by - A.N. Khan
* Senior Scientist & Former Assistant Director, National Environmental Engineering Research Institute, Nagpur
Rapid urbanization and the increase in the population of cities are recognized as being among the major challenges of health development. Between 1990 and 2025, the total urban population in developing countries is projected to increase threefold to almost 61% of the population.
It is associated with many health challenges related with water, environment, violence and injury, non-communicable diseases and their risk factors like tobacco use, unhealthy diets, physical inactivity and the risk associated with disease outbreaks.Time and again, the bright lights of the city prove an irresistible attraction for families living in the surrounding countryside. They converge in ever-growing numbers on the already over-crowded cities, only to face shortcoming in housing, water supply, sewage disposal, local transport and job opportunities.
The urban poor suffer from a wide range of diseases and other health problems, including chronic diseases and for some, communicable diseases such as tuberculosis and HIV/AIDS. The increasing concentration of people in urban centers has strained the capacity of most governments to provide basic services. Illegal slums and settlements are common. In such areas, people are usually deprived of access to the basic facilities of drinking water and waste disposal.
Resources are not adequate for removal or disposal of waste. Residents have little access to facilities which make for a reasonable quality of life and human development. Thus they often suffer from greater exposure to dust, unpleasant smells, chemicals and noise pollution, and the nature of dwelling makes them less able to withstand such hazards. There is direct link between people dwelling in such conditions and cholera, viral hepatitis, typhoid fever, schistomiasis, dirrhoeal and parasitic diseases that are carried by water or poor sanitation, overcrowding and poor diet.
They are also exposed to health risks of modern cities – traffic, pollution etc., and suffer the consequences of social and psychological instability as the traditional support structures of rural areas steadily disappear. Most people in such cities struggle to survive by participating in the informal economic sector where exposure to occupational hazard is of very little concern. Long – term exposure to high levels of air pollution in build up areas can cause respiratory disease, persistent decline in lung function, carcinogenic effects, effects on the nervous and immune systems, and development of chronic obstructive pulmonary disease.
The growing realization that most of the improvements in health which has occurred in the recent past has come about because of action outside the medical sector – economic development, better nutrition and education, better housing, and a cleaner environment - has fostered renewed interest in Preventive Medicine. To make cities healthy, we must, all those who deal with aspects of the urban system that directly or indirectly affect health, involve themselves in urban health planning.
Urban planning can promote healthy behaviour and safety through investment in active transport, designing areas to promote physical activity and passing regulatory control on tobacco and food safety. Improving urban living conditions in the areas of housing, water and sanitation will go a long way to mitigate health risks. Building inclusive cities that are accessible and age-friendly will benefit all urban residents.
Such actions do not require additional funding, but commitment to redirect resources to priority interventions, thereby achieving greater efficiency.