ABSTRACT
The environment has always been a major determinant of health. More than half of the world’s population is now living in urban areas. The positive contribution of cities and urban centres in economic and sociological advances are well recognized, but this contrasts with the historical findings in the epidemiological and public health literature of unfavourable health effects of cities and urban life termed the ‘urban penalty’. Urban environment as opposed to rural surroundings presents unique challenges and opportunities for health promotion. Health risks of particular concern in cities include environmental pollution and unhealthy lifestyles leading to rising levels of non-communicable diseases, over-crowdedness facilitating the spread of epidemic diseases and inequity of health care provision among people with different socio-economic status. The upside of course is concentration of specialist and emergency medical service easily accessible in terms of location if not necessarily in price. The city also provides ample opportunity for cost-effective health education activities. Indeed, on average, urban dwellers enjoy better health than their rural counterparts. Looking forward, healthy urban living in the future can be fostered by city planning and building design with health enhancement in mind. Finally, the evolving COVID-19 pandemic exposes the difficulties and benefits of infection control in an urban environment that will have significant impact on public health strategy.
