Health Aspects of the Urban Environment

Abstract

IN SHREVEPORT, LA., there was a medical shingle reading Specialist. I think perhaps it should be my shingle, too, because working in field of I am constantly being tossed between being a specialist in one area and looking at general situation and total policy in anoither. As a general specialist, I diagnose current illness in our cities as urban stress disease, a sociological condition resulting from cultural changes within this nation in last few years. It is a disease of large populations crowded together, resulting in a stress condition with psychological and physical symptoms. With our present communication capabilities, no one is immune to t,he pressures created' by this urba,n syndrome. Through radio, television, and modern transportation even most isolated people are involved in problems, concerns, and conditions of urban revolution. Our clothes, cars, and evening entertainment reflect urban civilization. I am concerned with prevention and control of factors producing or contributing to urban problems. I do not believe that one of today's tangible evidences of stress-the riotcan be cured. However, we can prevent situation from getting worse. major mission of should be prevention and control of factors in advance of crises. This is basic philosophy of and treatment or other after-the-fact remedies should be regarded as failure to carry o-ut primary mission. This is not neces,sarily a univeirsally anecepted interpretation of health in phrase public health, but I am interpreting it in its broadest sense-as in World Health Organization definition-to include a state of positive wellbeing. Public, to me, implies being political irL Aristotelian sense-the science and art of policy. I believe that failure, of most seientists and professionals in field to work from this viewpoint is responisible to, some, degree, for present social unrest. Fortunately, trend among leaders is to, involve and befcome involved with groups and individuals from many backgrounds whio wlerei formerly not used. Accordingly, can offer a very effective tool to help persons of divergent interests and backgrounds determine future courses of' action in our cities. This tool is epidemiology. In11 public, heialth, epidemiology was concerned originally with kinds of epidemics-yello-w fever, simallpox, and like-considered to be visitations upon people. Though urban stress 'disease, is different, I believe it, can also be prevented and controlleid if technique's of epidemiology which help identify and pinpoint proba,ble sourices of disruption are applied. What is involved is a step-by-step tracing of forc,e;s that explain diseaise or or 'any condition. I use phrase the forces that explain because I want to avoid word cause. To, many people, cause alnd effeet is an overly simplistic 'approach to most problems. 'For example, course of many diseases, such as lung cancer, is affected, influenced, or Dr. Prindle is Assistant Surgeon General and director, Bureau of Disease Prevention and Environmental Control, Public Health Service. This paper is based on a speech given at a centennial symposium, The City as Environment: Biological and Social Implications, Wayne State University, Detroit, November 16, 1967.