Monday, April 25, 2016

The Complicated Problem Of Urban Obesity

Kathmandu, Nepal city streets
Hello Everyone:

It is Monday, the start of a new week and new topics.  Before we get going on today's discussion on urban obesity, yours truly has to take step into the Candidate Forum for a few minutes and comment on a new development in the Republican race.

News broke that Governor John Kasich and Senator Ted Cruz have teamed up to try prevent Donald Trump winning the Republican nomination outright.  Mr. Trump blasted this move as "desperation."  Blogger has to agree with that assessment.  It is desperation on the part of both candidates, especially Gov. Kasich who was mathematically eliminated from the race, and the Republic National Committee.  Truthfully, the RNC has ignored its populist base for so long that it is completely flummoxed over what to do.  More on Wednesday.

"The City That Declared War On Obesity" 
Moving on from a quick comment on the latest developments in the American elections to urban obesity, in 2014, the Journal of Transport & Health ( published a study, Walking & Cycling: The contributions of health and transport geography,  that concluded "Cities are good for your waistline,..."  Aarian Marshall writes in her article for CityLab, "The Complicated Problem of Urban Obesity," the study "...found that places with more compact street networks and intersections-namely dense cities-are associated with lower levels of obesity, diabetes, high blood pressure, heart disease, and asthma."  Health concerns are typically not the first thing people think of when choosing a place to live, however, the authors of the study: Wesley E. Marshall, Daniel P. Piatkowski, and Norman Garrick conclude that it might be worth taking into consideration.

Kathmandu where urban obesity has increased
Flickr/Indrik myneur
Be that as it may, when we look at all cities, not just the very dense ones, the health outlook gets more complicated.  In January of this year CityLab's Aria Bendix observed that health issues among urban dwellers correlate with economic status, in part because "predominantly poor and minority neighborhoods have  been stranded by disastrous urban planning decisions: large roads, major highways that cut through communities, and metro lines far away from working-class population that need them."

The implications of the study reach far and wide.  A paper, Global Report on Urban Health (, recently released in conjunction with the International Conference on Urban Health (, held in San Francisco, policy writers from the World Health Organization and UN-Habitat ( demonstrated that urban health issues are increasing-in part because cities are also growing.  Researchers estimated by 2050 half of the world's population will live in cities, of that number, "2 billion of those will be in slums."  Regardless, urban health problems is not just a symptom of growing populations.  The report explained:

[I]t is important to underscore how cities contribute to health-harming behavior.  Poor transportation and an over-reliance on motorized transport have resulted in people spending longer periods of time commuting, the availability of affordable healthy food is restricted by poor urban planning polices and longer working and commuting hours, [and this,] coupled with increased female participation in the workforce, has contributed to dietary changes in favour of convenience food.  The interaction of these factors is reflected in the rising rates of overweight and obesity, particularly in urban areas and, increasingly, for the urban poor.  (

"Trends in prevalence of overweight and obesity
among urban women by country."

What does this look like in practice?  The researchers used 2015 numbers from the WHO's Global Health Observatory-finding that obesity, especially in female urban residents-is rising in some African, Asian-Pacific, and Latin American countries.  Carlos Dora, an epidemiologist who coordinates the WHO's healthy environments initiatives, cited a few important reasons why urban dwellers, women in particular, have seen spikes in the obesity rates since the beginning of the millennium.  Aarian Marshall writes, "In Beijing, for example, you might see some people take advantage of the relative density by walking and biking, but air pollution and the threat of injury by motorized vehicles does a number on the body."  Mr. Dora told Ms. Marshall,

...Once you exercise, you increase your respiratory rate, you breathe more, more air goes to the lungs, you increase your exposure to air pollution.

Low-capacity's lungs make it more challenging to work out thus, the unhealthy cycle perpetuates.  Naturally, the vehicles that create most of the pollution make it more daunting to get around cities.

Woman cooking in urban kitchen; The Philippines
Outdoor air pollution is not the sole cause of low-capacity lung.  Indoor air pollution, faced by women and children,  from cooking smoke poses an additional health hazard.  Ms. Marshall writes, "Cramped urban housing with decidedly bad ventilation doesn't help here, and about 3.8 million deaths due to stroke, heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer are lined to household air pollution each year." ( 

Of course, nutrition is another part of the solution.  Nutrition education (; June, 19, 2012), clean water, and sanitation (; Dec. 30, 2015) are components of the solution.  The authors of Global Report on Urban Health write, If we are to address health of populations in cities, a holistic approach  needs to be applied.

The key to solving urban health issues requires more than treatment-based healthcare policies.  they only acknowledge the problem after they start.  Urban planners and designers need to acknowledge that health issues emanate from the very fiber and marrow of cities, illnesses begin within the bones of urban planning.  The silver lining is that remedy lies within the very skeleton of urban planning too.

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