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The smaller towns in the GTA are in the middle of a suburban growth that is changing their environment towards a more urban and less rural landscape. Cities like Vaughan and Markham are making tremendous strides with the quick urbanize the cities. Vaughan is building a new Metropolitan centre thanks to the opening of a TTC subway station. Markham has recently turned in a hot spot for both public and private real estate investments in the GTA. With the growth of urbanization, there is also and expected growth of population in the York Region. Some problems that appear with more people and a more urban city are; noise, traffic jams, air pollution, and sanitation and health problems.

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Boomburbs: The rapid rise of Toronto’s northern suburbs

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Urban growth and landscape transformations in York region: How Vaughan and Markham are exploding.

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This picture shows how quickly homes and cities are being built. The extreme expansion of major cities is leading to areas like this. 

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This graph shows the increase in urban areas compared the the decrease in rural communities. 

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Canada's urban population is expected to reach between 36 and 42 million people by 2031, and a large share of this population will live in large cities. The growth of the physical cities and population has led to air and water pollution, problems with transportation, crime and a bigger gap in income. Urbanization affects the physical environment through the number of people, their activities and the increased demands on certain resources. Urbanization has negative consequences on health mainly because of pollution and overcrowded living conditions. Air pollution is a problem that is created when major cities like Toronto quickly urbanize. Long-term health effects.  from air pollution include heart disease, lung cancer, and respiratory diseases such as emphysema. Air pollution can also cause serious damage to people's nerves, brain, kidneys, liver, and other organs that are vital for life.

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Introduction

More than half of the world's population lives in urban areas. Due to the ongoing urbanisation and growth of the world's population, there will be about 2.5 billion more people added to the urban population by 2050, mainly in Africa and Asia. The world's urban areas are highly varied, but many cities and towns are facing problems such as a lack of jobs, homelessness and expanding squatter settlements, inadequate services and infrastructure, poor health and educational services and high levels of pollution.

In this study session, you will learn about the trends in urbanisation and the causes of urban growth. You will also learn about the demographic, health, environmental and social consequences of urbanisation.

Learning Outcomes for Study Session 5

When you have studied this session, you should be able to:

5.1 Define and use correctly all of the key words printed in bold. (SAQs 5.1 and 5.2)

5.2 Describe the global and local trends in urbanisation. (SAQ 5.3)

5.3 Explain the main causes of urban growth. (SAQs 5.1 and 5.2)

5.4 Describe the main positive and negative impacts of urbanisation. (SAQ 5.4)

5.1 Urbanisation trends

In Study Session 2 you learned about the overall trend in global population growth. Most of this increase is taking place in urban areas. Urbanisation is an increase in the number of people living in towns and cities. Urbanisation occurs mainly because people move from rural areas to urban areas and it results in growth in the size of the urban population and the extent of urban areas. These changes in population lead to other changes in land use, economic activity and culture. Historically, urbanisation has been associated with significant economic and social transformations. For example, urban living is linked with higher levels of literacy and education, better health, lower fertility and a longer life expectancy, greater access to social services and enhanced opportunities for cultural and political participation (UNDESA, 2014). However, urbanisation also has disadvantages caused by rapid and unplanned urban growth resulting in poor infrastructures such as inadequate housing, water and sanitation, transport and health care services.

5.1.1 Global trends in urbanisation

In 1960, the global urban population was 34% of the total; however, by 2014 the urban population accounted for 54% of the total and continues to grow. By 2050 the proportion living in urban areas is expected to reach 66% (UNDESA, 2014). Figure 5.1 shows the change in the rural and urban populations of the world from 1950 through to projected figures up to the year 2050.

The process of urbanisation affects all sizes of settlements, so villages gradually grow to become small towns, smaller towns become larger towns, and large towns become cities. This trend has led to the growth of mega-cities. A mega-city is an urban area of greater than ten million people. Rapid expansion of city borders, driven by increases in population and infrastructure development, leads to the expansion of city borders that spread out and swallow up neighbouring urban areas to form mega-cities. In 1970, there were only three mega-cities across the globe, but by the year 2000, the number had risen to 17 and by 2030, 24 more mega-cities will be added (see Figure 5.2).

The global trend in urbanisation is not the same in all parts of the world. Asia and Africa currently have the highest rates of urbanisation. Figure 5.3 shows a comparison of trends in more or less developed regions of the world.

5.1.2 Urbanisation in Ethiopia

Ethiopia is one of the least urbanised countries in the world today, and only 18% of its population lives in urban areas (JMP, 2014). In common with many other developing countries, however, this pattern is changing (Figure 5.4). Ethiopia's urban growth rate is more than 4.0% per year, which places it among the highest in Africa and the world (MWUD, 2007).

The rapid increase in urban populations has meant that peri-urban areas are growing much more quickly than formal urban centres. Peri-urban areas are those areas immediately around a town or city. They are areas in transition from countryside to city (rural to urban), often with undeveloped infrastructure, where health and sanitation services are under pressure and where the natural environment is at risk of degradation.

Defining the boundaries of urban, peri-urban and rural areas is not straightforward. They do not neatly separate themselves by lines on a map. On the contrary, the sprawling nature of urban development means that the areas merge into each other. The lack of a clear boundary can make it difficult to assess the size of towns by their population or geographical area. However, judgements have to be made and, for planning and administrative purposes, data on population size are collected. Table 5.1 shows the number of towns and cities in Ethiopia by population in 2007, the most recently published data.

Of the four cities with a population of more than 200,000, by far the largest is Addis Ababa. In 2007, the population of Addis Ababa was more than 3 million, which amounted to about 25% of Ethiopia's urban population (MWUD, 2007). The next-largest city, Dire Dawa, had only 293,000 occupants at that time. The impacts of urbanisation are generally much more evident in the capital than in other towns and cities.

5.2 Causes of urbanisation

Urbanisation in the developing world occurs for two main reasons: the natural increase of population and rural to urban migration.

5.2.1 Natural increase of population

From Study Session 2 you will know that the population is increasing in developing countries. This natural increase is a significant cause of the growing urban population.

As birth rates decline over time, according to the demographic transition model, the role of natural increase in determining the pace of urban population growth becomes less important in comparison to migration.

5.2.2 Rural to urban migration

In developing countries, urbanisation usually occurs when people move from villages to settle in cities in hope of gaining a better standard of living. The movement of people from one place to another is called migration. Migration is influenced by economic growth and development and by technological change (Marshall et al., 2009) and possibly also by conflict and social disruption. It is driven by pull factors that attract people to urban areas and push factors that drive people away from the countryside.

Employment opportunities in cities are one of the main pull factors. Many industries are located in cities and offer opportunities of high urban wages. There are also more educational institutions providing courses and training in a wide range of subjects and skills. People are attracted to an urban lifestyle and the 'bright lights' of city life. All of these factors result in both temporary and permanent migration to urban areas.

Poor living conditions and the lack of opportunities for paid employment in rural areas are push factors. People are moving away from rural areas because of poor health care and limited educational and economic opportunities as well as environmental changes, droughts, floods, lack of availability of sufficiently productive land, and other pressures on rural livelihoods.

Rural to urban migration can be a selective process, as some types of people are more likely to move than others. One of the factors involved is gender, because employment opportunities vary greatly with different jobs for men and women. Another factor is age. Young people are more likely to move to towns, with more elderly people and children left in rural areas. Selectivity in migration affects the population in both the rural and the urban areas. If more men move to towns and cities than women, this leaves a predominantly female society in rural areas.

5.3 Impacts of urbanisation

Although people are pulled towards the advantages of cities, the impacts of urbanisation are mixed. First we will look at the many positive impacts of urbanisation before going on to describe some of the challenges created by rapid unplanned urban growth.

Thriving towns and cities are an essential element of a prosperous national economy. The gathering of economic and human resources in one place stimulates innovation and development in business, science, technology and industry. Access to education, health, social services and cultural activities is more readily available to people in cities than in villages. In cities, child survival rates are better than in rural areas because of better access to health care (Mulholland et al., 2008). The density of urban populations makes it easier and less costly for the government and utilities to provide essential goods and services (Brockerhoff, 2000). For example, the supply of basic facilities such as fresh water and electricity can be achieved with less effort and less cost per person.

Schools, colleges and universities are established in cities to develop human resources. A variety of educational courses are available, offering students a wide choice for their future careers. People of many classes and religions live and work together in cities, which creates better understanding and harmony and helps break down social and cultural barriers. Cities also have advanced communication and transport networks.

However, these many benefits of urban life do not apply to all. Rapid population increases and unplanned growth create an urban sprawl with negative economic, social, and environmental consequences. In Ethiopia, the rate of urban growth often strains the capacity of local and national government to provide urban residents with even the most basic services of housing, water supply, sewerage and solid waste disposal (MWUD, 2008).

5.3.1 Housing

In developing countries, about a third of urban inhabitants live in impoverished slums and squatter settlements (UN-Habitat, 2012). Slums are urban areas that are heavily populated and have sub-standard housing with very poor living conditions, creating several problems.

In Addis Ababa, a report in 2008 found that 80% of the houses in the city were classed as slums due to the physical deterioration of its housing, overcrowding, high density, poor access and lack of infrastructure services (Tolon, 2008) (Figure 5.5).

Slum areas typically suffer from:

poor housing with small, overcrowded houses built very close together using inadequate materials and with uncertain electricity supply

restricted access to water supplies

little or no sanitation/latrine facilities and no solid waste disposal, which leads to a polluted and degraded local environment

inadequate health care facilities which, coupled with the poor living conditions, increases sickness and death rates

insecure living conditions - slum dwellers may be forcibly removed by landowners or other authorities.

Many low-income families gravitate to these informal settlements that proliferate in and around towns. Poverty is one of the most critical issues facing urban areas. Urban poverty degrades both the physical and social environment. This then makes it more difficult for people to escape from poverty and they fall victim to the 'vicious cycle' that you read about in Study Session 2.

5.3.2 Water supply and sanitation

The provision of water and sanitation services to growing urban settlements, peri-urban and slum areas presents critical challenges. The increased demand for water from the growing population can place added stress on already stretched resources. In and around cities, water is commonly in short supply and subject to increasing competition by different users. Urban growth leads to increasing demand for water for industrial and domestic use, which conflicts with agricultural demands.

It is especially difficult to provide water and sanitation services to deprived areas and the poorest people. Many people in these areas live without access to safe drinking water and proper sanitation. Even where adequate water supplies are available, sanitation and wastewater disposal are often inadequate or missing. Pit latrines and septic tanks are the usual methods for human waste disposal but they have limited capacity and are not always adequate to cope with the quantity of waste produced by many people living close together. Overflowing latrines and septic tanks contaminate surface water and create a serious health risk.

The lack of these essential services threatens not only the health and the environment of people in slum areas, but also that of people living in formal urban areas. In Africa and Asia most of the urban centres have no sewers at all, which affects rich and poor alike. This is true of many cities with a million or more inhabitants, as well as smaller cities and towns.

5.3.3 Wastes and pollution

Urbanisation affects land, water, air and wildlife because of the number of people, the amount of buildings and construction, and the increased demands on resources. It has impacts on the physical environment in several ways.
Water quality
In developing countries, including Ethiopia, many rivers in urban areas are more like open sewers (Figure 5.6). The lack of sanitation and sewerage systems has a dramatic impact on urban watercourses. People use the rivers to dispose of all their wastes from homes, industries and commercial businesses. Wastewater from human settlements contains organic material and nutrients; industrial wastewater contains many different types of toxic pollutant. These make the water unsafe for humans to use for many purposes including drinking and irrigation, as well as harming the fish and other animals and plants living in the water. Any changes to the quality of surface water also affects groundwater because they are linked by the processes of the water cycle so pollutants from the surface will infiltrate down and contaminate soil and groundwater as well.
Solid waste
In many towns and cities solid waste management is inefficient or non-existent. Solid waste management means the proper collection, transfer, recycling and disposal of all the solid material we throw away, including plastics, paper and cardboard, food wastes, electrical waste, etc. It also includes industrial, hospital and institutional wastes which often contain pathogens as well as hazardous and toxic chemicals, which need special care.

Urban waste often ends up in illegal dumps on streets, open spaces, wastelands, drains or rivers. This is frequently a problem in peri-urban areas, which are convenient for dumping wastes because of the availability of open space and ease of access from central urban areas. This can lead to the pollution of groundwater and surface waters which may be used as a source for drinking water. Sometimes the wastes are collected and taken to legalised waste disposal sites but these are not always properly managed to protect water bodies and groundwater.

The combustion of solid waste creates yet another environmental problem. People want to get rid of the wastes and they will burn them in their backyards if there is no collection system (Figure 5.7).
Air quality
Air quality in towns and cities is frequently very poor as a result of air pollution from many different sources (Figure 5.8). These include:

vehicle exhausts

smoke from domestic fires

outputs from factory chimneys

diesel-powered generators

dust from construction works and city streets.

Poor air quality has a significant impact on the health of many urban residents as well as leaving a damaging and unsightly layer of dust on plants, buildings and other surfaces.

5.3.4 Health

Urbanisation can have both positive and negative effects on health. The main benefits are associated with easier access to hospitals, clinics and health services in general. If you live close to these services you can reach a doctor in minutes rather than hours or days, so this improves emergency care and general health. There are also benefits from easier access to sources of information such as radio and television which may be used to communicate information about health to the general public. For example, women living in towns and cities are more likely to be informed about family planning, which results in reduction in family size and less frequent childbirth, with consequent benefits to general health.

However, urban life can also damage your health. Poor environment, housing and living conditions are the main reasons for poor health in urban areas. Contamination of water sources can cause epidemics of waterborne disease. Close proximity to other people can make the spread of many types of infectious disease more likely. The polluted air can also cause respiratory disease and contribute to premature deaths among more vulnerable sections of the population such as older people and children.

5.3.5 Food

Population movements also put pressure on food supplies and on food distribution. As people migrate to the cities, they tend to use purchased food instead of their own crops and this makes them more vulnerable to changes in food prices. As the population grows and the demand for water and land increases, it becomes difficult to increase food production in a sustainable way. The increase in urban demand, combined with a loss of agricultural land, means more pressure on rural people to produce food for the growing number of urban people.

Furthermore, pollution from urban areas can disrupt food supply. For example, fisheries are often damaged by urban domestic wastes and liquid effluents from city-based industries. (Effluent is another word for wastewater that flows out from a source.) In several Ethiopian cities, such as Bahir Dar, Hawassa, Bishoftu and others, untreated wastes are dumped into nearby lakes, which can damage the fish stocks (Figure 5.9).

5.3.6 Economic and social systems

The process of urbanisation has positive as well as negative economic and social changes. The positive effects include economic development, and education. However, urbanisation places stresses on existing social services and infrastructure. Crime, prostitution, drug abuse and street children are all negative effects of urbanisation. Also there tends to be a lack of social support for children in school and home by their hard-working, usually poor, parents. Inadequate income, overcrowded housing and poor living conditions create a fertile ground for the development of violence. Violent crime is more visible in the cities than in rural areas and it affects people's everyday life, their movements and the use of public transport. Crime in the city can create a sense of insecurity in its inhabitants. This unsafe feeling in city streets separates residential areas into higher-income and lower-income groups, which reduces the sense of community and forms areas with dissimilar incomes, costs and security levels.

In the next study session we will look at some of the ways in which these problems and challenges can be addressed by considering the future demands for urban living and by taking a planned approach to the development of new urban areas.

Summary of Study Session 5

In Study Session 5, you have learned that:

1. Urbanisation is a global trend reflecting the growing population of the world. The urban populations of less-developed countries are currently increasing at a faster rate than those of more-developed countries.

2. Urbanisation results from a natural increase in the population and rural to urban migration.

3. People migrate to towns and cities in hope of gaining a better standard of living. They are influenced by pull factors that attract them to urban life, and push factors that make them dissatisfied with rural living.

4. Urban living is associated with better employment and education opportunities, better health, greater access to social services and opportunities for social and cultural activities.

5. Uncontrolled migration and rapid urban growth are associated with increasing urban poverty and inequality and rises in slum and squatter populations. These people usually have inadequate water supply and sanitation services.

6. Urbanisation affects the physical environment through the impacts of the number of people, their activities and the increased demands on resources.

7. Urbanisation has negative consequences on health due mainly to pollution and overcrowded living conditions. It can also put added pressure on food supply systems.

8. The pressures of urban living may lead to crime and other consequences of social deprivation.

Self-Assessment Questions (SAQs) for Study Session 5

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions.

SAQ 5.1 (tests Learning Outcomes 5.1 and 5.3)

SAQ 5.2 (tests Learning Outcomes 5.1 and 5.3)

SAQ 5.3 (tests Learning Outcome 5.2)

SAQ 5.4 (tests Learning Outcome 5.4)

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Study Session 5 Urbanisation: Trends, Causes and Effects

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More than half of the world's population lives in urban areas. Due to the ongoing urbanisation and growth of the world's population, there will be about 2.5 billion more people added to the urban population by 2050, mainly in Africa and Asia.

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There is more damage in the picture then you can see though the process instead of the tranformation 

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The expansion and creation of towns and city's stems from the realization of instead of hunting crops and animals they will capture animals. Then breed them then kill them when fully grown for the most amount of food. This lead to more time to develop and expand there population This also lead to inventions which lead to human life expanding. When cities started to form was the innovations of to access energy while the amount of workers lead to exponential growth in population, size of the city and economy to allow everyone to strive. Cities that are bigger allow for more cash flow and jobs leading to the growth of the city even more. Until it might be to big and effect to much that has existed before the expansion ruining lives that existed there for a long time.

https://www.bbc.co.uk/teach/class-clips-video/geography-ks3-rapid-urbanisation/z4ybgwx

https://humantp.weebly.com/industrial-revolution.html#:~:text=The%20Industrial%20Revolution%20in%20its,a%20new%20society%5B7%5D.

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This short film is an ideal tool to introduce students to the processes of urban and rural development, and particularly how rapid urbanisation affects countries around the world today. It gives the students the opportunity to explore why people move from rural to urban areas and the positive and negative impacts and the challenges that such movements create. Points for discussion:

How does rapid urbanisation differ from urbanisation?

What challenges does rapid urbanisation present for urban areas?

What challenges does rapid urbanisation present for rural areas?

How can governments turn these challenges into opportunities?

Suggested activities: After watching this short film, students could explore case studies and further examples of rapid urbanisation and how it impacts on countries, particularly less economically developed countries. Students can develop maps to show the movement of populations and consider what mitigating factors government can take to realise the benefits and mitigate the drawbacks of rapid urbanisation. Students could explore how urbanisation patterns have changed over time, and whether or not the pace of urbanisation slows over time as countries become more economically developed. This short film is relevant for teaching geography at KS3 in England, Wales and Northern Ireland and 3rd and 4th Level in Scotland.

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This short film is an ideal tool to introduce students to the processes of urban and rural development, and particularly how rapid urbanisation affects countries around the world today. It gives the students the opportunity to explore why people move from rural to urban areas and the positive and negative impacts and the challenges that such movements create.

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This is how Vaughan plans to urbanize in the near future.

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Vaughan Metropolitan Centre and Transit Hub – It’ll Move You

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Buildings like these are being rapidly built, which means there is an abundance of construction which in-turn causes many problems.

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A Place to Grow, the Growth Plan for the Greater Golden Horseshoe, is the Government of Ontario’s initiative to plan for growth and development which supports economic prosperity, protects the environment, and helps communities achieve a high quality of life. A Place to Grow 2019, identifies a vision which is grounded in a set of guiding principles that provide the basis for guiding decisions on how land is to be developed, resources are to be managed and protected, and public dollars are to be invested.

The Secondary Plan has been prepared to ensure that new development will result in the creation of a complete community which will be compact, vibrant, inclusive, healthy, sustainable and diverse.

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Policies Related to the Topic & Why They are Important?x

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Policies Related to the Topic & Why They are Important?x

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As people move to urban places and the percent of people that live in cities tip towards it. there will be more stress on mayors to mass expand the cities leading to deforestation and other problems. The force of having to expand and worrying about inner conflict like inequality and health problems lead to certain policies being created. like one of Vaughan laws to make land that is made for the city used. This means that there are designated uses for land like Natural Areas. This law also says how preserving the already established land should stay allowing people to stay at there farm while expanding leading to minimal loss in jobs allowing the short term loss is not bad while expanding a city.

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The lands subject to this Amendment (“Subject Lands”) are
designated “New Community Areas”, “Natural Areas”, and “Agricultural” on Schedule 13 “Land Use” of VOP
2010. This Amendment will provide detailed policies with respect to land use, including height and density
provisions, urban design, the protection of cultural heritage and archaeological resources, transportation,
community facilities, natural heritage and open space. The intent of these policies is to facilitate the
development of a new community including new residential neighbourhoods. These policies are designed
to enable the creation of a complete community and ensure high quality development that is compatible
with surrounding land uses.

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when you urbanize to quick you have issues that effect everyone like when you need nutritional food, but there isn't enough so the food mass produced food (which is most likely unhealthy) is cheaper and theres more to go around. I have also noticed that the more we expand and theres more competition.When we work a lot it leads to less home made meals that normally have a well balanced diet. Instead we use fast food more which is bad for our health. Most of the issues are about overpopulation problems and competition these issues effect the poor the most, and some of the middle class. Competition/overpopulation also changed the economy the one example is the inflation and change of money from the baby boomers age to Gen Z age. This change is massive as the supply was so high but there was basically no demand leading to everything being cheaper. Now there is so much demand and A good amount of supply leading to higher expenses and harder to find housing. The only supply that generates fast enough to be Cheap is automated products. When cities quickly urbanize everyone is effected but the difference is who can handle it with healthy alternatives and spare cash.

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Urbanization refers to the mass movement of populations from rural to urban settings and the consequent physical changes to urban settings. In 2019, the United Nations estimated that more than half the world's population (4.2 billion people) now live in urban area and by 2041, this figure will increase to 6 billion people [ 1].

Cities are known to play multifaceted functions in all societies. They are the heart of technological development and economic growth of many nations, while at the same time serving as a breeding ground for poverty, inequality, environmental hazards, and communicable diseases [ 2]. When large numbers of people congregate in cities, many problems result, particularly for the poor. For example, many rural migrants who settle in an urban slum area bring their families and their domesticated animals-both pets and livestock-with them. This influx of humans and animals leads to vulnerability of all migrants to circulating communicable diseases and the potential to establish an urban transmission cycle. Further, most urban poor live in slums that are unregulated, have congested conditions, are overcrowded, are positioned near open sewers, and restricted to geographically dangerous areas such as hillsides, riverbanks, and water basins subject to landslides, flooding, or industrial hazards. All of these factors lead to the spread of communicable and non-communicable diseases, pollution, poor nutrition, road traffic, and so on [ 3, 4, 5]. The problems faced by the poor spill over to other city dwellers. As the trend to urbanization continues, this spillover effect increases and takes on a global dimension as more and more of the world's populations are affected [ 3].

Some of the major health problems resulting from urbanization include poor nutrition, pollution-related health conditions and communicable diseases, poor sanitation and housing conditions, and related health conditions. These have direct impacts on individual quality of life, while straining public health systems and resources [ 6].

Urbanization has a major negative impact on the nutritional health of poor populations. Because they have limited financial resources and the cost of food is higher in cities, the urban poor lack nutritious diets and this leads to illness, which contributes to loss of appetite and poor absorption of nutrients among those affected. Furthermore, environmental contamination also contributes to undernutrition; street food is often prepared in unhygienic conditions, leading to outbreaks of food-borne illnesses (e.g., botulism, salmonellosis, and shigellosis) [ 6]. Urban dwellers also suffer from overnutrition and obesity, a growing global public health problem. Obesity and other lifestyle conditions contribute to chronic diseases (such as cancers, diabetes, and heart diseases). Although obesity is most common among the wealthy, international agencies have noted the emergence of increased weight among the middle class and poor in recent years [ 7].

Populations in poor nations that suffer from protein-energy malnutrition [ 8] have increased susceptibility to infection [ 9] through the impact of micronutrient deficiency on immune system development and function [ 10]. Around 168 million children under 5 are estimated to be malnourished and 76% of these children live in Asia [ 11]. At the same time, the World Health Organization is concerned that there is an emerging pandemic of obesity in poor countries that leads to non-communicable diseases such as diabetes, cardiovascular disease, cancer, hypertension, and stroke [ 12].

Obesity is caused by increased caloric intake and decreased physical activity [ 13], something historically associated with wealth. However, people in urbanized areas of developing countries are also now vulnerable to obesity due to lack of physical space, continually sitting in workplaces, and excessive energy intake and low energy expenditure. In these areas, infrastructure is often lacking, including sufficient space for recreational activities. Further, in developing countries, as in developed countries, large employers frequently place head offices in urban capitals and work is increasingly sedentary in nature [ 14]. Another culprit associated with the risk of developing obesity is the change in food intake that has led to the so-called nutrition transition (increased the consumption of animal-source foods, sugar, fats and oils, refined grains, and processed foods) in urban areas. For instance, in China, dietary patterns have changed concomitantly with urbanization in the past 30 years, leading to increased obesity [ 15]. In 2003, the World Health Organization estimated that more than 300 million adults were affected, the majority in developed and highly urbanized countries [ 16]. Since then, the prevalence of obesity has increased. For example, in Australia, around 28% of adults were obese in 2014-2015 [ 17].

Pollution is another major contributor to poor health in urban environments. For instance, the World Health Organization estimated that 6.5 million people died (11.6% of all global deaths) as a consequence of indoor and outdoor air pollution and nearly 90% of air-pollution-related deaths occurred in low- and middle-income countries [ 18]. Poor nutrition and pollution both contribute to a third major challenge for urban populations: communicable diseases. The poor live in congested conditions, near open sewers and stagnant water, and are therefore constantly exposed to unhealthy waste [ 6]. Inadequate sanitation can lead to the transmission of helminths and other intestinal parasites. Pollution (e.g., from CO ₂ emission) from congested urban areas contributes to localized and global climate change and direct health problems, such as respiratory illnesses, cardiovascular diseases, and cancer for both the rich and the poor.

In addition to human-to-human transmission, animals and insects serve as efficient vectors for diseases within urban settings and do not discriminate between the rich and poor. The prevalence and impact of communicable diseases in urban settings, such as tuberculosis (TB), malaria, cholera, dengue, and others, is well established and of global concern.

National and international researchers and policy makers have explored various strategies to address such problems, yet the problems remain. For example, research on solutions for megacities has been ongoing since the early 1990s [ 19, 20]. These studies have concluded that pollution, unreliable electricity, and non-functioning infrastructure are priority initiatives; nevertheless, air pollution, quality of water in cities, congestion, disaster management issues, and infrastructure are not being systematically addressed [ 19, 20].

The impact of inner city transportation on health, such as road traffic, is emerging as a serious problem. Statistics show that a minimum of 10 people die every day on the railways in the city of Mumbai, India [ 21]. Vietnam is another example of a country that has seen a remarkable increase in road traffic accidents [ 22]. Improvements to the country's infrastructure have not been able to meet the increasing growth of vehicular and human traffic on the street. Vietnam reportedly has a population of 95 million and more than 18 million motorbikes on its roads. A deliberate policy is needed to reduce accidents [ 21].

Although urbanization has become an irreversible phenomenon, some have argued that to resolve the problems of the city, we must tackle the root causes of the problem, such as improving the socio-economic situation of the urban poor.

Until the conditions in rural areas improve, populations will continue to migrate to urban settings. Given the challenges that rural development poses, the root causes are unlikely to be addressed in the near future. Therefore, governments and development agencies should concentrate on adapting to the challenges of urbanization, while seeking to reduce unplanned urbanization.

Some examples of policies and practices that should be considered include (i) policies that consider whole-of-life journeys, incorporating accessible employment, community participation, mobility/migration and social transition, to break generational poverty cycles; (ii) policies addressing urban environmental issues, such as planned urban space and taxes on the use of vehicles to reduce use or to encourage vehicles that use less fuel as well as encourage bicycle use, walking, and other forms of human transportation; (iii) greater cooperative planning between rural and urban regions to improve food security (e.g., subsidies for farmers providing locally produced, unprocessed and low cost food to urban centers); (iv) social protection and universal health coverage to reduce wealth disparity among urban dwellers; including introduction of programs and services for health, for example by establishing primary healthcare clinics accessible and affordable for all including those living in urban slums [ 23].

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Urbanization: a problem for the rich and the poor? - Public Health Reviews

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Urbanization has long been associated with human development and progress, but recent studies have shown that urban settings can also lead to significant inequalities and health problems. This paper is concerned with the adverse impact of urbanization on both developed and developing nations and both wealthy and poor populations within those nations, addressing issues associated with public health problems in urban areas.