Hidden cities: a report on health inequities

WHO published “Hidden cities: unmasking and overcoming health inequities in urban settings” with the United Nations Human Settlements Programme (UN-HABITAT). The report was launched at last week’s Global Forum on Urbanization and Health, in Kobe, Japan, as part of WHO’s 2010 World Health Day campaign.

The report gives a comprehensive assessment of the social, economic and physical roots of health inequities in cities, and demonstrates that disaggregated data can help reveal health-related imbalances. Among other sources, the report draws on the rich experience of the WHO Regional Office for Europe in working with local governments on health and health equity in local policies in Healthy Cities networks.

While urban residents tend to have greater access to social and health services than their rural counterparts, enormous health disparities exist between people living in the same city. The rapid urbanization in high- and middle-income countries not only causes concerns about environmental risks and inadequate health infrastructures but also leads to a concentration of older populations in cities. Health policies need to respond to this demographic change to ensure urban health equity for all age groups.

“Urban health inequities are often overlooked owing to the way health information is typically collected and analysed. We need to be aware that, while urbanization has brought prosperity and health to countries and their citizens, it has also led to unfair differences in the health status of people living in cities,” says Ms Zsuzsanna Jakab, WHO Regional Director for Europe.

Urban health inequities can only be revealed when health-related information is disaggregated according to defining characteristics of city dwellers, such as their socioeconomic status or place of residence.

WHO and UN-HABITAT have developed tools to facilitate the creation of an evidence base. WHO’s urban health equity assessment and response tool (Urban HEART) promotes the use of available data, which are disaggregated by socioeconomic group and geographical area. Its response component enables users to determine the policies and interventions that will best support the reduction of particular health inequities. UN-HABITAT’s UrbanInfo helps users store, present and analyse urban indicators through a wide range of presentation tools.