a community participation questionnaire, including validating it against an external reference, general psychological distress. Participants were 963 randomly selected community members, aged 19-97, from coastal New South Wales, Australia, who completed an anonymous postal survey. There were 14 types of community participation, most of which were characterised by personal involvement, initiative and effort. Frequency of participation varied across types and between women and men. Based on multiple linear regression analyses, controlling for socio-demographic factors, nine types of participation were independently and significantly associated with general psychological distress. Unexpectedly, for two of these, "expressing opinions publicly" and "political protest", higher levels of participation were associated with higher levels of distress. The other seven were: contact with immediate household, extended family, friends, and neighbours; participating in organised community activities; taking an active interest in current affairs; and religious observance. We called these the "Big 7". Higher levels of participation in the Big 7 were associated with lower levels of distress. Participating in an increasing number of the Big 7 types of participation was strongly associated in linear fashion with decreasing distress.

Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan's man model "MANMO") to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions.

The rapid rise in extreme heat events in Australia recently is already taking a health toll. Climate change scenarios predict increases in the frequency and intensity of extreme heat events in the future, and population health may be significantly compromised for people who cannot reduce their heat exposure. Exposure to extreme heat presents a health hazard to all who are physically active, particularly outdoor workers and indoor workers with minimal access to cooling systems while working. At air temperatures close to (or beyond) the core body temperature of 37°C, body cooling via sweating is essential, and this mechanism is hampered by high air humidity. Heat exposure among elite athletes and the military has been investigated, whereas the impacts on workers remain largely unexplored, particularly in relation to future climate change. Workers span all age groups and diverse levels of fitness and health status, including people with higher than "normal" sensitivity to heat. In a hotter world, workers are likely to experience more heat stress and find it increasingly difficult to maintain productivity. Modeling of future climate change in Australia shows a substantial increase in the number of very hot days (>35°C) across the country. In this article, the authors characterize the health risks associated with heat exposure on working people and discuss future exposure risks as temperatures rise. Progress toward developing occupational health and safety guidelines for heat in Australia are summarized.

Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan's man model "MANMO") to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions.

The rapid rise in extreme heat events in Australia recently is already taking a health toll. Climate change scenarios predict increases in the frequency and intensity of extreme heat events in the future, and population health may be significantly compromised for people who cannot reduce their heat exposure. Exposure to extreme heat presents a health hazard to all who are physically active, particularly outdoor workers and indoor workers with minimal access to cooling systems while working. At air temperatures close to (or beyond) the core body temperature of 37°C, body cooling via sweating is essential, and this mechanism is hampered by high air humidity. Heat exposure among elite athletes and the military has been investigated, whereas the impacts on workers remain largely unexplored, particularly in relation to future climate change. Workers span all age groups and diverse levels of fitness and health status, including people with higher than "normal" sensitivity to heat. In a hotter world, workers are likely to experience more heat stress and find it increasingly difficult to maintain productivity. Modeling of future climate change in Australia shows a substantial increase in the number of very hot days (>35°C) across the country. In this article, the authors characterize the health risks associated with heat exposure on working people and discuss future exposure risks as temperatures rise. Progress toward developing occupational health and safety guidelines for heat in Australia are summarized.