Urban Public Health – An Imperative

Sir George Alleyne, a Pan American Health Organization Director Emeritus penned this Guardian article as a strong call to governments to take urbanization as a health imperative, and work to coordinate policies to deal with the health implications of rapid urbanization.As an urbanist, I am simply alarmed that we know more in this generation about housing, urbanization and health than we have previously, yet we are still so slow to act.

If you opened your eyes in a city today, chances are that you live in a unit of mass housing where you are one of 60,000 people living in a square mile in a city of an estimated 8 million. You are likely to be affected by air quality in your building, whether a work site or a living space, and because you most likely live near a main thoroughfare – road, train or waterway, you are affected by the vehicles that use these paths. The food you have for breakfast may come from a neighboring continent, and more likely you have no time to leave urban life for the relatively less hectic life in the country or rural area. Sound familiar?

Alleyne urges every minister to think of themselves as a minister of health, which I support. Communicable disease management is critical to sustaining health in urban areas, and we have the technology to connect health providers and patients, to create surveillance and to prevent further spread.

I would go further and suggest that the built environment affects our health through the quality of buildings and the air quality within. Structurally, the materials, techniques and oversight in many rapidly urbanized areas are moving at a pace that governments may not be able to keep. I would extend the responsibility of public health to private actors (architects, construction engineers, quantity surveyors) a, building inspectors and local governments who can make sure that the built environment does not crush us under collapsed buildings, illegal electrical fixtures or pipeline fires.

Our throats and lungs, among other parts of the respiratory system are suffering even more from increased  chronic respiratory illness caused by urbanization. Housing and health are inextricably linked, as the graphic from this 1992 WHO Commission on Health and Environment demonstrates.


The questions remain – Who will act? and How much further do we need to agitate for a new interest in urbanization and its effects on our health?



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