Abstract
From bustling business districts to vibrant cultural life, many of the things that make life in cities advantageous can be attributed to their ability to bring people together. Diverse social networks, which promote productivity and innovation, can, however, act as a vector for disease transmission during a pandemic. The social distancing and lockdown measures implemented during the COVID-19 pandemic have brought fast-paced city life to a standstill, giving citizens pause to recognise the necessity of adequate living conditions, the value of access to healthcare and the privilege of digital technology. Many of these response efforts have left the most socioeconomically disadvantaged at greater risk of catching and dying from COVID-19. They have exacerbated existing health inequalities and given rise to new ones. Many are calling for a socially just recovery, including 5 million health professionals representing over 50 countries in their open letter to the United Nations calling for ethical global leadership.1 The need for action on health inequalities was evident before the pandemic but this crisis provides an unprecedented opportunity for change and cities can be a focal point for this. While each city will require a unique recovery strategy from the pandemic, this commentary calls for a health equity approach to be universally adopted. Grounded in the Social Determinants of Health framework, this commentary suggests three ways cities could change as a result of the COVID-19 pandemic in the housing, healthcare and technology sectors. Public and urban health professionals could engage multi-level stakeholders from civil society to governments at local and national levels to improve daily living conditions, promote access to healthcare and harness the power of digital technologies to address urban health inequalities.
Highlights
From bustling business districts to vibrant cultural life, many of the things that make life in cities advantageous can be attributed to their ability to bring people together
A recent US report found that 70% of people who died of COVID-19 in Chicago were black, despite accounting for only 30% of the population.[4]
In India, 22% of the population living in urban informal settlements are shouldering the majority of COVID-19 cases.[5]
Summary
From bustling business districts to vibrant cultural life, many of the things that make life in cities advantageous can be attributed to their ability to bring people together. The social distancing and lockdown measures implemented during the COVID-19 pandemic have brought fast-paced city life to a standstill, giving citizens pause to recognise the necessity of adequate living conditions, the value of access to healthcare and the privilege of digital technology Many of these response efforts have left the most socioeconomically disadvantaged at greater risk of catching and dying from COVID-19. In India, 22% of the population living in urban informal settlements are shouldering the majority of COVID-19 cases.[5] These trends can be explained through the Social Determinants of Health framework,[2] which describes how the socioeconomically disadvantaged suffer poorer health outcomes due to a lack of access to adequate housing, health and social care, as well as education and employment opportunities This effect is amplified within cities, where rapid urbanisation has often left governments unable to provide the conditions necessary for a healthy life. Three key determinants which cities could target are living conditions, healthcare and technology
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