ABSTRACT
The Urban Transition is a phenomenon which is frequently labelled as ‘urbanisation’ – from the Latin urbe (‘city’ or ‘town’) and urbanus meaning ‘pertaining to the city’. Here we use the term ‘Urban Transition’ to highlight that the long shift in human populations from rural to urban existence poses qualitatively new challenges for public health. While urbanisation seems a modern idea, linked to the modern growth of cities, the idea that health and habitat are interrelated is very old. Certainly, human beings, and their domesticated animals, are unusual among animal species in having most of their deaths caused by disease. This reflects a change in human environmental conditions from the Neolithic agricultural revolution of some 12,000 years ago which brought people into close proximity with domesticated animals and with each other. To speak of an urban impact on health, therefore, is to have a coherence which is not captured by or subsumed within the notion of the Demographic Transition. As we show in this chapter, many writers have pointed out that the shift to urban existence has definable characteristics. We see the Urban Transition as posing new threats and opportunities for the quality of life and the public health. Sometimes these are extended and improved, sometimes drastically curtailed. The role of public health champions often makes the difference between good and bad urbanisation. The invisibility of public health which concerned us in Chapter 1 is largely due to the legacy of public health pioneers who recognised the threats from early urbanisation, and then acted, as we see below, but have subsided into unwarranted obscurity in public health.
