Geography Reference
In-Depth Information
today (Table
13.1
). Certainly there are signs of improvement in the mortality rates
in countries such as the U.S.A., with deaths now down to 34,000 a year in 2012,
from levels of 54,000 in the early 1970s, which is still a rate of 1.08 deaths per
1000 people a year and the size of a small country town. Even this figure is unac-
ceptable. In any case there is little room for complacency in world terms. After
all, 91 % of the fatalities are now in low and middle income countries, places that
contain only half of the world vehicles so far. This high proportion is because only
28 countries (with 7 % of the world population) have compulsory road safety stan-
dards in five critical areas: drink and driving regulations, speeding, failure to have
seat belts, child-retaining devices, and the enforced use of helmets for motorcyclists
and cyclists. In many countries mortality rates could be reduced if the following
problems were solved: lack of driving tests; safe crossing places and pavements for
pedestrians; refusal to obey traffic signals and adherence to the designation of one
side of the road for traffic in one direction; erratic driving behaviour; and limited
effective ambulance services that can quickly administer care and remove traffic
victims to hospitals. Although mortality and injury rates have dropped in most of
the developed world there is still room for progress in their cities, such as better
designed roads and junctions, especially at high traffic accident areas, effective laws
to reduce distracted driving, segregated bicycle lanes, more public transit, and, as
some cities are showing, saving lives by reducing speed limits in residential areas to
30 km/h or below. Improved transport systems and the use of bicycles also provide
more healthy options, with the latter in particular providing exercise.
The man-made urban environments also affect health through the higher noise
levels and the stress that many people feel in these areas, often combined with an
absence of meaningful supportive relationships, issues usually dealt with under the
social determinants of heath category. More specifically, health is also affected by
all the
pollutants
generated by human numbers and their activities, from faecal mat-
ter to noxious products of industrial process and in household goods, poisonous
chemicals and nuclear outputs in some places, and to the fumes and particulates
from burning fossil fuels (EPA
1999
). These not only cause local health problems,
but by altering the atmosphere are threatening to alter the climate of the planet.
Many of these have already been described in the sustainable development discus-
sion (Chap. 5). A WHO report (
2014a
) on pollution levels in 1600 cities of the
world maintains that air pollution—both indoor due to stoves and fires and outdoor
because of vehicle and industrial emissions from fossil fuel—leads to over 7 mil-
lion deaths annually from these sources. Although the Indian government disputes
the figures, the source shows that Delhi now has worse air quality than Beijing,
as measured in small airborne particles that are less than 2.5 micrometers in size
(PM25) which are associated with increased rates of bronchitis, lung cancer and
heart disease.
However, not all aspects of a created environment are damaging. The addition of
parks, green spaces, recreation trails and nature areas etc., have long been regarded
as having a positive effects on humans as the discussion on the relationship between
green space and health in the chapter on Green Cities has shown (Chap. 4). Such
areas provide an antidote, in at least some cities, to the increase in urban densities
and indoor living.
