Migration, Urbanism and Health: Moving Toward Systems-Informed Policy and Practice [version 2; peer review: 2 approved with reservations]

Migration and displacement are pivotal determinants of urban health, influencing both direct and indirect health outcomes. Migrants may face unique health risks, often exacerbated by economic, social, and environmental factors encountered during transit or upon resettlement. As migration patterns shift due to geopolitical, climatic, and economic pressures, they reshape the global and urban policy landscapes in unpredictable ways, presenting challenges that will continue to evolve in the coming decades. Many current legal frameworks do not adequately account for migrant populations, hindering effective policy responses. Therefore, effective urban health interventions must be inclusive of migrant populations and expand beyond healthcare services. A systems-thinking approach that recognizes the broader determinants of health—including housing, employment, social services, and urban infrastructure—is essential to address the intersecting challenges migrants face. Despite these challenges, migration remains crucial to the functioning of urban environments. Migrant workers consistently contribute to the healthy operation of cities, underpinning key infrastructure and services. However, to optimize policy responses and improve urban health outcomes, more robust data and evidence on the health risks and outcomes of migrants, as well as the structural drivers of migration, are needed. Moreover, macro factors such as climate change, future pandemics, and geopolitical shifts are likely to influence both migration dynamics and migrant health. This paper explores links between migration and urban health and identifies implications for policy and practice. It draws from a qualitative review of policy documents, academic literature, and illustrative examples from selected urban contexts. The paper calls for integrated, equity-oriented strategies that consider the structural and social determinants shaping migrant health. A systems-informed and holistic vision of urban health is required to integrate migration into the broader urban policy and planning frameworks to foster healthier, more resilient cities.