Cacciatore Stefano, Mao Sofia, Nuñez Mayra Villalba, Massaro Claudia, Spadafora Luigi, Bernardi Marco, Perone Francesco, Sabouret Pierre, Biondi-Zoccai Giuseppe, Banach Maciej, Calvani Riccardo, Tosato Matteo, Marzetti Emanuele, Landi Francesco
Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Aging Clin Exp Res. 2025 May 7;37(1):143. doi: 10.1007/s40520-025-03052-1.
Urbanization is reshaping global health, with over 55% of the world's population residing in urban areas, a figure projected to reach 68% by 2050. This demographic shift presents significant challenges and opportunities for public health, as urban environments exacerbate health disparities rooted in social determinants of health, such as economic stability, education, neighborhood conditions, and access to healthcare. Rapid urban growth, particularly in low- and middle-income countries, has led to the emergence of inequitable living conditions, environmental hazards, and limited access to essential health services, contributing to the early onset of multimorbidity and rising non-communicable disease burdens. Urbanization-driven factors such as obesogenic environments, sedentary lifestyles, air pollution, and inadequate sleep exacerbate cardiovascular and metabolic risks, while social exclusion, overcrowding, and inadequate mental health services heighten vulnerabilities. Emerging risks, including urban heat islands, noise pollution, and exposure to endocrine-disrupting chemicals, further compound urban health inequities. Effective mitigation requires multi-sectoral policies that prioritize health-promoting infrastructure, reduce environmental pollutants, foster equitable healthcare access, and address systemic barriers affecting marginalized groups. This review explores the intersections between urbanization and health inequities, emphasizing the importance of addressing traditional and emerging risk factors across the lifespan. Policy implications include promoting green infrastructure, enhancing urban mobility, expanding mental health care, and leveraging participatory governance to foster resilient and inclusive cities. By adopting an integrated approach that prioritizes social equity and sustainability, cities can mitigate health disparities and create healthier, more inclusive urban environments that support the well-being of all residents.
城市化正在重塑全球健康状况,全球超过55%的人口居住在城市地区,预计到2050年这一数字将达到68%。这一人口结构转变给公共卫生带来了重大挑战和机遇,因为城市环境加剧了源于健康的社会决定因素的健康差距,如经济稳定、教育、社区条件和医疗保健可及性。城市的快速发展,尤其是在低收入和中等收入国家,导致了不公平的生活条件、环境危害以及基本医疗服务可及性有限的出现,促使多种疾病提早发作,并使非传染性疾病负担不断增加。城市化驱动的因素,如致胖环境、久坐不动的生活方式、空气污染和睡眠不足,加剧了心血管和代谢风险,而社会排斥、过度拥挤和心理健康服务不足则增加了脆弱性。新出现的风险,包括城市热岛、噪音污染以及接触内分泌干扰化学物质,进一步加剧了城市健康不平等。有效的缓解措施需要多部门政策,这些政策应优先考虑促进健康的基础设施、减少环境污染物、促进公平的医疗保健可及性,并解决影响边缘化群体的系统性障碍。本综述探讨了城市化与健康不平等之间的交叉点,强调了在整个生命周期应对传统和新出现的风险因素的重要性。政策影响包括推广绿色基础设施、增强城市流动性、扩大心理健康护理,以及利用参与式治理来建设有韧性和包容性的城市。通过采取优先考虑社会公平和可持续性的综合方法,城市可以减少健康差距,创造更健康、更具包容性的城市环境,以支持所有居民的福祉。