Worldwatch State of the World 2007; Chapter 7: Charting a New Course for Urban Public Health

Worldwatch State of the World 2007
Chapter 7: Charting a New Course for Urban Public Health
by Carolyn Stephens and Peter Stair

For millions of people around the world, cities are places of hope and growth, but also despair and death. For a tiny minority, cities and towns are meccas of long life, health, and even luxury. F or the majority of urban residents, however, they offer the hope of opportunity but are often only home to pollution, disease, and insecurity.

As people move into low-income settlements that are vaster and denser than ever before, they are struggling to prosper in environments at least as challenging as the cities of Victorian Europe. These are places unable to draw in enough fresh water or to channel excrement away safely. Residents live in dilapidated, intensely crowded homes. They have little access to health services, and few are able to get the education or jobs that could raise them out of their situation. Although cities have gained a reputation as healthy places to live, the urban poor often have higher rates of infant deaths and under-five mortality than their rural counterparts.

Our urban future needs creative new solutions. Equity is perhaps the key to the more complex social problems of cities—and it also can lead toward sustainability. A city where all residents live together in peace, sharing the same spaces and the same resources, is far from today’s urban reality. A city where people think of the next generation and the planet as a whole is also far from this reality. But neither vision is impossible—either to imagine or to achieve.

Carolyn Stephens is a senior lecturer in environment and health at the London School of Hygiene & Tropical Medicine and a visiting professor in the Federal University of Paraná in Brazil. Peter Stair, a former MAP Fellow at Worldwatch Institute, is a Master’s candidate in the Department of City and Regional Planning, University of California–Berkeley.