Unhealthy cities

Unhealthy urban environments

Nature

By the turn of the century, half the 6.2 billion population of the planet will be urban. The unplanned and often chaotic growth of mega-cities will mean that at least half of their inhabitants will live in crowded tenements, shanty towns and slums without basis amenities. Overcrowding, filth and squalor encourages the spread of infectious diseases and poses massive threats to urban health. Even in the developed world, ill health as a consequence of urban living is prevalent.

The lack of adequate solid waste disposal and sewerage services causes serious public health problems in many cities, causing many diseases including often-fatal water-borne diseases such as cholera and dysentery.

Background

The significance of unhealthy cities emerged in the late 19th century, as rapid urbanization led to overcrowding, pollution, and disease outbreaks, notably highlighted by cholera epidemics in London and Paris. Throughout the 20th century, global awareness grew with studies linking urban environments to respiratory illnesses and reduced life expectancy. The World Health Organization’s Healthy Cities initiative in 1986 marked a turning point, framing urban health as a critical, interconnected global challenge.

Incidence

Unhealthy cities are a growing global concern, with over 90% of the world’s urban population exposed to air pollution levels exceeding World Health Organization guidelines. Rapid urbanization, inadequate infrastructure, and limited access to green spaces contribute to increased rates of respiratory illnesses, obesity, and mental health disorders. The problem is particularly acute in low- and middle-income countries, where urban populations are expanding most rapidly and resources for mitigation are often scarce.
In 2023, New Delhi, India, experienced hazardous air quality levels, with the Air Quality Index (AQI) surpassing 450 in several districts. Schools were closed and outdoor activities suspended, highlighting the acute health risks faced by residents.

Claim

Unhealthy cities are a crisis we can no longer ignore. Air pollution, lack of green spaces, and poor infrastructure are destroying our well-being and shortening lives. Millions suffer from preventable diseases simply because their environment is toxic. This is not just a public health issue—it’s a moral failure. We must demand urgent action to transform our cities into places where people can truly thrive, not just struggle to survive.

Counter-claim

The so-called issue of "unhealthy cities" is grossly exaggerated and hardly deserves our concern. People have always adapted to urban environments, and modern conveniences far outweigh minor health risks. With medical advances and personal choices, city dwellers can easily maintain their well-being. Focusing on this so-called problem distracts from truly pressing global issues. Frankly, the obsession with unhealthy cities is a waste of time and resources.