Summary
The topic of the current paper is to study the impact of the urban environment on the health of the population. It has long been observed that this surrounding has a negative impact on public health. Numerous studies are dedicated to this subject that help identify the features and main trends of this impact, and their qualitative as well as quantitative characteristics. However, the urgency of this problem is increasing in connection with the development and strengthening of the process of urbanization and especially its effect on the environment. On the one hand, urbanization improves living conditions of the population. However, on the other one, it leads to the displacement of natural systems, artificial and environmental pollution, and the increase of chemical, physical, and mental stress on the human body. A large city changes almost all components of the surrounding including atmosphere, vegetation, soil, topography, drainage network, groundwater, and even the climate. All this has a negative impact on the human health. The prevalence of many diseases is much higher in big cities. Among the residents of big cities, there is the formation of a new dynamic stereotype. In some cases, it can lead to the failure resulting in neuroses and a neurotic states. However, some scientists suggest that the environment is not the only factor that affects the state of health of the urban population. Some more reasons include the level of medical care, housing, good nutrition, rest, and many others.
The Impact of the Urban Environment on Health
Over the last 10-15 years, there has been a steady tendency of the increase of frequency and extremely negative impact of the factors of the environment on people. This process leads to increased morbidity and mortality, as well as further deterioration of the demographic situation. All it happens against the background of an insufficient level of mass medical care and causes a considerable economic loss. These circumstances stipulate for the high relevance of the development of medical studies, the improvement of the care quality in the prevention, as well as the restorative treatment and rehabilitation of the population of the country. The human environment in almost all its forms is able to have a negative impact on health. These days, urbanization has become one of the major factors of environmental pollution. It is leading to the worsening of health of the urban population.
The study of the influence degree of environmental factors of low concentrations on the human body throughout life is an actual problem. In most cases, the surrounding can cause a negative influence on people. Among the variety of adverse factors, one of the leading one is the weather including abnormal modes, solar and geomagnetic disturbances, and extreme weather events. Air pollution and climate change observed often exacerbate their action and lead to significant deviations of environmental parameters from the usual values. The ability to safely carry these shifts is individual in every person. It depends on age, sex, health, fitness, their professional activity, and other criteria. The combination of various geophysical and geological factors under the circumstances of the changing climate provokes new risks to human health at the individual and population levels, which have not been sufficiently studied. Despite the high relevance and practical significance of this problem, it is still being at an early stage of its solution. The studies have revealed certain regularities of the dynamics of environmental parameters and health indicators. Moreover, the researches have established a causal relationship between environmental processes and diseases.
One of the most characteristic features of modern society is the rapid growth of cities, the continuous pace of increase in the number of their inhabitants, and the formation of urban agglomerations. Urbanization as a process to enhance the role of towns in the development of community entails the most significant social transformation in the human history. In large cities, both positive and negative aspects of scientific and technological progress and industrialization are intertwined. Urbanization plays a negative impact on the health of people. In the book Handbook of Urban Health: Populations, Methods, and Practice, it is stated that, “There are urban exposures including pollution, food stores, traffic, and the elements of the building environment, all of which may affect the health of most if not all of the key populations in urban areas”.
There are the areas with high, medium, and low levels of anthropogenic prerequisites of deterioration of health. The analysis of factual data on the relationship of environmental quality and health level of population has shown the following facts. In the areas with the worst environmental-hygienic conditions, the life expectancy of men in urban areas by average of 1.9 years is shorter than in the zones with more favorable conditions. In women living in urban places with respect to ecologically unfavorable regions, life expectancy is mainly by 1.3 years higher than in the heavily contaminated locations. In such a way, in the regions with a higher anthropogenic impact on the human environment, the parameters characterizing the quality of health of population are worse.
The mortality rate in urban areas is a result of balance of negative and positive impacts on public health. The study of the influence of urbanization in mortality depending on the population and the territorial jurisdiction has indicated the existence of significant geographical differences of deaths of urban people in different countries. Mortality rates measured both using standardized and life expectancy indices are reduced in the more developed states. It is accompanied by a noticeable change in the structure of some causes of death. Thus, in some cities, the proportion of mortality from exogenous causes, i.e. the diseases of respiratory and digestive systems, infectious, parasitic and others and injuries, is much higher. However, in other cities, the rate of deaths from endogenous causes, such as cardiovascular diseases or cancer, is respectively lower. Moreover, in most zones, the highest mortality rates are found in some groups of small towns, i. e. 20-50 thousand people. The lowest level of mortality is in the states with the population of 500 thousand and more persons.
The group of cities outsiders consists mainly of such ones with less favorable climatic conditions with the primary development sectors of heavy engineering, chemical and petrochemical industry, as well as the low level of development of service areas. The so-called territorial-industrial complexes are characterized by a large number of different spheres with a variety of raw materials and processes combined with the large population centers of common communications, water supply and sewerage systems, as well as water treatment plants. These factors create much stress with xenobiotics on the environment and the population.
Intensive urbanization as a process of fundamental changes in the way and living conditions of the majority of population is connected with the mass migration of people, the changes in the structure of employment, and restructuring of family relationships. It is accompanied by the need to adapt to unusual living circumstances. Socio-cultural adaptation generates a huge load, which cannot remain without the consequences for the health and lives of people.
Social conditions, information, and intellectual overload cause mental fatigue and emotional stress among urban people. Stress can serve as a pathogenetic basis of neurotic, cardiovascular, endocrine, and other diseases, the number of which has continuously increased in recent years. Frequently, urban residents receive social and psychological tension associated with the decrease in social, economic, and environmental security. The mass adaptation to new and unfamiliar conditions of life is impossible without many setbacks and failures, without a strong psychological stress. It results in the increase in the number of premature deaths from accidents, poisoning, injuries, and the illnesses of the circulatory system. It explains the faster growth of the urban population’s mortality. The difficulties in adapting to the changing realities of life in cities are significantly greater than in villages.
Along with the impact of negative aspects of urban life and employment, the negative influence of urbanization on public health is determined to a great extent by a large increase in the pollution of the urban environment as well as the suburban area by chemical, physical, and biological agents. It is known that this contamination is applied to all environments, including air, ground, and water. The presence in the surrounding of physical, chemical, and biological factors, which do not occur naturally, creates a number of a new environmental situation being fundamentally different from that, to which a man has been adapting for thousands of years. They reduce the speed of natural immune protection and determine the increase in the incidence and mortality rates under the impact of deterioration in the quality of the environment.
Numerous works of scientists have established the effects of harmful substances in the air on human health. The spectrum of possible adverse effects of the influence of atmospheric pollution on people is extremely diverse. Atmospheric contaminations have an irritating impact to the mucous membranes of eyes, noses, throats, and upper respiratory tracts. They cause bronchospasm and disorder of cardiovascular activity. Prolonged inhalation of air pollution causes functional changes in the central nervous system, the metabolism of proteins, fats, carbohydrates, disorders of the immune-biological reactivity, and others.
One of the major problems of hygienic science is the study of prevalence of prepathological conditions in the certain population depending on the nature of the environment. One of manifestations of adverse effects of chemical contaminants may be an impact of these compounds or their metabolites on the structural organization and stability of metabolic membranes. In the literature, the issues of the influence of air pollution on the health of the adult working population, according to the levels of morbidity and mortality on the degree of pollution, is quite widely covered. The significant part of the research on the effect of environmental factors on health operates demographic indicators, morbidity, disability, and physical development, which insufficiently reflect both the health of people and the nature of relationships in the environment-health. Less attention is paid to the early detection of adverse shifts in the health status that should recommend targeted preventive measures.
In such a way, as a result of the intensive anthropogenic influence in the cities, especially in large ones, new spheres of life are formed. In many respects, they do not meet the conditions of the normal human life. In general, the crisis nature of the relationship of towns with the environment can be defined as a mismatch of the urbanization and industrialization scale with the level of environmental measures to prevent and neutralize harmful environmental impacts.
The anthropogenic artificial urban environment, which can be called the second nature, has a serious impact on people, their livelihoods, and performance. Thus, the quality of the urban surrounding can be seen in such complex criteria as health, i.e. physical and mental, of the urban population. There are many definitions of the term health. It is a state of dynamic equilibrium between an organism and an environment. In other words, health is an integral component of quality of life. On the quantitative side, it is determined by a set of interrelated indicators: morbidity, mortality, and disability. The data of numerous observations allowing evaluating the correlation between the air pollution and morbidity of the population have identified a number of certain unfavorable areas and cities. Assessing the impact of air pollution on human cases of residents shows that the contribution of this factor of the impact to the overall morbidity depends on the age group of the population (children – 37%, adults – 10%). Moreover, it is related to the forms of the disease (respiratory organs – 41%, endocrine – 16%).
Despite the fact the environment plays a great role in the formation of human health, many scientists affirm that it is not the most important factor. In the book Children in the Urban Environment: Linking Social Policy and Clinical Practice, it is affirmed that, “The impact of poverty, environmental pollutants, and limited access to health care all contribute to increased risks for poor health”. The set of environmental factors – natural, socio-economic, household, and anthropogenic can affect the entire population, its separate groups, and each person as unidirectional in a positive, negative or mixed way. For example, the negative impact on human health of adverse environmental conditions may be mitigated or completely offset by good social conditions – adequate nutrition, spacious, comfortable housing, regular rest in an ecologically clean area and good medical care. Both negative and positive environmental factors that influence all people or their substantial part almost never produce the same effects in absolutely all individuals composing this population. This pattern is associated with several factors – the biological characteristics of the body of each individual, the presence or absence of bad habits, the age, intensity and nature of work, and living conditions. In such a way, negative anthropogenic factors are not a cause of the fatal deterioration in health of people living in the area of these factors’ impact. Each potentially pathogenic criterion creates only the preconditions of ill health. It increases the risk of falling ill, becoming disabled, or dying at a young age. It, in relation to a particular individual, can realize or not realize. The more pronounced these preconditions are, the greater the likelihood of their occurrence in the form of reduced health is.
Many scientists and doctors state that the excessive working activity has a greater impact on the state of health of the urban population than the environment. Scientists have proved that a boring job or extra working hours, as well as the one that is associated with stress, leads to serious health problems and even premature death. Work, which adversely affects the family life, increases the challenge of premature death by 20 percent. The hated job increases the risk of a serious disease by 50 percent. If a person spends much time at work, he/she has a threat to earn depression. The doctors affirm that for the development of depression, it is enough to work 60% of the week and have a pretty heavy load. In this case, the risk of depression increases by 15 times. This problem is extremely relevant for the urban population. Women, who work long hours by 2 times are more likely to have pregnancy complications than those ones, who do not work or work smaller hours. Hypotrophic babies and children with iron deficiency anemia in this group are born significantly more often. Based on the scientific researches, it can be argued that in the present conditions, any woman of childbearing age working long hours and living in the environmentally polluted area experiences the following situation. She has a high risk of passing damage to reproductive health and the health of her unborn child. Survey data indicate high psychological stress and social pessimism of urban women. They are reflected in the organization of their lives and the existences of their families, as well as quantitative and qualitative characteristics of population reproduction. In modern conditions, the significant portion of parents is affected by stress. 45% of mothers experience it during pregnancy. These are rather high figures for pregnant women. Despite this, the majority of scientists are confident in the fact that the environment causes more damage to people’s health than other factors. It is especially true for rural residents who have moved to big cities and not accustomed to the urban environment.
In the recent years, awareness of the surrounding role as the most important factor determining the quality of public health has significantly increased. There is a definite relationship between urbanization, and environmental as well as public health. In general, many factors affect the health of the urban population. However, it cannot be stated that the surrounding is the only factor that determines the level of the people’s health. Human health is determined by such criteria as the quality of life such as social, economic, and psychological well-being, as well as the access and quality of health care, hereditary factors, lifestyles and bad habits, and some environmental factors. To be healthy means having a positive physical, mental, and social well-being. All these aspects are interrelated and influence each other. Social and behavioral factors are increasingly important in determining the state of health. Thus, the community’s component of the surrounding is not less important than its chemical or physical components.
