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Urban Challenges, Urban Solutions

November 9, 2011

Philadelphia skyline

Located in one of the nation’s largest urban centers, the Drexel University School of Public Health was established as a school without walls. Despite its exponential growth, the school maintains this deep commitment to improving urban health, and now reaches from its Philadelphia home to communities in the U.S. and around the world.

The Growing Importance of Urban Health

Urban health is a relatively new specialty within the public health field. Why urban health? Thirty years ago, four out of every 10 people in the U.S. were living in cities, but by 2050 this number is expected to grow to seven out of 10. In 1900, nearly 40 percent of the United States population was defined as “urban” by the Bureau of the Census; by 2008 that number had doubled to more than 80 percent.

Today, for the first time in history, more people are living in urban settings than in rural areas. However, this increased urbanization is resulting in significant health consequences. While cities offer a wealth of opportunities, such as greater access to employment, education, transportation, health care and economic growth, they also have brought about a sharp rise in lifestyle-related chronic diseases, greater health disparities, climate change and the urbanization of poverty. In many cases, city resources and infrastructure are overburdened and are not able to provide the necessary services for the well-being of all its residents.

The World Health Organization (WHO) reports that cities face a triple threat to urban health:

  • Infectious diseases, which thrive when people are crowded together;
  • Chronic diseases, such as diabetes, cancers and heart disease, which are on the rise with unhealthy lifestyles, including tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol;
  • Shouldering the burden of road traffic accidents, injuries, violence and crime.

Urban populations also experience some of the extremes of income and health inequality, with large differences in income between the highest and lowest-earning segments of the population. Income inequality has been increasing in the United States over the last 25 years and, for the low-earning segment, can have a significant negative impact on health. Areas with high income inequality and a low average income have been reported as experiencing nearly 140 deaths per 100,000 people, compared with a rate of less than 65 per 100,000 in other areas.

At their recent global health summit held in November 2010 in Kobe, Japan, WHO outlined five actions that will significantly increase the chances of better urban living conditions:

  • Promote urban planning for healthy behaviors and safety
  • Improve urban living conditions
  • Ensure participatory governance
  • Build inclusive cities that are accessible and age-friendly
  • Make cities resilient to disasters and emergencies

  A University-wide Commitment

Drexel is well-positioned to tackle these urban health issues. In fact, University President John A. Fry has challenged Drexel to fulfill its mission as a great urban university. In his convocation speech, President Fry said “Our highest purpose as a university is to educate and prepare leaders, who are capable of dealing with the great civic issues of our day, such as poverty, public education and the health of our cities. We do this in part by engaging them in meaningful civic activities, and letting them learn firsthand the joys and frustrations of public service at this most formative stage of their lives.”

He underscored his aspiration for Drexel to be “the most civically engaged university in the United States, across all three dimensions of engagement: academic, student and employee voluntarism, and institutionally supported neighborhood investment.” Recently the university began to address these challenges with the establishment of the Lindy Center for Civic Engagement. There is much more to come.

Urban Health at DUSPH

Every day the faculty, students and staff at the School of Public Health are tackling today’s urban health challenges. From HIV/AIDS to housing safety to chronic diseases our team is active in the urban health discussion. In this issue of Interaction we will share some of their work and their successes. We challenge our readers to become more actively involved in improving urban health.

See this and more articles in the latest Interaction magazine, a publication of the School of Public Health

--Richard Ochab, School of Public Health