President's Column: positive and negative public health effects of urbanisation

As a result of the 12th EUPHA conference in Oslo 2004, the book ‘Urbanisation and health’ was published recently.1 Urbanisation in the world today is an ongoing process that has a profound impact on people's living conditions and health status. The globalisation of markets, the desire for higher education, increased use of communication, and new information technologies are the driving forces behind this process. In 2003, as much as 73% of the population in Europe was living in cites or city suburbs, and it is estimated that by 2030 80% of the population will be urbanised. The continued growth of cities today is partly due to rural–urban migration and partly due to an influx of migrants from other countries. The urbanisation process has marked effects on the natural and cultural environment, on housing arrangements and social networks, as well as on work and employment patterns, not only in the cities, but also in the rural areas. Access to health care, social services, and cultural activities are in many cases better in the cities, but there the access may not be evenly distributed among the population. The urbanisation is also part of larger processes occurring in the world, of which market integration is the most important. Globalisation means flow of economic capital, labour, goods and services, as well as ideologies across national borders. Shifts in social networks and living arrangements may lead to changes in mental health and social capital, and a depletion of human capital …