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A prevalent solution to accommodate population growth due to urbanization is densification. However, this often pushes new residential housing closer to roads, increasing exposure to both noise and air pollution. The present study's aim was to estimate the health impacts of road traffic-related noise and air pollution for a low-income area (Drottninghög) in Helsingborg, Sweden, according to pre-densification (2012) and post-densification (2030) scenarios.

Road traffic noise was simulated at the façade of residential buildings using the Nordic prediction method, and exposure was assessed using SoundPLAN. Exposure-response functions (ERF) from the WHO were utilized for the following health outcomes associated with noise: annoyance, adverse sleep disturbance, ischemic heart disease (IHD) incidence and IHD mortality. Air pollution (nitrogen dioxide, NO2) was assessed using a Gaussian dispersion model (AERMODE). Health outcomes associated with NO2 included natural cause mortality, pediatric asthma, respiratory hospitalizations and low birth weight (LBW). ERFs were derived from meta-analyses. Health impact assessments were then performed for both scenarios.

Densifying Drottninghög according to the municipality's planned strategy would lead to a 15 % unit increase in the proportion of residents exposed to road traffic noise above the WHO's health-based guideline value (53 dB(A) Lden). This was estimated to markedly increase the proportion of residents highly annoyed by traffic noise (7.4–13.9 %) as well as those highly sleep disturbed (3.0–4.9 %). IHD incidence and IHD mortality attributed to noise would increase by an estimated 49 % and 44 %, respectively, post-densification. NO2 exposure was estimated to increase slightly (0.7 µg/m3) post-densification, which would contribute to an estimated 4–6 % increase in natural cause mortality, pediatric asthma, respiratory hospitalization and LBW.

Urban planning initiatives need to consider these prevalent urban environmental exposures and integrate a public health perspective into densification strategies. Doing so can create synergies in the built environment that promote healthy, sustainable cities.