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HEALTH: Putting the Focus on Cities

Gustavo Capdevila

GENEVA, Apr 7 2010 (IPS) - The world’s public health policy-makers should focus on urban health problems, since for the last three years the majority of the planet’s population is living in cities, World Health Organisation (WHO) experts say.

Statistics confirm that the centuries-long predominance of rural populations ended in 2007, and the trend is expected to continue so that by 2030 some 60 percent of people will be urban dwellers.

By 2050, the ratio will be seven city dwellers for every three living in rural areas. In contrast, 30 years ago only four out of 10 people lived in cities.

This transformation has been anticipated in recent decades, based on the growth of urban areas in low-income countries at a rate four times that of cities in wealthy nations.

It took 130 years for London’s population to grow from one million people to eight million, but the same growth in Bangkok took just 45 years, and only 25 years in Seoul.

“In general, urban populations are better off than their rural counterparts,” said WHO director-general Margaret Chan.


People living in cities “tend to have greater access to social and health services and their life expectancy is longer,” she pointed out.

But urban life is not all a bed of roses. People in cities also have to live with health threats like inadequate sanitation and refuse collection, air pollution, road traffic accidents, epidemics of infectious diseases and unhealthy lifestyles.

The “triple threat” to health in cities includes infectious diseases, which thrive where people live in crowded conditions; chronic non-communicable illnesses like diabetes, different types of cancer and cardiovascular disease, which are more frequent in cities because of unhealthy habits like smoking and alcohol consumption, fast food and sedentary lifestyles; and road traffic accidents, violence and crime.

If rapid urbanisation without proper planning is added to all these risks, the negative consequences for the health and safety of city dwellers can be even greater.

That is why cities require coordinated policies and actions across multiple disciplines including environment, transport, education, parks and recreation, and urban planning, said Ala Alwan, WHO assistant director-general for non-communicable diseases and mental health.

The WHO is shifting its focus toward the ever more urbanised world and its consequences for health, both beneficial and harmful. It is quick to point out, however, that by adopting appropriate measures, cities can be made healthier.

Better urban planning, improving city living conditions, ensuring participatory governance, building inclusive cities and making urban areas resilient to disasters and emergencies are WHO’s recommendations to overcome the challenges.

An aspect emphasised by experts is that the majority of the urban population expansion, whether caused by natural growth or migration, consists of poor people.

Nearly one billion people, equivalent to one-third of the world’s urban population, live in shanty towns and slums, in precarious and unhealthy conditions.

“If cities fail to deliver on the perceived promise of economic opportunities for the poor, large concentrations of unemployed young people may threaten social stability, security and the health of communities as a consequence,” said Chan.

Particularly in low-income countries, inequalities will increase if the combination of internal migration, natural growth and lack of resources causes cities to fail to deliver necessary services, experts said.

On World Health Day, celebrated Wednesday, the WHO called upon municipal authorities, concerned local residents, non-governmental organisations, the private sector, advocates for healthy living and others to take a close look at health inequities in cities, and to take action.

“And WHO will be doing more, today and into the future, to support those efforts,” said Chan, as she launched a global campaign for healthy cities.

 
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