REVIEWS ON ENVIRONMENTAL HEALTH

REVIEWS ON ENVIRONMENTAL HEALTH

Vol. 15: Nos. 1-2, 2000

SPECIAL ISSUE: URBAN HEALTH

Guest Editor: Roderick J. Lawrence

This special issue addresses the vast and complex subject of urban health. Urban health encompasses the direct pathological effects of chemicals, some biological agents, and radiation, as well as the influence of physical, psychological, and social dimensions of daily life (including housing, transport and numerous other environmental characteristics of urban areas and their hinterlands). Urbanization, a characteristic of the 20^th century, is a profound transformation of human settlements. Living and working conditions in cities influence the health and well-being of citizens. Cities are localities of relatively high exposure to: Environmental hazards, including air pollution, noise, water contamination, and solid wastes; Physical hazards, especially industrial, occupational, and traffic accidents related to the increasing complexity of urban infrastructure, services, and technology; and Social hazards, such as infectious disease, unemployment, social unrest and criminality.

The Contributions: Dr Dietrich Schwela and WHO Headquarters reviews the impact of ambient air pollutants on specific compartments of the human body with reference to specific groups of the population and in relation to variability within specific cities and between seasons. The contribution by Stansfeld, Brown, and Haines is a comprehensive review of published research on the effects of environmental noise on non-auditory aspects of health. Fuller-Thomson, Hulchanski, and Wang present a critical synthesis of recent studies of and the current sate of knowledge about the relation between housing and health. The strong link exists between homelessness and illness is addressed by Moore, who reviews the qualities of home and well-being and presents an empirical study of these qualities for 531 homeless individuals in London in the 1990s. Harrison and Heywood address housing, health, and community services for older people in Britain. Passchier, Knottnerus, Albering, and Walda discuss the health impact of large airports, based on a review prepared by an international Committee of experts and completed in 1999 for the Health Council of the Netherlands. Mark McCarthy reviews the social determinants and inequalities in urban health, including lack of income and lack of access to education, employment, housing, and social support, a significant indicator of urban morbidity, mortality, and social malaise. Briggs and Field review the objectives of the Health and Environmental Analysis for Decision-Making Project (HEADLAMP), initiated by the Who in the 1990s. The application of the Local Agenda 21 initiative of the Rio Earth summit has led to more resources being attributed to developing methods and collecting data to formulate environmental health indicators. Hunt and Lewin’s contribution is based on the results of a comparative study of how decision-makers in four cities make decisions with or without using community based environmental health indicators. Dr. Gregory Goldstein from WHO Headquarters confirms that urban living conditions have a key influence on the incidence of both respiratory and diarrhea diseases, especially among infants and children and shows that urban health problems are not only the result of lack of potable water, basic sanitation, and waste disposal but also result from lack of stable employment and housing tenure. Conner and Tanjasiri review the concept of citizen participation, as discussed by the urban planning professions in the 1960s. The WHO Urban Food and Nutrition Action Plan is discussed by Pedersen, Robertson and de Zeeuw. Dubé presents the rationale, goals, and policies of the National Capital Commission of Canada to show how strategic environmental assessment that integrates health promotion has been used as a tool for urban planning in Ottawa and its hinterlands. In the concluding article, Dr. Agis Tsouros states that urban health is recognized as being of crucial importance and that municipal authorities have a key role to play in health promotion. Although urban policies and program have rarely been a high priority in the manifestos of governments or political parties, today there are many good reasons why urban health policies should be given a much higher priority by national and municipal authorities to promote the quality of life of all citizens and their health and well-being in the immediate future.

Table of Contents

Editorial Introduction: Urban Health: A New Agenda?

Roderick Lawrence

Air Pollution and Health in Urban Areas

Dietrich Schwela

Noise and Health in Urban Environment

Stephen Stansfeld, Bernadette Brown and Mary Haines

Public Health Impacts of Large Airports

Wim Passchier, Andre Knottnerus, Harma Albering and Ingrid Walda

Social Determinants and Inequalities in Urban Health

Mark McCarthy

The Health-Housing Relationship: What Do We Know?

Esme Fuller-Thomson, J. David Hulchanski, Stephen Hwang

Health and Home for Homeless People

Jeanne Moore

Health Beings at Home: The Health and Housing Interface for Elderly People

Lyn Harrison and Frances Heywood

Informing Environmental Health Policy in Urban Areas: The HEADLAMP Approach

David Briggs and Ken Field

Exploring Decision-Making for Environmental Health Services: Perspectives from Four Cities

C. Hunt, S. Lewin

Healthy Cities Project: Overview of a WHO International Programme

Gregory Goldstein

Communities Defining Environmental Health: Examples from the Colorado (USA) Healthy Communities Initiative

Ross Conner and Sora Park Tanjasiri

Food, Health and the Urban Environment

R. Pederson, A. Robertson, H. de Zeeuw

Urban Health: An Urban Planning Perspective

Pierre Dube

Postscript: Why Urban Health Cannot be Ignored: the Way Forward

Agis Tsouros

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