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When it comes to urban health, the world should look towards Latin America as a start

The future of social progress and equity will hinge on the decisions made and policies implemented in cities around the world; this is where Latin America can make an impact.



Posted on February 28, 2018
Photo of cable car over mountain in Rio de Janeiro, Brazil

By Ana V. Diez Roux, MD, PhD, MPH and Adriana C. Lein, MSc-GH

Policymakers, researchers, and global development practitioners alike may find the question of how to describe Latin America and its position of the global stage to be as pressing as it is perplexing. If the past decades have taught us anything, it’s that the region has a unique dynamic strength in the face of globalization, economic transformation, and shifting political landscapes. Latin America, in many ways, tends to defy expert predictions, for better or for worse. But, it’s exactly the region’s diversity and unpredictability that makes it so important to examine.

Latin America, which is home to approximately 625 million people, is as socially, economically, and politically diverse as it is geographically sprawling. Changing social, political and economic tides as well as oscillations between democracy and dictatorship have characterized the region for many decades. The end of the 20th century brought an end to right-wing military regimes and ushered in a wave of free elections in many countries. A distinguishing feature of Latin America has been rapid urbanization which took place over the four decades. Today with 80% of its population living in cities, Latin America is one of the most urbanized regions in the world.

The implications of Latin America’s urbanization are numerous, both for the region itself and the world. Urbanization brought both benefits and challenges. For one thing, cities are hubs for just about everything imaginable; the good--innovation, economic opportunities, social progress- and the bad- poverty, inequality, crime, violence, disease. While urbanization is a global trend not confined to Latin America, there are characteristics unique to the region and its processes of urbanization that merit attention. The first is the sheer magnitude of its urbanization- reflected both in its share of the world’s megacities, as well as the quantity of its emerging intermediate and smaller sized cities. The second is the heterogeneity of urban social, economic, and physical environments across the region.

Latin America’s cities are also characterized by pronounced social inequalities. In fact, over half of the world’s 30 most unequal cities are in the region. These inequalities are revealed in the social and spatial exclusion of disadvantaged populations, be it along lines of socioeconomic status, race, gender, ethnicity, education level, or a combination. Poverty is also increasingly becoming an urban phenomenon as 60% of the region’s poor and half of the extremely poor live in cities. Cities are quickly becoming stages for the greatest challenges to health and sustainable development that the planet will face in the coming years.

In its global report on Urban Health, the World Health Organization declared that healthier and more sustainable cities are the vehicles through which sustainable development agendas will be realized. The future of social progress and equity will hinge on the decisions made and policies implemented in cities around the world; this is where Latin America can make an impact.

The region has explored and implemented innovative reforms in urban settings, from comprehensive urban redevelopment programs to the Open Streets initiative to promote physical activity, to taxes on sugar-sweetened beverages, and transformed public transportation systems, all with the goals of improving living standards, inclusivity, and connectivity. The variation in population demographics and urban conditions, together with the changes that may emerge in response to new policies, can offer insights into what works- and what doesn’t- to build healthier and more sustainable cities.

As the world explores better ways to design, manage, and govern cities so that they promote population health and environmental sustainability, the Latin American experience is worth looking at.


This post was written by Ana V. Diez Roux and Adriana C. Lein as a contribution to Cities, Sectors, and Health, run by the SALURBAL Project. To contact the blog or learn more about the SALURBAL project email

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