Tokyo, JapanRapid urbanization is the dominant demographic trend in the 21st century. Urban design must focus on optimizing natural resources and human health. When building and managing cities, it must be a priority to reduce the overall ecological footprints by reducing impacts on biodiversity; air and water pollution; and per capita energy, water, and arable land use. Designing highly efficient cities and simultaneously capitalizing on health co-benefits, such as cleaner air and using physical activity as transportation, could make an enormous positive impact on health. Further research is needed to develop principles of effective sustainable urban design that promote the physical and mental health of urban dwellers while reducing the global ecological footprint of the world's cities.

Learning Objectives

  • L1: Compare and contrast the health benefits with the health harms of urbanization.
  • L2: Explain the drivers of regional urbanization, including sociocultural and economic factors.
  • L3: Describe ongoing changes in the demographics of urban centers.
  • L4: Propose potential interventions in the urban context to improve health, considering economic, political and sociocultural influences.


Oanh NTK, Leelasakultum K. Mapping exposure to particulate pollution during severe haze episode using improved MODIS AOT-PM10 regression model with synoptic meteorology classification. GeoHealth [Internet]. 2017. Publisher's VersionAbstract
Severe smoke haze from biomass burning is frequently observed in Northern Thailand during dry months of February–April. Sparsely located monitoring stations operated in this vast mountainous region could not provide sufficient particulate matter (PM) data for exposure risk assessment. Satellite aerosol optical thickness (AOT) data could be used, but their reliable relationship with ground-based PM data should be first established. This study aimed to improve the regression model between PM10 and Moderate Resolution Imaging Spectroradiometer AOT with consideration of synoptic patterns to better assess the exposure risk in the area. Among four synoptic patterns, each representing the totality of meteorology governing Northern Thailand on a given day, most severe haze days belonged to pattern 2 that featured conditions of clear sky, stagnant air, and high PM10 levels. AOT-24 h PM10 regression model for pattern 2 had coefficient of determination improved to 0.51 from 0.39 of combined case. Daily exposure maps to PM10 in most severe haze period of February–April 2007 were produced for Chiangmai, the largest and most populated province in Northern Thailand. Regression model for pattern 2 was used to convert 24 h PM10 ranges of modified risk scale to corresponding AOT ranges, and the mapping was done using spatially continuous AOT values. The highest exposure risk to PM10 was shown in urban populated areas. Larger numbers of forest fire hot spots and more calm winds were observed on the days of higher exposure risk. Early warning and adequate health care plan are necessary to reduce exposure risk to future haze episodes in the area.
van Praag CDG, Garfinkel SN, Sparasci O, Mees A, Philippides AO, Ware M, Ottaviani C, Critchley HD. Mind-wandering and alterations to default mode network connectivity when listening to naturalistic versus artificial sounds. Scientific Reports [Internet]. 2017. Publisher's VersionAbstract
Naturalistic environments have been demonstrated to promote relaxation and wellbeing. We assess opposing theoretical accounts for these effects through investigation of autonomic arousal and alterations of activation and functional connectivity within the default mode network (DMN) of the brain while participants listened to sounds from artificial and natural environments. We found no evidence for increased DMN activity in the naturalistic compared to artificial or control condition, however, seed based functional connectivity showed a shift from anterior to posterior midline functional coupling in the naturalistic condition. These changes were accompanied by an increase in peak high frequency heart rate variability, indicating an increase in parasympathetic activity in the naturalistic condition in line with the Stress Recovery Theory of nature exposure. Changes in heart rate and the peak high frequency were correlated with baseline functional connectivity within the DMN and baseline parasympathetic tone respectively, highlighting the importance of individual neural and autonomic differences in the response to nature exposure. Our findings may help explain reported health benefits of exposure to natural environments, through identification of alterations to autonomic activity and functional coupling within the DMN when listening to naturalistic sounds.
Almada AA, Golden CD, Osofsky SA, Myers SS. A case for Planetary Health/Geohealth. GeoHealth [Internet]. 2017;1 (2) :75-78. Publisher's VersionAbstract

Concern has been spreading across scientific disciplines that the pervasive human transformation of Earth's natural systems is an urgent threat to human health. The simultaneous emergence of “GeoHealth” and “Planetary Health” signals recognition that developing a new relationship between humanity and our natural systems is becoming an urgent global health priority—if we are to prevent a backsliding from the past century's great public health gains. Achieving meaningful progress will require collaboration across a broad swath of scientific disciplines as well as with policy makers, natural resource managers, members of faith communities, and movement builders around the world in order to build a rigorous evidence base of scientific understanding as the foundation for more robust policy and resource management decisions that incorporate both environmental and human health outcomes.

Desjeux P. The increase in risk factors for leishmaniasis worldwide. Trans R Soc Trop Med Hyg [Internet]. 2001;95 :239-43. Publisher's VersionAbstract

Economic development leads to changing interactions between humans and their physical and biological environment. Worldwide patterns of human settlement in urban areas have led in developing countries to a rapid growth of mega-cities where facilities for housing, drinking-water and sanitation are inadequate, thus creating opportunities for the transmission of communicable diseases such as leishmaniasis. Increasing risk factors are making leishmaniasis a growing public health concern for many countries around the world. Certain risk factors are new, while others previously known are becoming more significant. While some risk factors are related to a specific eco-epidemiological entity, others affect all forms of leishmaniasis. Risk factors are reviewed here entity by entity.

Ulrich RS. View through a window may influence recovery from surgery. Science [Internet]. 1984;224 :420-1. Publisher's VersionAbstract

Investigations of aesthetic and affective responses to outdoor visual environments have shown a strong tendency for American and European groups to prefer natural scenes more than urban views that lack natural elements (1, 2). Views of vegetation, and especially water, appear to sustain interest and attention more effectively than urban views of equivalent information rate (2). Because most natural views apparently elicit positive feelings, reduce fear in stressed subjects, hold interest, and may block or reduce stressful thoughts, they might also foster restoration from anxiety or stress (3).

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