More than 50% of the world’s population now lives in urban areas. Urbanization implies “considerable changes in the ways in which people live, how they earn their living, the food they eat, and the wide range of environmental factors to which they are exposed.” There is an underlying assumption that urban populations will be healthier than rural areas and that urbanization equates with modernization. However, this is not always seen in the empirical data. Especially, research about transitions to urban areas in african countries have showed to bring many health hazards.
https://www.csis.org/analysis/urbanization-sub-saharan-africa
A past conception regarding rural versus urban health was the idea of an “epidemiological transition” that occurs when populations move from underdeveloped areas to urban ones. With the onset of modernization it was thought that the burden of disease would shift from infectious to chronic causes. In the past, most deaths were caused by infectious diseases, degenerative diseases, and violence; thus, people did not often live long enough to be afflicted by chronic causes of death such as heart disease and diabetes. While this transition does exist in some extent, today it is more appropriate to talk about a “double burden” of disease, both infectious and chronic.
This double burden, especially in sub saharan and around half of the countries in the East African region is often present in areas that have experienced rapid urbanization. Throughout most of human history, populations were not large enough to sustain highly transmissible infectious diseases for long periods of time. Now, however, this is no longer the case. Because people are living closer to one another in often unsanitary environments, the potential for infectious disease transmission is much higher. In addition to higher rates of infectious diseases, rapid urbanization has led to poor living and working conditions, and thus more chronic diseases. For example, poor urban individuals who live in moldy apartments are more likely to be afflicted with asthma.
Furthermore, overworked factory employees are more likely to suffer from work-related injuries and environmental pollution. The report states that in the period leading up to 2050, the studied East African countries (which, according to the report, constitute the least urbanized region in the world) will experience rapid urbanization and that this urbanization could result in reduced poverty levels if there is social protection customized for and extended to poor people in urban areas. According to the report, the general higher mobility of individuals and greater fluctuations in income in urban areas make extending social protection in urban areas difficult.
Sources:
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007234/
– https://www.brookings.edu/blog/africa-in-focus/2017/09/01/figure-of-the-week-urbanization-poverty-and-social-protection-in-east-africa/
– https://read.oecd-ilibrary.org/development/social-protection-in-east-africa_9789264274228-en#page31
East Africa 
Dear group,
I like the way you disproved the statement that people living in an urban area are healthier than rural areas because of the many health hazards they face. You correctly state that infectious diseases were used to be a main reason for death in the past. An important thing I would add is that this is because people are getting older due to new technologies and interventions that tackle those infectious diseases. Additionally, it is also important to mention that most chronic diseases arise at higher age. Therefore, nowadays chronic diseases are becoming a more common cause of death than infectious diseases. This creates the double burden of diseases.
My compliments for how you showed the influence of urbanization on this topic on various levels.
Kindly regards,
Tharsini
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Dear group,
Firstly, very interesting blog post in which you are targeting an important problem of the double burden disease. As you described, Africa is experiencing a double burden of diseases, which characterised by the increasing prevalence of chronic non-communicable diseases (NCD) and the battle to deal with infectious diseases. The burden of NCDs disproportionately affects populations in low and middle income countries (LMIC) where health systems are weak. In LMICs, especially in sub Saharan Africa there is a rapid increase of NCDs due to urbanisation, rapid population growth, increased life expectancy and lifestyle factors. This has become really clear for me from your post.
However, I missed some depth. Perhaps you can explain more about the effects of the change in lifestyle and the barriers to the health system in LMICs to cope with this double burden (Because you would expect that there are more hospitals in the urban areas so the prevalence of double burden would be lower)
Furthermore, would recommend to add some more number of the prevalence of CDs/NCDs in the urban and rural areas to show the impact of urbanisation on both.
I enjoyed reading your blog, keep up the good work!
Kind regards,
Julia Schellekens
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Hi group!
You’re blogs are very easy to read and to understand, just like the rest of your blogs! I was just wondering, is there a certain message you’d like to deliver? Is there a certain problem you want to give more attention? Otherwise try and give examples of certain areas in East Africa where urbanisation is a huge issue. This makes the blog even more entertaining to read and to give more power to your message!
Just trying to give feedback, it is hard to find issues in a well written blog!
Kind regards,
Max Bakker
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Hi everyone,
First of all, compliments on the clear and easy to understand way of writing within this blog post, and actually all of your blog. Moreover, your blog looks really beautiful and professional. Good job on that!
At the 2nd paragraph of you blog you state: “A past conception regarding rural versus urban health was the idea of an “epidemiological transition” that occurs when populations move from underdeveloped areas to urban ones.”
I was wondering why you’ve chosen to address the term epidemiological transition, when you’re not really explaining it any further within your blog post.
Moreover, is it always the case that during this epidemiological transition people move from ‘underdevelopad areas’ to urban ones ? Because the actual defintion of the epidemiological transition is: “a phase of development witnessed by a sudden and stark increase in population growth rates brought by improved food security and innovations in public health and medicine, followed by a re-leveling of population growth due to subsequent declines in fertility rates”. So thus this ALWAYS mean that people move from underdeveloped areas to urban ones?
Could this epidemiological transition also occur within urban areas?
Besides that, maybe using the words underdeveloped areas and urban ones isn’t completely correct. Rural areas can be developed as well, whereas urban areas could be highly underdeveloped (think of slums).
And maybe you could add some data / statistics / numbers etc? This makes the message you would like to deliver more interesting to read.
Kind regards,
Eva Feijt
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