BASSETERRE St. Kitts, April 10th, 2013 -- Urbanization has brought about rapid changes in living environments and lifestyles of many city dwellers. Public health challenges arise from lack of physical activity, poor nutrition, polluted air, poor water quality, overcrowded housing and deficient waste management solutions.
Environmental hazards are responsible for about a quarter of the total burden of disease worldwide. Reports confirm that up to 13 million deaths can be prevented every year by making environments healthier to live in and around.
Healthier environments could significantly reduce the incidence of many types of cancers, cardiovascular diseases, asthma, lower respiratory infections, musculoskeletal diseases, road traffic injuries, violence, poisonings and drownings.
Diarrheal disease and environmentally induced injuries can nearly be eliminated and approximately 40 percent of malaria and lung infections could be prevented through improved city planning.
A staggering one third of all disease in children under 5 is caused by environmental factors according to the World Health Organization (WHO). Of this group, addressing hazardous environmental risk factors could save the lives of 4 million children.
Poor city planning also impacts the adult population as well. For example, it contributes to domestic and sexual violence against women, rape and the spread of sexually transmitted infections. Inadequate planning is not solely to blame, but the lack of basic necessities such as adequate toilets, places to bathe and proper lighting can make life insecure for women.
Compounding the problem is that violence against women, from rape to domestic abuse, often goes unspoken about and unreported. Unfortunately, what is consistently seen and accepted becomes a cultural and generational norm.
Recipes for disease
The health of a city dweller lies in the social, economic and physical environments that one constantly lives in. Urbanization is happening at an alarming pace and urban health issues require the cooperation between the conventional health sector and non-health sectors.
Urbanization has brought about changes in one’s family structures and working styles. These changes can be seen in the number of working mothers, number of hours worked and the amount of time spent outside of the home. More work and less time often equates to poorer lifestyles regardless of financial statuses.
A second family member working can help provide ends meat or facilitate one’s perceived quality of living. Poverty often prevents families from consuming fruits and vegetables that contain essential nutrients but interestingly, financial prosperity does the same.
Once considered luxury items are now daily occurrences as parents eat and provide their children with what they never had – sodas, crisps, sugar-filled processed foods and takeaways. This combination is a known recipe for obesity, cancer, heart disease and diabetes.
Essentially, status symbol living produces disease. Society often chooses to pay for chemotherapies, surgeries and medications instead of buying fruits, vegetables and healthy choices. This is primarily due to managing one’s health reactively versus proactively.
Cancers, cardiovascular diseases and diabetes are often silent conditions and present with no symptoms until they are in advanced stages. Lack of physical activity, poor dietary choices and tobacco use are known to eventually create disease. The secret is to not wait until you develop the disease to try to treat it.
Modern medicine is primarily reactive in nature. This means that treatments will only be used if a disease is detected. If no disease is detected, you’re healthy until you’re told otherwise. This can create a false sense of security and possibly even delay or postpone disease prevention techniques.
Prevention is always better than cure. Many health experts are calling this healthcare reform. Healthcare systems are often over-worked, under-staffed and have limited resources in the prevention and treatment of disease. The responsibility is now fundamentally yours.
Making positive changes
Education addresses one’s internal motivation by teaching the why of change, not just the how. A lot of healthcare is passive and does not encourage lifestyle changes or explain the big picture why.
If a goal is to lose weight, for instance, a person must start with understanding that carrying extra weight will place them at risk for weight-related illnesses such as heart disease, cancer and diabetes. The focus must not be on the how to lose weight but the why.
The why may be to have a better quality of living, to save money, to be healthier and more independent, to play with grandchildren or to be able to enjoy one’s favorite hobbies and past times. Without losing weight, one may not be able to achieve these items.
Proper health education addresses the decisions, habits and lifestyle choices that lead to the health problems in the first place. Until a person is willing to abandon the current status quo, they are unwilling—perhaps even unable—to make any long-term changes.
Making the changes necessary
Under the Healthy Cities initiative, the WHO encourages local governments to incorporate public health issues and concerns into all aspects of public policy and development. They also encourage cities to closely work with companies and non-government organizations to help link public health policy to economic promotion and community development.
Environmental strategies must focus on issues such as physical fitness and obesity, nutrition, alcohol reduction and tobacco cessation. Crosscutting actions could focus on making healthy foods available in schools, establishing smoke-free environments in parks, restaurants and public spaces.
Safety is often used as a reason not to be physically active. Cities must establish more walkable and/or bikeable communities that promote, support and engage physical activities. Community gardens, parks and community initiatives such as farmer’s markets are other options.
Look for programs in which community health workers, mobile clinics and health educators reach people where they live. Choices are made in the home and solutions must start there. Educational programs can be implemented into school curricula and serve to create healthy habits at a young age.
Such interventions can be taken nationwide through the use of mass media and take place within community institutions, such as civic organizations, schools, churches, work sites, voluntary agencies, or other organizations.
Scientists are looking for innovative cures while the public and policy makers must look to make innovative platforms to promote healthy habits. Healthy communities in essence will be based on the partnership of science and self-responsibility in action.
Dr Cory Couillard is an international healthcare speaker and columnist for numerous newspapers, magazines, websites and publications throughout the world. He works in collaboration with the World Health Organization's goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement.
Email: drcorycouillard@gmail.com
Facebook: Dr Cory Couillard
Twitter: DrCoryCouillard
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