Time to Prioritize Healthy Urban Living

The jury is still out on the question of the rate of urbanization in Africa. This is simply because no African country has reliable and up-do-date population census data. In Nigeria for example, every census since 1952 has been contested; in Kenya, population by ethnicity is often highly emotive. But what is incontestable is the fact that urbanization is on the march.

By 2030, the proportion of Africa’s urban population will surpass 50 percent. According to a recent UN-HABITAT report the population of Dar-es-Salaam is projected to grow by 85 percent between 2010 and 2025. Here at home, Nairobi’s, population will swell by about 78 percent over the next 25 years. Urbanization is not just about the glitz of the city or an escape from the drab and drudgery of life on the farm by rural folk.

The city is not just about skyscrapers. The appeal of the city is defined by the quality of ideas it generates, the innovation it sparks and the opportunities it opens for its inhabitants. Spontaneous and serendipitous exchange of ideas turn cities into vibrant hubs of innovation. And yes, in Africa, cities are about the modern convenience, better access to services, including water and sanitation, education, health and jobs.

Moreover, cities are an indomitable economic dynamo. Home to less than 10 percent of Kenya’s population the City of Nairobi generates more than 40 percent of Kenya’s $44 billion GDP. The top 100 American metropolitan areas, home to 65 percent of the population generate 75 percent of the GDP. According to the Cities Special Initiative of McKinsey & Company 600 cities will generate about two-thirds of the world’s GDP by 2025. Cities are the real drivers of national fortunes.

But there is another side to the urbanization saga. Urbanization includes social, psychological and health changes that constitute the demographic movement. One consequence of urbanization is exercise deprivation and poor diets, which contribute invariably to obesity. Owing to increasing urbanization, a growing number of African countries are now suffering from the burden of obesity, diabetes and cardiovascular diseases, on top of nutritional deficiencies and infectious diseases. About 10 percent of the U.S. population shows some symptoms of depression and over 65 percent of them are overweight. Although the causal links are unclear, scientists are exploring the complicated physical and psychological links between obesity and a range of cardiovascular and metabolic diseases.  

A study conducted in Uganda in 2011 shows that increasing urbanization in developing countries could lead to an explosion in the incidence of heart disease and diabetes. Based on a survey a survey of 7,340 participants drawn from 25 villages, the study found that even small changes to more urban lifestyles were associated with increased risk to cardiovascular and metabolic diseases. There is now evidence to demonstrate that obese or fat animals are more likely to develop cancer than lean animals. Cancers in fat animals also grow faster and larger, spread more quickly, and are more resistant to treatment.

Recent studies have shown that mood and anxiety disorders are more prevalent among city dwellers and the incidence of schizophrenia is strongly much higher in people born and raised in cities. Such studies point to a new approach for integrating social sciences and neurosciences to understand and respond compressively the health challenge of urbanization. According to World Health Organization, developing countries are likely to see a disproportionately large increase in mental disorders, depression, substance abuse, alcoholism, crime, family disintegration, and alienation.

Here are four things that promote unhealthy urban living, which we must address now:

1.     Regulate the proliferation of fast food outlets offering processed foods, high-calorie snacks and sugary beverages. As an alternative we should have more open markets where farmers, mostly urban and peri-farmers, sell fresh food;

2.     Encourage active lifestyles by building more pedestrian and cycle paths to encourage walking and biking as modes of commuting to work and leisure;

3.     Create safe public recreational spaces within five a minute walk in every major residential neighborhood;

4.     Regulate mass media marketing of food and beverages, which tend to shift people’s preference from healthy and nutritious foods.

Based on the results of the 2009 population census, over 32 percent of Kenyans now live in urban centres. This significant and growing population, which is projected to reach 50 percent by 2030, makes creating a healthy urban environment an urgent policy priority.