Public Health in Megacities and Urban Areas: A Conceptual Framework

Abstract

In this chapter, first, we will briefly discuss worldwide urbanisation processes with major dimensions of public health challenges in megacities and urban areas. Second, we present some empirical findings from public health surveys conducted in the megacity of Dhaka, Bangladesh. Third, a conceptual framework is proposed based on our research on megacities within the framework of the German Research Foundation’s priority programme “Megacities – Megachallenge: Informal Dynamics of Global Change” and forth, a description of the burden of disease – classified as group I, II and III diseases – in urban areas including their determinants are presented. Lastly, strategies to improve the quality of life in megacities and urban areas are discussed. The burden of disease in megacities has no homogeneous appearance throughout the world. This is true for differences between the cities in different continents or countries and for cities within one country. Even within a city, the distribution of the disease burden can be quite unequal between certain subpopulations. Urban health is influenced by various factors (Fig. 1.3) and is reflected by the proposed multilevel framework of urban health (Fig. 1.4). Therefore a general statement about the disease burden in megacities would not be appropriate. Within the following sections some key issues for megaurban health will be presented and core patterns of disease burden, classified according to the WHO disease grouping, will be introduced.