Threats to Urban Health

Carolyn Stephens (carolyn.stephens@lshtm.ac.uk) is a senior lecturer in environment and health policy at the London School of Hygiene and Tropical Medicine and visiting professor in environment and health policy at the National University of Tucum Argentina.

The future looks more urban than ever. As urban demographer Ellen Brennan has observed, “In a few years, roughly around 2006, a crossroads will be reached in human history, when half of the world’s population will be residing in urban areas.” By 2030, three-fifths of the world’s population will live in urban areas.

Evidence indicates, though, that this future may be more unequal than ever. The majority of urban people will live in Asia, Africa, and Latin America - in countries that are getting relatively poorer, not richer. The latest World Bank data show the ratio of income per capita in the richest countries over that in the poorest countries has increased from 11 to 1 in 1870, to 38 to 1 in 1960, and to 52 to 1 in 1985. And poverty in the poorest countries appears to have become more urbanized. An urban world with growing inequality bodes ill for the health of urban dwellers.