Creating Healthier Cities

More than half of the world’s population lives in urban areas, and the number is increasing in developed and developing nations. In the United States, about 80 percent of the population lives in metropolitan areas. Around the world, almost 180,000 people move into cities each day.

Over the next 15 to 20 years, many cities in Africa and Asia will double in size. Fifty years ago, China was mostly a country of rural villages; today more than 150 of its cities have a population of 1 million or more. The prediction is that two-thirds of the world’s population will live in cities by 2050. In the developed world, cities are sprawling into suburban and even rural areas. Increasingly, cities have become centers of income inequality, housing the wealthiest and poorest sectors of the population. In many cities, deteriorating living conditions for vulnerable populations threaten the health of all. These trends will stress the public health infrastructure, health care and social services systems and society’s capacity to provide safe environments in which to live and work. The CUNY School of Public Health seeks to meet this challenge by finding new ways to make city living healthier for all.

Promoting Healthy Aging

The increasing proportion of the population that is over 65 presents a major challenge to public health in New York as well as globally.

While increased longevity is one of the crowning achievements of the 20th century, as the number of older people exceeds the number of children, new problems emerge, including a smaller proportion of the population in the workforce, declining birthrates and more age-related health problems. Older people also represent an invaluable social resource for improving urban life. The CUNY School of Public Health seeks to discover new paths to healthy urban aging throughout the lifespan and to contribute to programs and policies that make opportunities for healthy aging more available to all.

Advancing Health Equity

Cities have become the focal point of national and international disparities in health, helping some sectors of the population to achieve unprecedented longevity and quality of life while other groups fall deeper into poverty, illness and premature death.

The increasing movement of people into and out of cities and nations further increases the diversity of urban populations and urban living conditions, requiring public-health professionals to address the variety of cultural, social, environmental and behavioral factors that influence health and disease. Furthermore, it is well established that the poor and racial and ethnic minorities in the United States have reduced life expectancy and higher mortality and disease rates for many chronic diseases and other conditions. Eliminating these inequalities has long been an important priority of many government and nonprofit agencies. The CUNY School of Public Health seeks to play a leadership role in developing a comprehensive, well-coordinated strategy for accomplishing this goal.

Preventing Chronic Disease

Chronic diseases account for a growing burden of the world’s illnesses and in New York City are the leading causes of continued socioeconomic and racial/ethnic disparities in health.

Between 2002 and 2030, the mortality rates for heart disease, cancer, respiratory disease and diabetes type 2 are expected to increase by almost 20 percent worldwide while infectious disease rates are expected to decline by more than 40 percent. In high-income countries, the rates for chronic disease are expected to increase by 11.5 percent while the rates for infectious diseases will decline by almost 15 percent. Chronic diseases are not the inevitable consequence of aging, but unless the United States and other countries find new ways to reduce their burden, they will impose a growing health and economic cost.

The United States is spending about 17 percent of its gross domestic product on health care – more than twice the average of other industrialized nations. Furthermore, annual health care costs are growing about twice the rate of inflation, and recent estimates are that by 2016, annual expenses will be about 20 percent of the gross domestic product. Such expenditures are not sustainable in a global economy; hence the development of knowledge and practices to reduce the burden of chronic diseases are a major goal of the CUNY School of Public Health.

Experts agree that control of chronic diseases will require the integration of genetic, biological, economic, environmental and sociocultural knowledge to inform interdisciplinary, multi-level interventions that address the full spectrum of the life course. By using these diverse disciplinary perspectives to inform its curriculum and research agenda, the CUNY School of Public Health will contribute the health professionals, practices, research and policy that can bring chronic diseases under control.