Urban health: evidence, challenges, and directions

Annu Rev Public Health. 2005;26:341-65. doi: 10.1146/annurev.publhealth.26.021304.144708.


Urbanization is one of the most important demographic shifts worldwide during the past century and represents a substantial change from how most of the world's population has lived for the past several thousand years. The study of urban health considers how characteristics of the urban environment may affect population health. This paper reviews the empirical research assessing urban living's impact on population health and our rationale for considering the study of urban health as a distinct field of inquiry. The key factors affecting health in cities can be considered within three broad themes: the physical environment, the social environment, and access to health and social services. The methodologic and conceptual challenges facing the study of urban health, arising both from the limitations of the research to date and from the complexities inherent in assessing the relations among complex urban systems, disease causation, and health are discussed.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Causality
  • Climate
  • Environmental Exposure
  • Environmental Health
  • Evidence-Based Medicine
  • Forecasting
  • Global Health*
  • Health Services Accessibility / organization & administration
  • Health Status
  • Humans
  • Needs Assessment
  • Organizational Objectives
  • Population Dynamics
  • Public Health / methods*
  • Public Health / trends
  • Research Design
  • Residence Characteristics
  • Sanitation
  • Semantics
  • Social Environment
  • Urban Health Services / organization & administration*
  • Urban Health* / statistics & numerical data
  • Urban Health* / trends
  • Urbanization / trends
  • Water Supply