Shaping cities for health: Complexity and the planning of urban environments in the 21st Century (original) (raw)
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Inequalities in urban areas: innovative approaches to complex issues
Scandinavian Journal of Public Health, 2002
Urbanization, a characteristic of the twentieth century, is a profound transformation of human settlement processes and their outcomes, which has not been well understood in terms of both positive and negative impacts. This paper argues that the interrelations between urban planning, health, social, and environmental policies have been poorly articulated until now. Although sectoral approaches have often applied remedial and corrective measures to overcome unsatisfactory conditions in urban areas, today we know that infectious diseases stemming from insanitary conditions are not the leading cause of morbidity and mortality in Europe. Nonetheless diverse forms of ill health remain associated with place of work and residence. Therefore, in order to deal with the complexity and diversity of urban areas there is an urgent need to move from conventional, sectoral approaches based on biomedical models of health to coordinated action stemming from an ecological interpretation of health including its social determinants. This kind of approach is presented in order to promote health and social development at the local level.
2018
1School of Public Health, MRC-PHE Centre for Environment and Health, WHO Collaborating Centre on Non-Communicable Disease Surveillance and Epidemiology, Imperial College London,; 2Faculty of Architecture, The University of Hong Kong, Hong Kong, China; 3Public Health England, London, UK; 4James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh; 5Centre for Urban Management Studies, Institute of Statistical, Social and Economic Research (ISSER), University of Ghana, Accra, Ghana; 6LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Cities and health: an evolving global conversation
Cities & Health, 2017
The Cities and Health journal sees its launch in 2017. Looking back over half a century of growth and global expansion in economic activity, although there have been societal benefits, negative impacts are starting to take their toll on planetary resources and human health. As we enter what is being termed The Anthropocene, the city is becoming the preferred habitat for humanity. The imprint of city lifestyles, in terms of both resource use and waste, is found across the globe, threatening the ecosystem services that support our health. In cities themselves, due to risks and challenges to health, we are witnessing a rise in non-communicable disease, twinned with infectious disease for the many who live increasingly in informal or slum urban development. High levels of health inequity are found within urban populations. The resultant health problems are placing increasing strain on health services, with pressure only set to increase due to continuing urbanization and ageing populations. Evidence increasingly demonstrates that many aspects of city and neighbourhood form, urban and transport design, and residential environments play an important role in mediating health and health equity outcomes. The new journal Cities & Health is being launched to support political, academic and technical leadership and transdisciplinarity in this field. For this endeavor we will need to reexamine the nature of evidence required before we act; to explore how academics, policymakers, practitioners and communities can best collaborate using the city as a laboratory for change; and to develop capacity building for healthier placemaking at professional and community level.
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Urban spaces and health inequity
In the recent urban era, health inequity is a major challenge faced by planners and policy makers. With the increasing trend of people moving to urban zones and areas in the search of better stature of life and job opportunities, increased pressure and load on the already fragile urban infrastructure is visible resulting in social, cultural and economic inequities. Whereas health inequities are a major consequence of socio-cultural and economic inequalities in our society resulting in poor health services and amenities to the economically week, racial, ethnic and religious minorities and migrants. This paper mainly focuses on the inclusion of the planned urban spaces with the heath inequity problems such that the socially excluded and weaker section of the society thrive harmoniously. We suggest that an integrated approach in defining and developing urban spaces and areas with proper actions to deal with health inequity can magnify other steps and policies to deal with the health inequity present in our society and which is the need of the 21st century. We close with the suggestions to improve research and development in the field of environmental conditions, changing patterns in the urban environment and health inequity in the modern-day society to cope up with the problem of security that must be available to all. These practices may include urban slum upgradation and rejuvenation, participatory and integrated public approach, epidemic control and urban ecosystem services of health. We conclude that if the national and international communities and agencies are serious about the SDGs, stronger efforts and actions should be taken to improve the urban spaces, living conditions, socioeconomic conditions which can promote health equity to all.
Urban Planning and Health Equity
Journal of Urban Health, 2011
Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.
Global health in an increasingly urban world
Journal of Public Health and Emergency
Global health in an increasingly urban world Over the past few decades, urbanization has been increasing rapidly across all regions of the globe. According to the United Nations (UN), today more than half of the world's population-more than 4.3 billion people-lives in urban areas (1). By 2050, it is expected that about 70% of the global population will be urbanized (2), and nearly 99% of new urbanization will take place in the developing world, largely Africa and Asia. This unprecedented growth is making cities focal points for numerous environmental and public health hazards. The UN's Sustainable Development Goal (SDG) #11 is to "make cities inclusive, safe, resilient and sustainable" (3). To achieve this goal, and to protect and promote health, we must carefully consider the role of urban environments in shaping population health. Physical, mental, and social health are affected by living conditions, such as housing, work environments, and recreational spaces. For example, where we live and work may increase our exposures to hazards such as toxic chemicals (i.e., lead, mold, and asbestos), pollution (i.e., noise, indoor and outdoor air pollution), infectious diseases, and accidents. In addition, we know that unhealthy behaviors are also common in urban populations, where residents adopt more sedentary lifestyles and changes in dietary patterns that shift towards processed, convenience foods. Lack of safe spaces for walking and active living also are major drivers in the world's growing rates of non-communicable diseases. Urban sprawl, a term used to describe when a city's population is dispersed over an increasingly large area, is problematic because it marginalizes poor people by forcing them into densely populated, informal settlements of slums in remote or peripheral parts of cities. Many people in slums live in extreme poverty, lacking access to the basic necessities of life, such as safe water and sanitation, healthy food, and healthcare facilities (4). Cities also face enormous problems with poverty and overcrowding, violence, mental health issues, and heightened vulnerability to the consequences of natural disasters. Cities are also major contributors to climate change; about three-fourths of all greenhouse gas emissions are tied to human activity in urban areas, and are also responsible for 60-80% of all energy consumption despite only occupying 3% of the planet's surface. Sustainable development is highly dependent upon the effective management of urban growth in both developed and developing countries (5). In 1950, only two cities were megacities (New York City and Tokyo), defined as cities with more than 10 million residents. By 2010, there were over 20 megacities and now there are close to 40, most of which are located in the global South. We expect that just in the next few years, we will reach 9% of the world's population living in a megacity. As urban populations grow and cities expand, the urban environment will play an increasingly important role in global health and sustainable development. But the implications of urbanization are not all negative. In fact, the rapid expansion of cities, especially in developing countries, can lead to enormous positive social, economic and environmental transformations. Urbanization can contribute to economic growth, heighten population well-being, and improve resource efficiency. For example, there is a powerful link between urbanization and economic growth; more than 80% of global GDP is generated in cities. Urbanization can contribute to increased productivity and social mobility by facilitating innovation and new ideas and a wealth of opportunities (6), including access to education and jobs, especially for girls and women. On average, living standards are better in urban populations than in rural. For example, access to electricity, and improved water and sanitation is generally higher in urban areas. A well-designed urban environment can promote physical activity and other healthy habits, encourage social connectedness, and prevent injuries and promote safety. Further, the UN says that urban living "has the potential to use resources more efficiently, to create more sustainable land use, and to protect the biodiversity of natural ecosystems". For example, heating an apartment building that houses 100 people requires less energy than heating 100 separate homes. And a subway uses far less energy to transport commuters than cars. Cities can become part of the climate solution by promoting urban forests and green spaces, which help to capture carbon emissions and induce a cooling effect that reduces energy demand (7). This special issue of JPHE focuses on urbanization and health. The Association of Pacific Rim Universities (APRU) was created in 1997 and the Secretariat is based in Hong Kong. As a network of leading universities linking the Americas, Asia, and Australasia, APRU brings together thought leaders, researchers, and policy-makers to exchange ideas and collaborate on practical solutions to the challenges of the 21st century. The APRU Global Health Program, housed at the University of Southern California, organizes an annual conference to bring together experts from around the region to exchange ideas and knowledge relating to global health. The articles included in this issue were all invited papers that were presented at the 2021