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Understanding Inner City Health
Inner city health, simply put, refers to the health status
of, and health issues faced by, individuals living within
the inner city. Also referred to as 'urban health', inner
city health examines the ways in which social, environmental
and policy-specific factors act to affect health, and what
the health outcomes look like at the individual and population
level.
Globally, almost half of the world's population lives in
urban environments. In Canada, 70% of the population lives
in cities with populations over 100,000. Large urban centres
are often characterized by areas of high population density,
as well as various environmental, social, and health problems.
Since urbanization trends are unlikely to change in the near
future -- virtually all population growth in the next 30 years
will occur in urban environments -- the health problems of
cities, and those of inner cities in particular, will grow.
Social and economic disadvantage is a growing concern as
we see an ever widening gap between rich and poor. Accompanying
this gap are large gradients in health, with the poor being
those suffering due to compromised health and well-being.
While some factors linking ill health, urbanization, and social
disadvantage are understood, there is a great deal that remains
unexplained.
The focus of inner city health research is to gain greater
understanding of the social, economic, and systemic factors
that influence both individual and population health, and
to evaluate interventions leading to improved health care
delivery and improved health.
Health research in the inner city has historically focused
on selected diseases or populations. Yet, inner city residents
share many health concerns because of their common geographic,
social, and structural conditions. For example, inner-city
environments include concentrations of several populations
who experience poor health, including individuals with substance
abuse problems, victims of violence, individuals with chronic
and persistent mental illness, the disabled, and people living
with HIV. Populations at particular risk for ill health are
also over-represented in urban environments, including those
with inadequate housing, poor nutrition, food insecurity low
education, high unemployment, or low income. The environmental
and social conditions of inner cities, including high population
density, air pollution, social isolation, language and cultural
barriers to care, crime, and exposure to occupational and
environmental hazards, can also cause or exacerbate illness.
Inner city health research is committed to examining health
issues that are specific to vulnerable and disadvantaged populations
that tend to be over-represented in large urban centres.
The importance of health among inner city populations has
been recognized by various organizations, and significant
action is being taken. Internationally, the World Health Organization's
(WHO) Healthy Cities Program focuses attention and resources
on the issue of health in urban contexts.
WHO recognizes and is committed to addressing health in the
urban context, through its policy and technical programmes,
its direct work with cities, and its work with national governments
to support and develop the urban dimension. (Source: Statement
by World Health Organization to the Special Session of the
General Assembly For an Overall Review and Appraisal Of the
Implementation of the Outcome of the United Nations Conference
on Human Settlements (HABITAT II), New York, 6 June 2001).
In the United States, several organizations and research
centres, such as the Urban Institute in Washington and the
Center for Urban Epidemiologic Studies in New York, have been
established to combat the growing problem of social, economic
and health disadvantage in the country.
Thank you to St. Michael's Hospital
in Toronto, Canada, for this article.
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