The Non-linear Health Consequences of Living in Larger Cities (original) (raw)
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Social Science & Medicine, 2005
A majority of the world's population will live in urban areas by 2007 and cities are exerting growing influence on the health of both urban and non-urban residents. Although there long has been substantial interest in the associations between city living and health, relatively little work has tried to understand how and why cities affect population health. This reflects both the number and complexity of determinants and of the absence of a unified framework that integrates the multiple factors that influence the health of urban populations. This paper presents a conceptual framework for studying how urban living affects population health. The framework rests on the assumption that urban populations are defined by size, density, diversity, and complexity, and that health in urban populations is a function of living conditions that are in turn shaped by municipal determinants and global and national trends. The framework builds on previous urban health research and incorporates multiple determinants at different levels. It is intended to serve as a model to guide public health research and intervention. r
City-Size and Health Outcomes: Lessons from the USA
Economics Bulletin, 2007
In this paper, we compare health outcomes in cities of different sizes. Using 2001 National Health Interview Survey data for adult urban-US population, it is shown that individual health is better in bigger cities compared to small or medium sized ones. This result holds after controlling for potentially confounding variables including age, gender, education, marital status, smoking, income, asset-ownership, and race. Possible sources of selection bias are controlled using many model specifications and population sub-groupings. Although, stiff challenges for healthcare delivery exist for large cities, an aggressive urban health policy should also put strong emphasis on improving health in small and medium sized cities to reduce urban health disparities in the USA. Policy implications for other developed and developing countries are also hypothesized.
Economics & Human Biology, 2017
It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanizationthe process of the population shifting from rural to urban areas within countriesin affecting four important drivers of NCDs worldwide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980-2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40 mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3 kg/m 2 lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2 p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita.
Effects of urbanization on incidence of noncommunicable diseases
2012
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.
Urbanization, urbanicity, and health
Journal of Urban Health, 2002
A majority of the world's population will live in urban areas by 2007. The most rapidly urbanizing cities are in less-wealthy nations, and the pace of growth varies among regions. There are few data linking features of cities to the health of populations. We ...
Urban Scaling of Health Outcomes: a Scoping Review
Journal of Urban Health
Urban scaling is a framework that describes how city-level characteristics scale with variations in city size. This scoping review mapped the existing evidence on the urban scaling of health outcomes to identify gaps and inform future research. Using a structured search strategy, we identified and reviewed a total of 102 studies, a majority set in high-income countries using diverse city definitions. We found several historical studies that examined the dynamic relationships between city size and mortality occurring during the nineteenth and early twentieth centuries. In more recent years, we documented heterogeneity in the relation between city size and health. Measles and influenza are influenced by city size in conjunction with other factors like geographic proximity, while STIs, HIV, and dengue tend to occur more frequently in larger cities. NCDs showed a heterogeneous pattern that depends on the specific outcome and context. Homicides and other crimes are more common in larger ...
Health differences in an unequal city
Cities have a significant influence on people's mental and physical health. City planning has the potential to change behaviors and incentivize a healthier lifestyle through the provision of public goods and urban infrastructure. The bulk of the evidence correlating city configuration and population health comes mostly from cities in the global north, with little evidence from cities in developing countries. This analysis seeks to contribute to bridging this evidence gap. This empirical analysis presents an insight into population health conditions (phy-sical health and overweight-obesity) and its correlation with gender and socioeconomic conditions. Data comes from an extensive annual population survey conducted in Cali, Colombia. Results show that women and the poor report a higher probability of poor physical health and a higher number of days reporting poor mental health. Overweight and obesity are slightly increasing in the city, particularly amongst women, but there is no clear pattern by socioeconomic conditions. Overweight and obese people are more common amongst married couples, with lower educational attainment and lack of physical activity. This analysis aims to provide insights that can better inform urban policies and city planners to contribute to the global agenda of the Sustainable Development Goals to make cities sustainable, equitable, and livable.
Urban as a Determinant of Health
Journal of Urban Health-bulletin of The New York Academy of Medicine, 2007
Cities are the predominant mode of living, and the growth in cities is related to the expansion of areas that have concentrated disadvantage. The foreseeable trend is for rising inequities across a wide range of social and health dimensions. Although qualitatively different, this trend exists in both the developed and developing worlds. Improving the health of people in slums will require new analytic frameworks. The social-determinants approach emphasizes the role of factors that operate at multiple levels, including global, national, municipal, and neighborhood levels, in shaping health. This approach suggests that improving living conditions in such arenas as housing, employment, education, equality, quality of living environment, social support, and health services is central to improving the health of urban populations. While social determinant and multilevel perspectives are not uniquely urban, they are transformed when viewed through the characteristics of cities such as size, density, diversity, and complexity. Ameliorating the immediate living conditions in the cities in which people live offers the greatest promise for reducing morbidity, mortality, and disparities in health and for improving quality of life and well being.
2022
The Urbanization of the World that has been accelerated since the rise of the Neoliberal capitalism, Global Value Chains Revolution, Easternization of the Globalization and Trade and Prosperity Age has provided significant Capitalisation and Destructive effects of Urbanization. Unfortunately, by so doing, it has put the whole world at a greater risk of Urban-related Diseases including Chronic Diseases, Obesity, Suicide, Mental Health and Behavioral Disorders and Drug, Sex, Alcohol and Tobacco Addictions. However, in the ' Highly Urbanized, Industrialized, Prosperous, Polluted and Dense ' Cities and Nations of the World like the US ', Capitalisation and Destructive effects of Urbanization ' have been more pronounced than the ones of the ' Less Urbanized, Industrialized and Prosperous Nations of the South. Accordingly, James Michael Walker (2022) finds that the shift away of the US productive structure from the Middle-income and Routinized Industrial Economy to the Service-oriented and Knowledge-intensive Economy since the rise of the Neoliberal capitalism in the 80s did provide significant prosperity and wellbeing opportunities that helped transform US into the ' Most Powerful High-income and Upstream Economy ' of the World. Furthermore, the wellbeing opportunities have been improved with the Medical Science Revolution and ' Endogeneous Factors ' such as adoption of Healthy Lifestyle, Access to Healthcare Services and the rise of Income per capita. As a result, the above shifts have increased ' Life Expectancy ' in US. However and unfortunately, the above prosperity, wellbeing and life expectancy opportunities did not prevent the Capitalisation and Destructive effects of Urbanization in US to increase the Urban-related Diseases and make it easier for one of them including Chronic Diseases to become the leading cause of deaths. Furthermore, as expected, ' The Capitalisation and Destructive effects of Urbanization ' were more important in the ' Highly Prosperous, Urbanized, Polluted and Dense Cities and States of US' than in others Small-size and Medium-size Cities. That's the case for New York where the shift away from Resource-driven economy to the Industrial City to the Service-oriented and Knowledge-intensive Economy from the 18th century till now did provide significant prosperity and wellbeing opportunities. As a result,like the federal level, NY also did experience an increase in ' Life expectancy' and dramatic reduction of mortality rate. However, like the federal level, both Capitalisation and Destructive effects of the Urbanization of NY did put this state at a greater risk of Urban-related Diseases such as "Chronic Disease and Obesity" particularly since the 60s. Furthermore, of the Chronic Diseases and like at the global level, Heart Diseases and Cancer took the lead of Chronic Diseases in the US Cities and States. Therefore, there could be a positive correlation within Agglomeration economies, Destructive and Capitalisation effects of Urbanization and Urban-related Diseases. Furthermore, whether it's inside of NY or in other Large-size, Medium-size and Small-size Cities of the US, there has been a ' Structural, Economic, Gender, Age, Social and Spatial gap in Capitalisation and Destructive effects of Urbanization that in turn did support and structure the Structural, Economic, Gender, Age, Social and Spatial gap in Urban-related Diseases and Deaths related to them. This is mainly due to the significant Socioeconomic inequalities in health, income, education, jobs, wealth and residential goods and services face by them compared to Core Populations. Unfortunately, the above vulnerability of the Peripheral Population to Heart diseases such as CVD is dramatically reducing their Life Expectancy. Furthermore, James Michael Walker (2022) finds a vicious circle within Heart Diseases and Mental Health and Behavioral Disorders. For example, he finds that Heart diseases nourish Mental illnesses that in turn nourish Heart diseases. As a result, according to JACC (2020), countries should invest in existing cost-effective public health programs and clinical interventions to target modifiable risks, promote healthy aging across the lifespan, and reduce disability and premature death due to CVD. Key Words: The Urbanization; Capitalisation and Destructive effects of Urbanization; Urban-related Diseases; Chronic Diseases ; Life Expectancy; Heart Diseases; Cardiovascular Diseases; Structural, Economic, Gender, Age, Social and Spatial gap in Capitalisation and Destructive effects of Urbanization.
Quantifying urbanisation as a risk factor for non-communicable disease
Journal of Urban Health, 2011
Aim of this study was to investigate the poorly understood relationship between the process of urbanization and non-communicable diseases (NCDs) in Sri Lanka using a multicomponent, quantitative measure of urbanicity. NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n=4,485/5,000; response rate=89.7%). We constructed a measure of the urban environment for seven areas using a seven-item scale based on data from study clusters to develop an-urbanicity" scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors.