Rapid Urbanization: Increasing Health Issues
Cities are known to play multifaceted functions in all societies. They are the heart of technological development and economic growth of many nations, while at the same time serving as a breeding ground for poverty, inequality, environmental hazards, and communicable diseases. When large numbers of people congregate in cities, many problems result, particularly for the poor. For example, many rural migrants who settle in an urban slum area bring their families and their domesticated animals—both pets and livestock—with them.
This influx of humans and animals leads to vulnerability of all migrants to circulating communicable diseases and the potential to establish an urban transmission cycle. Further, most urban poor live in slums that are unregulated, have congested conditions, are overcrowded, are positioned near open sewers, and restricted to geographically dangerous areas such as hillsides, riverbanks, and water basins subject to landslides, flooding, or industrial hazards.
All of these factors lead to the spread of communicable and non-communicable diseases, pollution, poor nutrition, road traffic, and so on. The problems faced by the poor spill over to other city dwellers.
As the trend to urbanization continues, this spillover effect increases and takes on a global dimension as more and more of the world’s populations are affected. Some of the major health problems resulting from urbanization include poor nutrition, pollution-related health conditions and communicable diseases, poor sanitation and housing conditions, and related health conditions. These have direct impacts on individual quality of life, while straining public health systems and resources.
Urbanization has a major negative impact on the nutritional health of poor populations. Because they have limited financial resources and the cost of food is higher in cities, the urban poor lack nutritious diets and this leads to illness, which contributes to loss of appetite and poor absorption of nutrients among those affected. Furthermore, environmental contamination also contributes to undernutrition; street food is often prepared in unhygienic conditions, leading to outbreaks of food-borne illnesses (e.g., botulism, salmonellosis, and shigellosis). Urban dwellers also suffer from overnutrition and obesity, a growing global public health problem. Obesity and other lifestyle conditions contribute to chronic diseases (such as cancers, diabetes, and heart diseases). Although obesity is most common among the wealthy, international agencies have noted the emergence of increased weight among the middle class and poor in recent years.
Populations in poor nations that suffer from protein-energy malnutrition have increased susceptibility to infection through the impact of micronutrient deficiency on immune system development and function Around 168 million children under 5 are estimated to be malnourished and 76% of these children live in Asia. At the same time, the World Health Organization is concerned that there is an emerging pandemic of obesity in poor countries that leads to non-communicable diseases such as diabetes, cardiovascular disease, cancer, hypertension, and stroke .
Obesity is caused by increased caloric intake and decreased physical activity, something historically associated with wealth. However, people in urbanized areas of developing countries are also now vulnerable to obesity due to lack of physical space, continually sitting in workplaces, and excessive energy intake and low energy expenditure. In these areas, infrastructure is often lacking, including sufficient space for recreational activities. Further, in developing countries, as in developed countries, large employers frequently place head offices in urban capitals and work is increasingly sedentary in nature. Another culprit associated with the risk of developing obesity is the change in food intake that has led to the so-called nutrition transition (increased the consumption of animal-source foods, sugar, fats and oils, refined grains, and processed foods) in urban areas.
Solutions to Health Issues
National and international researchers and policy makers have explored various strategies to address such problems, yet the problems remain. For example, research on solutions for megacities has been ongoing since the early 1990s . These studies have concluded that pollution, unreliable electricity, and non-functioning infrastructure are priority initiatives; nevertheless, air pollution, quality of water in cities, congestion, disaster management issues, and infrastructure are not being systematically addressed. Until the conditions in rural areas improve, populations will continue to migrate to urban settings. Given the challenges that rural development poses, the root causes are unlikely to be addressed in the near future. Therefore, governments and development agencies should concentrate on adapting to the challenges of urbanization, while seeking to reduce unplanned urbanization.
Some examples of policies and practices that should be considered include (i) policies that consider whole-of-life journeys, incorporating accessible employment, community participation, mobility/migration and social transition, to break generational poverty cycles; (ii) policies addressing urban environmental issues, such as planned urban space and taxes on the use of vehicles to reduce use or to encourage vehicles that use less fuel as well as encourage bicycle use, walking, and other forms of human transportation; (iii) greater cooperative planning between rural and urban regions to improve food security (e.g., subsidies for farmers providing locally produced, unprocessed and low cost food to urban centers) (iv) social protection and universal health coverage to reduce wealth disparity among urban dwellers; including introduction of programs and services for health, for example by establishing primary healthcare clinics accessible and affordable for all including those living in urban slums.
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