Journal of Urban Health

, Volume 90, Issue 2, pp 343–357 | Cite as

The Urban Health Transition Hypothesis: Empirical Evidence of an Avian Influenza Kuznets Curve in Vietnam?

  • James Herbert Spencer


The literature on development has focused on the concept of transition in understanding the emergent challenges facing poor but rapidly developing countries. Scholars have focused extensively on the health and urban transitions associated with this change and, in particular, its use for understanding emerging infectious diseases. However, few have developed explicit empirical measures to quantify the extent to which a transitions focus is useful for theory, policy, and practice. Using open source data on avian influenza in 2004 and 2005 and the Vietnam Census of Population and Housing, this paper introduces the Kuznets curve as a tool for empirically estimating transition and disease. Findings suggest that the Kuznets curve is a viable tool for empirically assessing the role of transitional dynamics in the emergence of new infectious diseases.


Avian influenza Vietnam Emerging infectious disease Urban transition Health transition 



The author would like to thank the East West Center’s Research Program, in particular John Vogler and Nancy Lewis, and ISCA Technologies for assistance in assembling the data. The research is associated with National Science Foundation Award #0909410. All factual and analytic errors, of course, are the author’s own.


  1. 1.
    Butler D. Mashups mix data into global service. Nature. 2006; 439: 6–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Bunnell T. Kampung rules: landscape and the contested government of urban(e) Malayness. Urban Studies. 2002; 39(9): 1686–1701.CrossRefGoogle Scholar
  3. 3.
    Costa CH, Werneck GL, Rodrigues L Jr, Santos MV, Araújo IB, Moura LS, Moreira S, Gomes RB, Lima SS. Household structure and urban services: neglected targets in the control of visceral leishmaniasis. Ann Trop Med Parasitol. 2005; 99(3): 229–236.PubMedCrossRefGoogle Scholar
  4. 4.
    Douglass M. From global intercity competition to cooperation for livable cities and economic resilience in Pacific Asia. Environ Urban. 2002; 14(1): 53–68.CrossRefGoogle Scholar
  5. 5.
    Friedmann J. China’s urban transition. Minneapolis: University of Minnesota Press; 2005.Google Scholar
  6. 6.
    Gubler DJ. The global emergence/resurgence of arboviral diseases as public health problems. Arch Med Res. 2002; 33: 330–342.PubMedCrossRefGoogle Scholar
  7. 7.
    Kapan DD, Bennett SN, Ellis B, Fox J, Lewis ND, Spencer JH, Saksena S, Wilcox BA. Avian influenza (H5N1) and the evolutionary and social ecology of infectious disease emergence. EcoHealth. 2006; 3(3).Google Scholar
  8. 8.
    Kessides C. The urban transition in sub-Saharan Africa: implications for economic growth and poverty reduction. Washington, DC: Cities Alliance; 2006.Google Scholar
  9. 9.
    King DA, Peckham C, Waage JK, Brownlie J, Woolhouse MEJ. Epidemiology: infectious diseases: preparing for the future. Science. 2006; 313(5792): 1392–1393.PubMedCrossRefGoogle Scholar
  10. 10.
    Kijima M, Nishide K, Ohyama A. Economic models for the environmental Kuznets curve: a survey. J Econ Dyn Control. 2010; 34(7): 1187–1201.CrossRefGoogle Scholar
  11. 11.
    Knudsen, Slooff. Vector-borne disease problems in rapid urbanization: new approaches to vector control. Bull World Health Organ. 1992; 70(1): 1–6.PubMedGoogle Scholar
  12. 12.
    Kuznets S. Economic growth and income inequality. Am Econ Rev. 1955; 45(1): 1–28.Google Scholar
  13. 13.
    Lambin EF, Geist H, Lepers E. Dynamics of land use and cover change in tropical regions. Annu Rev Env Resour. 2003; 28:205–241.CrossRefGoogle Scholar
  14. 14.
    Montgomery MR, Stren R, Cohen B, Reed HE, eds. Cities transformed: demographic change and its implications in the developing world. London: Earthscan; 2004.Google Scholar
  15. 15.
    Oliveira CCG, Lacerda HG, Martins DRM, Barbosa JDA, Monteiro GR, Queiroz JW, Sousa JMA, Ximenes MFFM, Jeronimo SMB. Changing epidemiology of American cutaneous leishmaniasis (ACL) in Brazil: a disease of the urban–rural interface. Acta Trop. 2004; 90(2): 155–162.PubMedCrossRefGoogle Scholar
  16. 16.
    Osterholm MT. Preparing for the next pandemic. N Engl J Med. 2005; 352: 1839–1842.PubMedCrossRefGoogle Scholar
  17. 17.
    Smith KR. Development, health, and the environmental risk transition. In: Shahi G, Levy BS, Binger A, Kjellstrom T, Lawrence R, eds. International perspectives in environment, development, and health. New York: Springer; 1997: 51–62.Google Scholar
  18. 18.
    Smith KR, Ezzati M. How environmental health risks change with development: the epidemiologic and environmental risk transitions revisited. Annu Rev Environ Resour. 2005; 30: 291–333.CrossRefGoogle Scholar
  19. 19.
    Special Journal Issue. Becoming urban: periurban dynamics in Vietnam and China. Pacific Affairs. 2011; 83(3): 425–534.Google Scholar
  20. 20.
    Spencer JH. Health, human security and the peri-urban transition in the Mekong Delta: market reform, governance and new analytic frameworks for research in Southeast Asia. Int J Asia-Pacific Stud. 2007; 3(2): 43–64.Google Scholar
  21. 21.
    Spencer JH, Guzinsky C. Periurbanization, public finance, and local governance of the environment: lessons from small-scale water suppliers in Gresik, Indonesia. Environ Plann. 2010; 42(9): 2131–2146.CrossRefGoogle Scholar
  22. 22.
    Stöhr K. Avian influenza and pandemics—research needs and opportunities. N Engl J Med. 2005; 352: 405–407.PubMedCrossRefGoogle Scholar
  23. 23.
    Ungchusak K, Auewarakul P, Dowell SF, et al. Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med. 2005; 352: 333–340.PubMedCrossRefGoogle Scholar
  24. 24.
    Waibel M. The production of urban space in Vietnam’s metropolis in the course of transition: internationalization, polarization, and newly-emerging lifestyles in Vietnamese society. Trialog. 2006; 89(2).Google Scholar
  25. 25.
    Wilcox BA, Colwell RR. Emerging and re-emerging infectious diseases: biocomplexity as an interdisciplinary paradigm. EcoHealth. 2005; 2(4): 244–257.CrossRefGoogle Scholar
  26. 26.
    Wilcox BA, Gubler DJ. Disease ecology and the global emergence of zoonotic pathogens. Environ Health Prev Med. 2005; 10(5): 263–72.PubMedCrossRefGoogle Scholar
  27. 27.
    Wilcox Bruce A, Gubler D, Pizer HF. Urbanization and the social ecology of emerging infectious diseases. In: Mayer KH, Pizer HF, eds. Social ecology of infectious diseases. Boston: Elsevier/Academic Press; 2007: 113–37.Google Scholar

Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  1. 1.East West Center’s Environmental Change, Vulnerability and Governance Program, and the University of Hawai’i at Manoa’s Department of Urban & Regional PlanningHonoluluUSA
  2. 2.Department of Urban & Regional PlanningUniversity of Hawai’i at ManoaHonoluluUSA

Personalised recommendations