Geography Reference
In-Depth Information
Despite occasional attempts to improve the condition of people in these informal
settlements there is still an enormous amount of work to do, given the scale of these
problems and the limited funds and trained personnel of the city administrations.
Indeed, at base the older developed world solutions to create healthier, man-made
environments are still needed. Although modern medicine, especially for infectious
disease has kept mortality rates low so far, the constant exposure to unhealthy con-
ditions and stress in these slums, combined with the new growth of antimicrobial
resistance mean that these areas could be the breeding grounds for future epidemics.
This fear should speed up efforts to improve these often squalid environments.
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Conclusions
Improving the health of people in cities is part of their basic needs and a matter of
social justice. It is one of the most important of the new policies contributing to live-
able urban places. The old urban health disadvantages were solved by the nineteenth
century engineering and regulatory approaches, and by the enormous advances in
medical knowledge and care. Yet too many urban places still need basic sanitation,
safe water supplies and adequate numbers of health care professionals and facilities.
In addition new concerns have arisen about gaps in the delivery of health care, even
in the developed world, with a need to address the societal structural conditions
that lead to high inequalities and poor health. The new Healthy City programmes
are creating positive changes through greater political involvement and community
engagement, with policies designed to improve access to health care, such as spa-
tial targeting and the use of Health Impact Assessments. The concept of `wellness'
stresses the need for active health promotion and research into the impact of the
many health determinants, especially the often downplayed environmental, eco-
nomic and social domains.
Although these new approaches are undoubtedly improving the health of people
in many cities, they are not enough. It has been shown that urban living creates
greater risks from such problems as traffic and pollution, but also from less time
spent outdoors. One problem is that some pregnant mothers who have limited expo-
sure to sunlight may be inhibiting the development of their foetuses, which seems to
account for the recent increases in many autoimmune diseases. Another comes from
an enormous recent rise in levels of myopia in young urban Chinese and other Asian
children in particular, with 70% of children affected in some areas. Studies have
discounted the general effect of genetic factors and shown that the children affected
are not spending enough time outdoors, with too much time studying indoors and
exposure to electronic devices. Control groups of Australian children and rural Chi-
nese did not have this problem, which seems to be a consequence of a lengthening
of the eyeball along its main axis due to a lack of exposure to sunlight (Lougheed
2014
, Rose and Saw 2013).
