Moore Melinda, Gould Philip, Keary Barbara S
Office of Global Health Affairs, U.S. Department of Health and Human Services, Rockville, Maryland 20857, USA.
Int J Hyg Environ Health. 2003 Aug;206(4-5):269-78. doi: 10.1078/1438-4639-00223.
Nearly half the world's population now lives in urban settlements. Cities offer the lure of better employment, education, health care, and culture; and they contribute disproportionately to national economies. However, rapid and often unplanned urban growth is often associated with poverty, environmental degradation and population demands that outstrip service capacity. These conditions place human health at risk. Reliable urban health statistics are largely unavailable throughout the world. Disaggregated intra-urban health data, i.e., for different areas within a city, are even more rare. Data that are available indicate a range of urban health hazards and associated health risks: substandard housing, crowding, air pollution, insufficient or contaminated drinking water, inadequate sanitation and solid waste disposal services, vector-borne diseases, industrial waste, increased motor vehicle traffic, stress associated with poverty and unemployment, among others. Local and national governments and multilateral organizations are all grappling with the challenges of urbanization. Urban health risks and concerns involve many different sectors, including health, environment, housing, energy, transportation, urban planning, and others. Two main policy implications are highlighted: the need for systematic and useful urban health statistics on a disaggregated, i.e., intra-urban, basis, and the need for more effective partnering across sectors. The humanitarian and economic imperative to create livable and sustainable cities must drive us to seek and successfully overcome challenges and capitalize on opportunities. Good urban planning and governance, exchange of best practice models and the determination and leadership of stakeholders across disciplines, sectors, communities and countries will be critical elements of success.
目前，世界上近一半的人口居住在城市地区。城市提供了更好的就业、教育、医疗和文化机会；它们对国家经济的贡献也不成比例。然而，快速且往往无规划的城市增长通常与贫困、环境退化以及超出服务能力的人口需求相关联。这些情况使人类健康面临风险。在全球范围内，可靠的城市健康统计数据基本无法获取。城市内部细分的健康数据，即城市内不同区域的数据，更是罕见。现有数据表明存在一系列城市健康危害及相关健康风险：住房条件差、拥挤、空气污染、饮用水不足或受污染、卫生设施和固体废物处理服务不完善、病媒传播疾病、工业废料、机动车交通增加、与贫困和失业相关的压力等等。地方和国家政府以及多边组织都在应对城市化带来的挑战。城市健康风险和问题涉及许多不同部门，包括卫生、环境、住房、能源、交通、城市规划等。文中强调了两个主要政策要点：需要在细分的、即城市内部的基础上获取系统且有用的城市健康统计数据，以及需要跨部门建立更有效的合作关系。创建宜居且可持续城市的人道主义和经济需求必须促使我们去寻求并成功克服挑战，抓住机遇。良好的城市规划和治理、最佳实践模式的交流以及跨学科、跨部门、跨社区和跨国利益相关者的决心与领导力将是成功的关键要素。
