This chapter shows how supplanting indigenous African spatial and physical development strategies with Eurocentric varieties has contributed to the degradation, rather than the improvement, of health conditions on the continent. It explains some important characteristics of modernist spatial and physical planning with implications for public health. The structure of towns built on modernist planning principles in Africa differs markedly from that of the indigenous ones they supplanted. Indigenous African towns evolved from villages and hamlets. The variable promotion and protection of public health based on their geographic location, which was tied to other human characteristics, particularly race', is a colonial legacy in Africa. The link between social factors and public health can be easily appreciated by simply imagining the cost implications and affordability issues inherent in coming by the basic amenities of life, including shelter, food, and clean water.