Urban Health

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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