Over the past year, the working team on decision-support tools has focused on guiding the implementation of nature-based solutions (NBS) in urban environments. These solutions are “inspired and supported by nature, which are cost-effective, simultaneously provide environmental, social and economic benefits and help build resilience. Such solutions bring more, and more diverse, nature and natural features and processes into cities, landscapes and seascapes, through locally adapted, resource-efficient and systemic interventions”, as defined by the European Commission. Led by the University of Turin, and in collaboration with Links Foundation, the pilot aims to support local stakeholders and decision-makers in making evidence-based, equity-oriented choices that link urban planning, health, and environmental sustainability. Together with municipal technical staff and other stakeholders from the city of Turin in Italy, the pilot has co-created two complementary tools:
- a priority mapping tool, identifying urban areas where NBS implementation can deliver the greatest health and equity benefits, and
- a NBS selection tool, supporting the identification of appropriate interventions tailored to local contexts.
Together, these components are designed to answer two key decision-making questions: where is action most needed and which solutions are most suitable?
Priority mapping for health equity
To answer the first question, a priority mapping methodology was developed to identify urban areas where NBS implementation could maximize health gains and address inequities. The approach builds on a methodology (see Ellena et al. 2023) previously developed by the LINKS Foundation (in collaboration with the Italian Supraregional Epidemiology Service (SEPI)1 and Euro-Mediterranean Center on Climate Change (CMCC)2), which was tailored to JA PreventNCD and follows a hazard – exposure – vulnerability framework, with a focus on urban heat and air pollution.
Demo versions of priority maps were developed for the city of Turin and presented to local stakeholders. These maps were progressively refined based on feedback and updated local datasets. Currently, a technical guide is being created to document the priority mapping step-by-step. The final guide will help other (pilot) cities conduct their own priority mapping for any relevant NBS projects.
Advancing the NBS selection tool
Regarding the second question, in early 2025 the team also started developing the NBS Selection Tool. In recent months, the team has moved from development into a piloting phase with the City of Turin . Iterative testing and application of the tool have provided a series of valuable updates to improve its relevance for real-world decision-making.
While different approaches to structuring health benefits were explored during development, the current framework integrates scientific evidence on the associations between NBS and health. It also takes into account ecosystem services delivery considerations, offering a holistic perspective on health outcomes and broader co-benefits.
Connecting the NBS to Health - the evidence base
To strengthen the connection between NBS and health, in addition to ecosystem services, research has been conducted that maps epidemiological evidence on associations and impacts of NBS on non-communicable diseases, related risk factors, and pathways. The research was carried out alongside tool development and will result in a scoping review paper, with the protocol registered on the Open Science Framework. The findings are being directly integrated into the tool, updating and complementing the preliminary evidence drawn from existing reviews and guidelines, and ensuring alignment with the most up-to-date research.
Piloting and next steps
Current versions of both tools are being actively used in piloting activities with the City of Turin through the evaluation of existing NBS projects and the exploration of new implementation scenarios. The newest versions and their outputs have also been recently presented, marking the transition from development to the first implementation phase.
With the activities approaching important milestones, efforts are focused on consolidating evidence integration, finalizing guidance materials, and preparing dissemination outputs, including formal reporting and writing of the scoping review. Through this integrated approach, JA PreventNCDcontinues to translate scientific evidence into practical tools that support healthier, more equitable urban environments.
Andrej Čikvari
Department of Clinical and Biological Sciences - University of Turin, Italy
Simone Fukuda
Links Foundation, Italy
Image attachment 1 - Map of priority areas for NBS implementation on example of Turin, Italy - final result of the priority mapping methodology. One of the piloting activities uses this map and the selection tool in the two indicated areas to identify which NBS could be implemented, demonstrating how the two tools could be used together.
Image attachment 2 - Screenshot of the NBS4HUE Selection tool with main elements of the results dashboard visible
References
Marta Ellena, Giulia Melis, Nicolás Zengarini, Eduardo Di Gangi, Guglielmo Ricciardi, Paola Mercogliano, Giuseppe Costa, Micro-scale UHI risk assessment on the heat-health nexus within cities by looking at socio-economic factors and built environment characteristics: The Turin case study (Italy), Urban Climate, Volume 49, 2023, 101514, ISSN 2212-0955,