Urban as a Determinant of Health

Vlahov, David; Freudenberg, Nicholas; Proietti, Fernando Augusto; Ompad, Danielle C.; Quinn, Andrew; Nandi, Vijay; Galea, Sandro

doi:10.1007/s11524-007-9169-3

Cited by 375 publications

(286 citation statements)

References 53 publications

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“…In a 2007 paper on urban growth and population health, the authors recommended the inclusion of urbanicity as a potential determinant of health. 31 Indeed, our findings suggest a sensitivity of residential areas to noise disruptions from such urban standards as traffic intensification. Municipal planning policies and initiatives should consider integrating traffic restrictions and controls in residential areas and school zones.…”

Section: Discussionmentioning

confidence: 68%

Noise Levels Associated with Urban Land Use

et al. 2012

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Recent trends towards the intensification of urban development to increase urban densities and avoid sprawl should be accompanied by research into the potential for related health impacts from environmental exposure. The objective of the current study was to examine the effect of the built environment and land use on levels of environmental noise. Two different study areas were selected using a combination of small area census geography, land use information, air photography, and groundtruthing. The first study area represented residential land use and consisted of two-to three-story single-family homes. The second study area was characteristic of mixed-use urban planning with apartment buildings as well as commercial and institutional development. Study areas were subdivided into six grids, and a location was randomly selected within each grid for noise monitoring. Each location was sampled four times over a 24-h day, resulting in a total of 24 samples for each of the two areas. Results showed significant variability in noise within study areas and significantly higher levels of environmental noise in the mixed-use area. Both study areas exceeded recommended noise limits when evaluated against World Health Organization guidelines and yielded average noise events values in the moderate to serious annoyance range with the potential to obscure normal conversation and cause sleep disturbance.

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Section: Discussionmentioning

confidence: 68%

Noise Levels Associated with Urban Land Use

et al. 2012

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“…If even a small proportion of this saved money is used to assist the self-organisation of slum dwellers to improve access to safe water, sanitation and garbage removal, the likely health benefits would be enormous. 55,56 If we accept the argument that a reliance on 'fast' modes of transport consumes more time in total, and that this has a range of negative health impacts, what can be done to improve health through changes to transport in cities? The answer to this is twofold: changes in the transport behaviours of individuals or households and a fundamental re-think of current government policy on urban transport.…”

Section: Resultsmentioning

confidence: 99%

Speed Kills: The Complex Links Between Transport, Lack of Time and Urban Health

Tranter

2010

J Urban Health

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Road safety experts understand the contribution of speed to the severity and frequency of road crashes. Yet, the impact of speed on health is far more subtle and pervasive than simply its effect on road safety. The emphasis in urban areas on increasing the speed and volume of car traffic contributes to ill-health through its impacts on local air pollution, greenhouse gas production, inactivity, obesity and social isolation. In addition to these impacts, a heavy reliance on cars as a supposedly 'fast' mode of transport consumes more time and money than a reliance on supposedly slower modes of transport (walking, cycling and public transport). Lack of time is a major reason why people do not engage in healthy behaviours. Using the concept of 'effective speed', this paper demonstrates that any attempt to 'save time' through increasing the speed of motorists is ultimately futile. Paradoxically, if planners wish to provide urban residents with more time for healthy behaviours (such as exercise and preparing healthy food), then, support for the 'slower' active modes of transport should be encouraged. INTRODUCTIONDecreasing the speed of urban transport can have positive impacts on the economy, the environment and health. This paper outlines the main themes of existing research on these impacts and then explores the possibility that there is a more subtle, but no less important, link between speed and health. The paper argues that speed has a cost that can be measured in money and in time. This can produce a paradox whereby 'faster' modes of transport lead to a loss of time. Lack of time, or time pressure, has been identified as an important factor in urban health, due to its negative impact on mental health but also due to its impact on the ability or willingness of people to engage in physical exercise or to avoid fast (junk) food.The arguments about the health impacts of speed apply most clearly to the use of private motor vehicles, and this paper focuses on the health impacts of increasing the speed of cars. However, some of the arguments are also relevant to other highspeed modes. For example, high-speed trains can encourage urban sprawl, the complex negative health impacts of which are outlined below.Tranter is with the School of Physical, Environmental and Mathematical Sciences, UNSW@ADFA, Canberra, ACT, Australia.Correspondence: Paul Joseph Tranter, PhD, School of Physical, Environmental and Mathematical Sciences, UNSW@ADFA, Canberra, ACT, Australia. (E-mail: paul.tranter@adfa.edu.au) EXISTING UNDERSTANDINGS OF THE LINKS BETWEEN SPEED AND HEALTHSpeed is most commonly seen as a health issue in relation to road crashes. There are several other ways in which the speed of motorised traffic is linked to factors that have clear negative health impacts. Increasing the speed of motorised traffic increases levels of pollution. 1 High car speeds can affect levels of physical activity through reductions in active transport, including children's independent mobility. Local social interactions are disrupted by high...

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“…5 These trends have resulted in unprecedented growth of slums and unplanned settlements on the periphery of most African cities. 6 These informal settlements are hubs of deprivation, risky health behaviors, and environmental pollution, and people living therein are often systematically excluded from opportunities, capacity, and empowerment that would enable them to gain better control of their lives and health. [7][8][9] Young people in informal settlements face unique challenges as they transition to adolescence and adulthood in such a hostile environment characterized by high levels of unemployment, crime and substance abuse, poor schooling facilities, as well as poor sexual and reproductive health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

2008

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In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility-and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya's Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.

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Urban as a Determinant of Health

Cited by 375 publications

References 53 publications

Noise Levels Associated with Urban Land Use

Noise Levels Associated with Urban Land Use

Speed Kills: The Complex Links Between Transport, Lack of Time and Urban Health

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

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