Bulletin of the World Health Organization (BLT)

Urbanization and health

For the first time in history, more than 50% of the world’s population lives in an urban area. By 2050, 70% of the world’s population will be living in towns and cities.

“The world is rapidly urbanizing with significant changes in our living standards, lifestyles, social behaviour and health,” says Dr Jacob Kumaresan, director of the World Health Organization’s Centre for Health Development based in Kobe, Japan. “While urban living continues to offer many opportunities, including potential access to better health care, today’s urban environments can concentrate health risks and introduce new hazards”.

Motor vehicles are a major contributor to air pollution.
Motor vehicles are a major contributor to air pollution.

Health challenges particularly evident in cities relate to water, environment, violence and injury, noncommunicable diseases (cardiovascular diseases, cancers, diabetes and chronic respiratory diseases), unhealthy diets and physical inactivity, harmful use of alcohol as well as the risks associated with disease outbreaks. City living and its increased pressures of mass marketing, availability of unhealthy food choices and accessibility to automation and transport all have an effect on lifestyle that directly affect health.

The World Health Organization has chosen the theme of “urbanization and health” for World Health Day, on 7 April 2010, in recognition of the effect urbanization has on our collective health globally and on every individual. Its goal is to draw worldwide attention to the theme of urbanization and health and to involve governments, international organizations, business and civil society in a shared effort to put health at the heart of urban policy.

1000 cities, 1000 lives for World Health Day 2010

Many cities are planning outdoor exercise classes as part of World Health Day.
Many cities are planning outdoor exercise classes as part of World Health Day.

This year’s World Health Day campaign “1000 cities, 1000 lives” calls upon cities to open up public spaces for health activities for one day during the week of 7–11 April 2010. Many cities have planned activities such as closing off portions of streets to motorized traffic, town hall meetings with mayors, clean up-campaigns and events that promote social solidarity.

The aim is to encourage discussion and debate between city leaders and their citizens to take action to improve policies, attitudes and behaviour in the face of some of the more negative aspects associated with urbanization that impact health.

WHO has used social media such as Facebook and YouTube so that individuals all over the world can participate and interact. It has been collecting stories of urban health champions such as Japanese school student Yuhta Oishi who successfully campaigned to ban smoking in the streets of his city of Shizuoka.

Other events planned for 2010 include:

  • World Expo in Shanghai, which runs from May to October, with the theme of “Better City, Better Life”.
  • The launch of a report by UNHABITAT and WHO on urbanization and health, with a special theme of reducing health inequities in urban settings.
  • A new tool called Urban HEART (Health Equity Assessment and Response Tool) for national and municipal leaders to assess and respond to inequities in their urban settings.
  • A Global Forum in Kobe, Japan, in November will showcase the year’s findings and successes on urbanization and health.
World Health day: around the world
Obesity is rising among Mexican children.
Arantxa Cayón Nieto/Health Secretary of Michoacán
Obesity is rising among Mexican children.
  • An intense day of physical activity for children and teenagers is planned for 11 April, in the main street of Lázaro Cárdenas, an industrial city in Mexico. More than 2000 children and their parents are expected to join in fun exercise programmes with the help of a team of physical education teachers. In Lázaro Cárdenas, families have few opportunities to share time with their children to promote physical exercise and schools very often lack sports teachers and facilities. “High consumption of junk food puts youngsters at risk of obesity and other related diseases,” says Aránzazu Cayón Nieto, spokesperson from the health secretariat of Michoacán state.
  • In Somalia, more than 1 million people will receive health-related text messages for World Health Day. Messages have been selected and translated into Somali language and the largest mobile phone network in Somalia has agreed to send these messages free of charge.
  • In Jalalabad, Afghanistan, there is a plan to plant up to 100 000 trees.
  • In San Luis, Argentina, the Plaza Independencia and four surrounding streets will be open to residents.
  • Melbourne, Australia, plans a half- day family event including a run and bike on the Grand Prix circuit where participants are encouraged to carry a sign of their city of birth to demonstrate the multicultural nature of the city.
  • In Damphu, Bhutan, the day will be marked by raising awareness on health issues.
  • In Medellin, Colombia, there are activities planned for the whole population, including festivals, celebration of physical activity week and activi- ties involving old and young people.
  • Pointe Noire, the Congo, will focus on public hygiene activities such as cleaning the streets and waterways and will open streets to soccer, vol- leyball and a traditional women’s sport called Nzango.
  • In Port Said, Egypt, the plan includes walking for health, drawing for health, music for health, playing for health.
  • Golf lessons will be given in Cannes, France, to commemorate World Health Day.
  • Bangalore, India, plans to offer free tests for eyesight, blood pressure and weight as well as planting saplings.
Five key areas for action

the ability of governments to build essential infrastructures that make life in cities safe, rewarding and healthy, particularly in low- income countries,” says Kumaresan. “We are at a key turning point in history where we can take concrete actions to address the health issues associated with these urbanization trends.”

What can cities do to meet the challenges?

  • Promote urban planning for healthy behaviours and safety.
  • Improve urban living conditions, including access to adequate shelter and sanitation for all.
  • Involve communities in local decision- making.
  • Ensure cities are accessible and age- friendly.
  • Make urban areas resilient to emergencies and disasters.
City facts
  • More than half the world’s population now live in cities.
  • By 2030, six out of every 10 people will be city dwellers, rising to seven out of every 10 people by 2050.
  • Between 1995 and 2005, the urban population of developing countries grew by an average of 1.2 million people per week, or around 165 000 people every day.
  • One in three urban dwellers lives in slums, or a total of 1 billion people worldwide.
  • Globally, road traffic injuries are the ninth leading cause of death, and most road traffic deaths occur in low- and middle-income countries. Almost half of those who die in road traffic crashes are pedestrians, cyclists or users of motorized two-wheelers.
  • Urban air pollution kills around 1.2 million people each year around the world, mainly due to cardiovascular and respiratory diseases. A major proportion of urban air pollution is caused by motor vehicles, although industrial pollution, electricity generation and in least developed countries household fuel combustion are also major contributors.
  • Tuberculosis (TB) incidence is much higher in big cities. In New York City, TB incidence is four times the national average. In the Democratic Republic of the Congo, 83% of people with TB live in cities.
  • Urban environments tend to discourage physical activity and promote unhealthy food consumption. Participation in physical activity is made difficult by a variety of urban factors including overcrowding, high-volume traffic, heavy use of motorized transportation, poor air quality and lack of safe public spaces and recreation/sports facilities.