Journal of Urban Health

, Volume 92, Issue 5, pp 785–799 | Cite as

The Non-linear Health Consequences of Living in Larger Cities

  • Luis E C Rocha
  • Anna E. Thorson
  • Renaud Lambiotte
Article

Abstract

Urbanization promotes economy, mobility, access, and availability of resources, but on the other hand, generates higher levels of pollution, violence, crime, and mental distress. The health consequences of the agglomeration of people living close together are not fully understood. Particularly, it remains unclear how variations in the population size across cities impact the health of the population. We analyze the deviations from linearity of the scaling of several health-related quantities, such as the incidence and mortality of diseases, external causes of death, wellbeing, and health care availability, in respect to the population size of cities in Brazil, Sweden, and the USA. We find that deaths by non-communicable diseases tend to be relatively less common in larger cities, whereas the per capita incidence of infectious diseases is relatively larger for increasing population size. Healthier lifestyle and availability of medical support are disproportionally higher in larger cities. The results are connected with the optimization of human and physical resources and with the non-linear effects of social networks in larger populations. An urban advantage in terms of health is not evident, and using rates as indicators to compare cities with different population sizes may be insufficient.

Keywords

Urbanization Population dynamics Public health Urban health Complex systems 

References

  1. 1.
    United Nations, Department of Economic and Social Affairs, Population Division. World Urbanization Prospects, the 2011 Revision. United Nations: New York; 2012.Google Scholar
  2. 2.
    United Nations, Department of Economic and Social Affairs, Population Division. World Urbanization Prospects, the 2014 Revision, Highlights (ST/ESA/SER.A/352). United Nations: New York. 2014.Google Scholar
  3. 3.
    Leon DA. Cities, urbanization and health. Int J Epidemiol. 2008; 37: 4–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Vlahov D, Galea S, Gibble E, Freudenberg N. Perspectives on urban conditions and population health. Cad Saude Publica. 2005; 21: 949–57.CrossRefPubMedGoogle Scholar
  5. 5.
    National Research Council. Mortality and morbidity. Is city life good for your health? in Cities Transformed. Demographic Change and Its Implications in the Developing World. 7th ed. Washington DC: The National Academies Press; 2003.Google Scholar
  6. 6.
    Buch T, Hamann S, Niebuhr A, Rossen A. What makes cities attractive? The determinants of urban labour migration in Germany. Urban Stud. 2014; 51: 1960–78.CrossRefGoogle Scholar
  7. 7.
    Jacobs J. The economy of cities. Vintage Publisher 1970. 288pGoogle Scholar
  8. 8.
    Bettencourt LMA, Lobo J, Helbing D, Kühnert C, West GB. Growth, innovation, scaling, and the pace of life in cities. PNAS. 2007; 104: 7301–6.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Bettencourt LMA, Lobo J, Strumsky D, West GB. Urban scaling and its deviations. Revealing the structure of wealth, innovation and crime across cities. PLoS ONE. 2010; 5: e13541.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Gomez-Lievano A, Youn H, Bettencourt LMA. The statistics of urban scaling and their connection to Zipf’s law. PLoS ONE. 2012; 7: e40393.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Sarzynski A. Bigger is not always better. A comparative analysis of cities and their air pollution impact. Urban Stud. 2012; 49: 3121–38.CrossRefGoogle Scholar
  12. 12.
    Fragkias M, Lobo J, Strumsky D, Seto KC. Does size matter? Scaling of CO2 emissions and U.S. urban areas. PLoS ONE. 2013; 8: e64727.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Oliveira EA, Andrade JS Jr, Makse HA. Large cities are less green. Sci Rep. 2014; 5(4235).Google Scholar
  14. 14.
    Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban–rural differences in psychiatric disorders. Acta Psychiatr Scand. 2010; 121: 84–93.CrossRefPubMedGoogle Scholar
  15. 15.
    Rydin Y, Bleahu A, Davies M, et al. Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet. 2012; 379: 2079–108.PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Cyril S, Oldroyd JC, Renzaho A. Urbanisation, urbanicity, and health. A systematic review of the reliability and validity of urbanicity scales. BMC Public Health. 2013; 13(513).Google Scholar
  17. 17.
    Eve RA, Horsfall ST, Lee M. Chaos, complexity, and sociology. Myths, models, and theories. SAGE Publications, Inc. Thousand Oaks: California; 1997. 360p.Google Scholar
  18. 18.
    Mitchell M. Complexity. A guided tour. New York, NY: Oxford University Press; 2011. 368p.Google Scholar
  19. 19.
    Shingleton A. Allometry: the study of biological scaling. Nat Educ Know. 2010; 3(2).Google Scholar
  20. 20.
    West GB, Brown JH, Enquist BJ. A general model for the origin of allometric scaling laws in biology. Science. 1997; 276: 122–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Martinez J, Pampalon R, Hamel D, Raymond G. Does living in rural communities rather than cities really make a difference in people's health and wellness? Institut national de santé publique du Quebec 2004Google Scholar
  22. 22.
    Galea S, Freudenberg N, Vlahov D. Cities and population health. Soc Sci Med. 2005; 60: 1017–33.CrossRefPubMedGoogle Scholar
  23. 23.
    Melo HPM, Moreira AA, Batista E, Makse HA, Andrade JS. Statistical signs of social influence on suicides. Sci Rep. 2014; 4(6239).Google Scholar
  24. 24.
    Antonio FJ, De Picoli S Jr, Teixeira JJV, Mendes RS. Growth patterns and scaling laws governing aids epidemic in Brazilian cities. PLoS ONE. 2014; 9: e111015.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Anderson RM, May RM. Infectious diseases of humans. Dynamics and control. New York, NY: Oxford University Press; 1991. 768p.Google Scholar
  26. 26.
    Schlapfer M, Bettencourt LMA, Grauwin S, et al. The scaling of human interactions with city size. J R Soc Interface. 2014; 11(20130789).Google Scholar
  27. 27.
    Acuna-Soto R, Viboud C, Chowell G. Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic. PLoS ONE. 2011; 6: e23467.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Britton WJ, Lockwood DN. Leprosy. Lancet. 2004; 363: 1209–19.CrossRefPubMedGoogle Scholar
  29. 29.
    Gubler DJ. The economic burden of dengue. Am J Trop Med Hyg. 2012; 86: 743–4.PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Malta DC, Iser BPM, de Sá NNB, et al. Tendências temporais no consumo de tabaco nas capitais brasileiras, segundo dados do VIGITEL 2006, a 2011. Cad Saúde Pública. 2013; 29: 812–22.CrossRefPubMedGoogle Scholar
  31. 31.
    Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007; 357: 370–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Gallos LK, Barttfeld P, Havlin S, Sigman M, Makse HA. Collective behavior in the spatial spreading of obesity. Sci Rep. 2012; 2(454).Google Scholar
  33. 33.
    Christakis NA, Fowler JH. The collective dynamics of smoking in a large social network. N Engl J Med. 2008; 358: 2249–58.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Lobo J, Bettencourt LMA, Strumsky D, West GB. Urban scaling and the production function for cities. PLoS ONE. 2013; 8: e58407.PubMedCentralCrossRefPubMedGoogle Scholar
  35. 35.
    Sornette D, Maillart T, Ghezzi G. How much is the whole really more than the sum of its parts? 1 + 1=2.5. Superlinear productivity in collective group actions. PLoS ONE. 2014; 9: e103023.PubMedCentralCrossRefPubMedGoogle Scholar
  36. 36.
    Walsh D, Bendel N, Jones R, Hanlon P. It’s not ‘just deprivation’: why do equally deprived UK cities experience different health outcomes? Public Health. 2010; 124: 487–95.CrossRefPubMedGoogle Scholar
  37. 37.
    Dalziel BD, Pourbohloul B, Ellner SP. Human mobility patterns predict divergent epidemic dynamics among cities. Proc R Soc B. 2013; 280: 1766.CrossRefGoogle Scholar
  38. 38.
    Jahan NK, Allotey P, Arunachalam D, et al. The rural bite in population pyramids. What are the implications for responsiveness of health systems in middle income countries? BMC Public Health. 2014; 14(2): S8.PubMedCentralCrossRefPubMedGoogle Scholar
  39. 39.
    O'Malley AJ, Arbesman S, Steiger DM, Fowler JH, Christakis NA. Egocentric social network structure, health, and pro-social behaviors in a national panel study of Americans. PLoS One. 2012; 7: e36250.PubMedCentralCrossRefPubMedGoogle Scholar
  40. 40.
    Sundquist K, Frank G, Sundquist J. Urbanisation and incidence of psychosis and depression. Follow-up study of 4.4 million women and men in Sweden. Br J Psychiatry. 2004; 184: 293–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Vigod SN, Tarasoff LA, Bryja B, et al. Relation between place of residence and postpartum depression. CMAJ. 2013; 185: 1129–35.PubMedCentralCrossRefPubMedGoogle Scholar
  42. 42.
    Afroz R, Hassan MN, Ibrahim NA. Review of air pollution and health impacts in Malaysia. Environ Res. 2003; 92: 71–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Um J, Son S-W, Lee S-I, Jeong H, Kim BJ. Scaling laws between population and facility densities. PNAS. 2009; 106: 14236–40.PubMedCentralCrossRefPubMedGoogle Scholar
  44. 44.
    Rozenfeld HD, Rybski D, Gabaix X, Makse HA. The area and population of cities: new insights from a different perspective on cities. Am Econ Rev. 2011; 101: 2205–25.CrossRefGoogle Scholar
  45. 45.
    Arcaute E, Hatna E, Ferguson P, et al. Constructing cities, deconstructing scaling laws. J R Soc Interface. 2014; 12: 20140745.CrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2015

Authors and Affiliations

  1. 1.Department of Mathematics and naXysUniversité de NamurNamurBelgium
  2. 2.Department of Public Health SciencesKarolinska InstitutetStockholmSweden

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