Most of the top 10 causes of death are closely related to rapid and unplanned urbanization and poor urban design and planning. Cities face the triple health burden of infectious diseases such as tuberculosis, HIV/AIDS, pneumonia, dengue and diarrhoea; noncommunicable diseases (NCDs) such as cardiovascular diseases, asthma, cancer, diabetes and depression; and violence and injuries, including road traffic injuries.

Urbanization at the global scale significantly impacts health through changes in social and environmental landscapes. While cities are engines of economic growth, innovation and social progress, they are also epicentres for diseases and drivers of climate change, changes in land use and natural resource depletion. As urban populations grow, cities influence public health with respect to issues ranging from inadequate housing and transport to poor sanitation, waste management, air quality and noise level; increases in violence and injury affect most the poorest and vulnerable. Health inequities are perhaps most stark in urban areas, sometimes varying from street to street. The majority of refugees and migrants, in particular migrants in irregular situations, and other disadvantaged groups tend to be clustered in the most deprived and environmentally degraded neighbourhoods with less mobility, fewer work and educational opportunities, poorer access to health services and below average health outcomes.

In 2018, 61% of refugees were living in urban areas and 47% of these were women and girls; many were residing in informal settlements or other inadequate housing situations. These groups are disproportionately impacted by health crises through the compounded effect of structural economic, social and gender inequalities with issues such as crowding, lack of access to health care, lack of culturally and linguistically appropriate information and discrimination or stigma.

Social determinants of health

Guidance, training, reports