Cities, urbanization and health

Abstract

It is in cities, and not the countryside, where the human ‘creative flame’¹ has burnt most brightly. For millennia they have been the centres and drivers of commercial, scientific, political and cultural life, having major influence upon whole countries and regions. The positive and progressive aspects of cities and urban centres recognized by historians, economists and other social scientists contrast with the more pessimistic tone of much of the epidemiological and public health literature on cities and urban life. In part this derives from the iconic place in our discipline of accounts of poor urban health in the 19th century in countries such as Britain. Almost everyone who has taken a course in epidemiology will have come across John Snow's classic studies of cholera in London in the 1840s, with its attendant images of poor sanitation and contaminated water.²