Urban size and the quality of human health: A social indicator approach

Abstract

In recent years, many studies have emerged in economics on various topics in the area of health; however, conspicuously absent from the literature is an investigation of the relationship of the quality of human health to city size and urban growth. The possible existence of a functional relationship between health quality and urban size has importance to a large set of economic issues. For instance, discussions concerning optimum city size, welfare policies, national health insurance programs, wage contracts, and the advantages and disadvantages of urban growth would be clarified by additional knowledge of systematic variations in the quality of health with urban size. One normally conjures up ghastly images of poor health conditions in large cities. Since the time of Friedrich Engels' horrifying descriptions of the conditions of working class Manchester in 1844 which [Engels, 1978, p. 584] "undermine(d) the health of thousands" to present day reports of harmful externalities, one is left with the impression the quality of human health and urban size are inversely related. Recent studies have shown that negative externalities, such as air and water pollution, traffic congestion, and noise, tend to increase with city size [i.e., Mazek and Laird, 1972]. Empirical tests on quantifiable measures of these externalities have also revealed their significant associations with the incidence of specific disease and death rates) Since urban