"Obesity in the City" – urbanization, health risks and rising obesity rates from the viewpoint of human biology and public health

Abstract

In 2007, for the first time worldwide, more people lived in urban conurbations than in rural settlement structures. This advancing urbanization has dramatically altered the living situation, the use of space, as well as human behavior along with the health situation and disease burden. This process began in Europe as early as the 19th century, while developing and emerging countries in particular are currently exposed to increasing urbanization. The burden of disease is clearly altered by living in a confined space, by environmental pollution in urban areas, the impossibility of producing food oneself, and being lost in an anonymous crowd. While city air made people “free” in medieval times, it often makes them “sick” today. Obesogenic environments represent a special problem in urban areas. A lack of physical activity, adverse dietary habits, and stressful and unsafe neighborhoods increase the risk of becoming overweight and obese in urban centers. Recently, modernization in rural areas and an adaptation to urban habits there increase the obesity rates in rural areas in high-income as well as low- and middle-income countries, too. Within cities, marked spatial differences in the prevalence of overweight and obesity occur. In Vienna, Austria, overweight and obesity rates during childhood and adolescence differ markedly between the individual Viennese districts. Highest overweight and obesity rates occur in districts characterized by a low socioeconomic status.