Urbanization and Health

1. Urbanization and Health
(Findings from Article Review)
Mohammad Aslam Shaiekh
MPH-3rd Batch
School of Health and Allied Sciences (SHAS)
Pokhara University (P.U)
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2. Contents:
 Articles in a Short Glance
 Introduction (From Personal Perspectives)
 Author’s Point ofViews (from Article perspectives)
 Urbanization and Associated factors
 Conclusion
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3. Article in a Short Glance
 Authors: David A Leon
 Journal: International Journal of Epidemiology
 Volume: 37:4-8, 2008
 Published By : Oxford University on the behalf of
International Epidemiological Association
 Subject Matter: Urbanization and Health
 Draft Accepted on : 10th December 2007
 Publication: on 10th January 2008
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4. Urbanization: Personal Perspectives
Urbanization is the process by which there is an
increase in the proportion of people living in urban area
 Urbanization is the physical growth of rural or
natural land into urban areas as a result of
population immigration to an existing urban areas.
 Urbanization occurs because people move from
rural areas (Countryside) to urban areas (town and
cities)
 Among the first countries to become urbanized
were Great Britain and Some European countries
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5. Cause of Urbanization: Personal Perspectives
Urbanization occurs naturally from individual & corporate
effort to reduce time and expense in commuting and
transportation while improving opportunities for jobs, educations,
housing, and transportations.
 Living in cities permits individual and family to take advantages
of opportunities of proximity, diversity, and market place
competition
 It is easy to see why someone living on a farm might wish to
take their chance moving to the cities and make enough
money to send back home to their struggling family.
 Better basic services and job opportunities
 A greater verities of entertainment and better quality of
educations.7/6/2018 Aslam Aman_MPH 5

6. Urbanization: Push & Pull factors
Push Factors Pull Factors
Lack of Educational facilities Better & Higher Facilities
Lack of Job Opportunities Better & more Opportunities
Lack of Health Facilities Better Health Facilities
Lack of sewerage & electricity Availability of electricity
Land lord system Better living standards
Unequality & Traditional System UpdatedVersion
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7. Drawbacks of Urbanization: Personal Perspectives
Huge demand on land, water, housing, transport and
employment.
 Not all people enjoy the same standards of living
 Many urban people live in closely built shacks made of packing
cases, sheets of plastic, and corrugated iron
 Some urban people have a good supply of water and
electricity.
 Waste from bathroom and toilet goes directly into the city’s
sewers
 Squatters, however, lack these benefits and are forced to use
open drains and pit toilets.These can creates health hazard.7/6/2018 Aslam Aman_MPH 7

8. Author’s Point ofViews :
 Commercial, scientific, political and cultural life have major
influence upon whole country and urbanization.
 In 19th Century the Great Britain had the poor condition of
the urban health.
 John Snow’s done the classic studies of cholera in London in
the 1840s, with its attendant images of poor sanitation and
contaminated water.
 This history finds a resonance in contemporary concerns
about the impact of cities and urbanization on health.
1) First, there are the health and social problems of inner-city
areas of high income countries such as drug addiction,
violence and HIV/AIDS.3
2) Second, there is concern about the health and welfare of the
growing number of people in low and middle income
countries who are living in urban areas— many of whom are
in what are classified as slums.7/6/2018 Aslam Aman_MPH 8

9. Author’s Point ofViews
3) Third, increasing global urbanization is classed as a threat to
‘Public Health Security’ as the unprecedented level of population
agglomeration may facilitate the spread of epidemic diseases.
Finally, there is the plausible connection between urbanization
and the rising levels of non-communicable diseases in low and
middle income countries.
 Most of the growth in the world’s population over the next 25
years is anticipated to be in the urban populations of low and
middle income countries, particularly those in Africa and Asia.
2007 Millenium Development Goals report 8 presents data
showing that the proportion of the urban population in
developing countries who are living in slums has in fact fallen
since 19907/6/2018 Aslam Aman_MPH 9

10. Author’s Point ofViews
 The processes driving urbanization, rural-to-urban migration is
typically given the most attention because Such migrant studies have
been highly informative about the nature and timing of
environmental influences on disease risk.
 The health of cities in the 19th century has been at the heart of the
‘standard of living’ debate. This concerns the effects of
industrialization and urbanization on the economic, social and
health status of Britain and other populations that underwent these
momentous changes in the 19th century. increase in life expectancy
seen in Britain at this time.
 Urbanization and the rapid growth of cities in the middle of the
19th century has increased and mortality rates in large cities
appear to have been higher than the national average, because of
higher levels of overcrowding, poor sanitation and lack of access to
clean water found in cities and towns compared with rural areas.7/6/2018 Aslam Aman_MPH 10

11. Urban Health problems and associated factors
 The article suggests that in most instances child health is better, and
mortality lower, in urban than in rural areas.
 There is no clear and compelling evidence of an emerging urban
health penalty that puts urban children at greater risk than rural
children
 It has found that in developing countries, under-5 mortality was
higher in rural than urban areas
 The absence of an urban penalty in child health in low and middle
income countries today is the result of a combination of factors.
i. First, in these countries absolute poverty and malnutrition are
mainly rural phenomena. As malnutrition is an important risk
factor for death from common childhood infections of diarrhoeal
and respiratory disease7/6/2018 Aslam Aman_MPH 11

12. Urban Health Problems and Associated Factors
ii) Secondly, urban populations tend to have higher vaccination coverage
rates than their rural counterparts.
iii) Thirdly, dissemination and uptake of effective interventions such as
oral rehydration therapy are likely to be more effective in an urban
setting.
Children’s living conditions, health and survival in urban areas in most
low and middle income countries are poor compared with those in
high income countries. Moreover, as is often highlighted, there are big
inequalities in child health and mortality within cities—between the
poor and the affluent.
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13. Urban Health Problems and Associated factors
 The rise of non-communicable diseases in low and middle income
countries is being driven by enormous social and economic changes,
of which urbanization is one dimension.
 Urbanization is associated with profound changes in diet and in
exercise that in turn increase the prevalence of obesity,30 with
attendant increases in risk of type II diabetes and cardiovascular
disease
 In China, however, there is some evidence that the excess rates in
urban areas that were apparent in the 1980s are disappearing as
the prevalence of hypertension & obesity has been rising rapidly in
rural areas.
 Urban–rural convergence suggests that there are rising rates of
over weight and obesity in many rural populations, particularly in
countries with growing economies.
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14. Urban Health Problems & Associated factors
 The rise of non-communicable diseases in low and middle income
countries is being driven by enormous social and economic changes,
of which urbanization is one dimension.
 Smoking, one of the most preventable and important causes of
cardiovascular disease and cancer, is rising in prevalence in low and
middle income countries. However, it is very striking that in India
and China there is evidence that smoking prevalence is now higher
in rural than urban populations despite the prevalence of cancer is
high in urban peoples.
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15. Urbanization & Associated factors
 The greater wealth and economic vitality of cities compared with
the countryside is one of the primary reasons why people come to
and stay in urban areas. The possibilities of employment to meet
basic needs are often greater than in rural areas.
 For governments and other agencies it is easier and cheaper per
head to provide services (however limited) to people living in cities
than to the rural poor who are often dispersed over vast geographic
areas.
 the services and interventions that are thus more readily available
to the urban population are truly effective in reducing morbidity and
mortality—in childhood in particular
 The growing problem of non-communicable diseases is a particular
problem for the urban areas of low and middle income countries
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16. Conclusions
 There are real urban threats to health, on balance cities and urban
living, particularly in the developing countries. It is desirable that
epidemiologists and public health advocates develop a better and
more informed understanding of the nature of urbanization and the
differences between urban and rural life settings.
 In particular careful study is required of the way in which urban–
rural differences in disease risk are heterogeneous and often
context-specific.
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17. Flowering:
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18. Flowering:
THANK YOU
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