Harness Urban Complexity for Health and Well-Being

Abstract

Introduction to Global Health ChallengesTo improve global health and well-being for cities, three global realities must be considered: the demographic shift related to aging of the population, the epidemiologic shift from infectious to noncommunicable diseases as the major threats to health, and climate change -which is changing disease patterns and quality of life, as well as, for some cities, creating serious challenges to their physical infrastructure.All of these critical challenges to health around the world converge in cities and the rapid rate of urbanization worldwide make attention to urban health a critical component of sustainable development.The number and size of cities is expanding in all regions of the world, with China positioned as the world's largest urban nation (see Chapter 1.1 ).Rapid urbanization is already presenting challenges to all countries, but its pace and scale are greatest in low-and middle-income countries, not only because of the rise of megacities (those with populations over 10 million), but primarily due to the rapid development of midsized cities of 250,000 to 500,000 inhabitants.While the rapid rise in the world's population of people aged 60 years or older is a public health triumph, it adds an additional challenge to advancing the health of people in cities: in the next four decades, 21 percent of the population will be over 60 years old, though the rate of increase of this demographic will still be higher in developed countries than in developing ones.Creating urban environments that support active, healthy aging, and health-promoting conditions for all ages is critical to preventing unsustainable pressures on health and social service systems and to maintaining a healthy workforce and active, engaged citizens.The epidemiologic shift towards noncommunicable diseases, or NCDsincluding primarily cardiovascular disease, or CVD; diabetes; cancer; and pulmonary disease -has made NCDs the number one cause of death globally, with a disproportionate impact in low-and middle-income countries and their already fragile healthcare systems.Deaths from NCDs are projected to increase

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