Urbanization and Global Health: The Role of Air Pollution

  • Qing WANG 1. Dept. of Economic, School of Business, Dalian University of Technology, Panjin, Liaoning, China 2. Dept. of Social Medicine and Maternal & Child Health, School of Public Health, Shandong University, Jinan, Shandong, China
Keywords: Urbanization, Global health, Air pollution


Background: The world is experiencing the biggest wave of urban growth in history. The association between urbanization and health at the global level, as well as the role of air pollution, has not been studied. We aimed to examine the effect of urbanization on global health and the role of air pollution. Methods: Unbalanced panel data comprising 3, 093 observations of 163 countries for 1990–2012 from the World Bank database was used. An infinite distributed lag model was applied to estimate the contemporary and long-term effects of urbanization on health outcomes measured by mortality, under-five mortality, infant mortality, life expectancy at birth(all; female; and male). Results: Urbanization was positively related to global health in the short term and long term. In the short run, 1% increase in urbanization was associated with reduced mortality, under-five mortality, and infant mortality of 0.05%, 0.04%, and 0.04%, respectively, as well as increased life expectancy of 0.01 year. The effects of urbanization were stronger for high-income countries. However, air pollution undermined the positive impacts of urbanization on health. Conclusion: Although urbanization leads to improved global health, air pollution undermines the positive effects of urbanization on health. Developing sustainable urbanization practices is crucial for addressing the challenges of pollution caused by urbanization.  


1. United Nations(2017). World Urbanization Prospects. https://www.unfpa.org/urbanization
2. Moore M, Gould P, Keary BS (2003). Glob-al urbanization and impact on health. Int J Hyg Environ Health, 206(4-5): 269-78.
3. Rostampoor-Vajari M (2012). Growing ur-banization and its impact on the mental health of people in developing coun-tries. Hyperbolic Problems Theory Numerics & Applications, 67(2): 889-98.
4. Eckert S, Kohler S (2014). Urbanization and health in developing countries: a system-atic review. World Health Popul, 15 (1): 7–20
5. Vlahov D, Freudenberg N, Proietti F et al. (2007). Urban as a determinant of health. J Urban Heal, 84(Suppl 1): 16-26.
6. Otsu A, Araki S, Sakai R, Yokoyama K, Scott VA (2004). Effects of urbanization, economic development, and migration of workers on suicide mortality in Japan. Soc Sci Med, 58(6):1137-46.
7. Bandyopadhyay S, Green E (2013). Urbani-zation and mortality de-cline. http://personal.lse.ac.uk/BANDYOPS/BGurb.pdf
8. Vögele J (2000). Urbanization and the urban mortality change in imperial Germa-ny. Health Place, 6(1): 41-55.
9. Economic and Social Commission for Asia and the Pacific Population Division of United Nations (1980). Migration, urban-ization and development in the republic of Korea. Bangkok Thailand Escap, 61(2): 3–19.
10. Haines MR, Craig LA, Weiss T (2000). De-velopment, health, nutrition, and mortali-ty: the case of the 'antebellum puzzle' in the United States. https://core.ac.uk/download/pdf/6777674.pdf
11. Preston SH, Haines MR, Pamuk E (1981). Effects of industrialization and urbaniza-tion on mortality in developed countries. International Population Conference, Manila. https://www.popline.org/node/388274
12. Santana P, Costa C, Marídell’Olmo M et al (2015). Mortality, material deprivation and urbanization: exploring the social patterns of a metropolitan area. Int J Equity Health, 14: 55.
13. Oyasawyer D, Fernandezcastilla R, Mon-temor RL (1987). The impact of urbani-zation and industrialization on mortality in Brazil. World Health Statistics Quarter-ly, 40(1): 84-95.
14. Barrett JR (2010). A marked disadvantage: rapid urbanization and mortality of young children in Nigeria. Environ Health Per-spect,118(6): A259.
15. Angkurawaranon C, Wattanatchariya N, Doyle P, Nitsch D (2013). Urbanization and non-communicable disease mortality in Thailand: an ecological correlation study. Trop Med Int Health, 18(2): 130–40.
16. Poel EV, O'Donnell O, Doorslaer EV (2012). Is there a health penalty of Chi-na's rapid urbanization? Health Econ, 21(4): 367-85.
17. Zhu YG, Ioannidis JPA, Li H et al (2011). Understanding and Harnessing the Health Effects of Rapid Urbanization in China. Environ Sci Technol, 45 (12): 5099–104.
18. Gong P, Liang S, Carlton EJ et al (2012). Urbanisation and health in China. Lancet, 379(9818):843-52.
19. Jia M, Wu X (2016). Urbanization, socioec-onomic status and health disparity in China. Health Place, 42: 87-95.
20. Allender S, Foster C, Hutchinson L, Arambepola C (2008). Quantification of urbanization in relation to chronic diseas-es in developing countries: a systematic review. J Urban Health, 85 (6): 938–51.
21. Salahodajev R (2014). Over-urbanization and air pollution: a cross-country analysis. Int Eco Letters, 3(2): 7.
22. Janke K, Propper C, Henderson J (2009). Do Current Levels of Air Pollution Kill? The Impact of Air Pollution on Popula-tion Mortality in England. Health Econ, 18(9):1031-55.
23. GBD Risk Factors Collaborators (2016). Global, regional, and national life expec-tancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 388(10053):1459-1544
24. Prüss-Üstun A, Wolf J, Corvalán C et al (2016). Preventing disease through healthy envi-ronments. A global assessment of the burden of disease from environmental risks. World Health Organization, Geneva, pp. 10-68.
25. Lin R S, Sung FC, Huang SL et al. (2001). Role of urbanization and air pollution in adolescent asthma: a mass screening in Taiwan. J Formos Med Assoc, 100(10):649-55.
26. The World Bank (2017). World Develop-ment Indicators. http://data.worldbank.org
27. Kaplan RM, Anderson JP (1988). A general health policy model: update and applica-tions. Health Serv Res, 23(2): 203-35.
28. Neumayer E(2004). Recessions lower (some) mortality rates: evidence from Germany. Soc Sci Med, 58(6): 1037–1047.
29. Koyck LM(1988). Distributed lags and investment analysis. North-Holland Publishing Com-pany: The Netherland, pp.63-68.
30. Hsiao WC, Heller PS (2017). What macroe-conomists should know about health care policy. International Monetary Fund, America. https://www.imf.org/external/pubs/ft/wp/2007/wp0713.pdf
31. Wu J(2010). Urban sustainability: An inevita-ble goal of landscape research. Landsc Ecol, 25: 1–4.
32. World Bank. Urban Population. https://data.worldbank.org/indicator/SP.URB.TOTL.IN.ZS
33. Shen L, Zhou J (2014). Examining the effec-tiveness of indicators for guiding sustain-able urbanization in China. Habitat Int, 44: 111–20.
34. Yigitcanlar T(2015). Smart cities: an effective urban development and management model? Aust Plan, 52: 27–34.
35. Zhou J, Shen L, Song X, Zhang X (2015). Selection and modeling sustainable ur-banization indicators: A responsibility-based method. Ecol Indic, 56: 87–95.
36. United Nations (2000). United Nations Millen-nium Declaration: Resolution; UN: New York, pp.7-8.
37. North Atlantic Treaty Organization (2016). 2004 Istanbul Summit. Available from: https://en.wikipedia.org/wiki/2004_Istanbul_summit
38. Plan SG (2012). Beyond Clean and Green towards Environmental Sustainability. Ministry of the Environment and Water Resources: Singapore.
39. Mexico City Government, Green Plan “Plan Verde”. https://dac.dk/en/join/network/
40. Shen LY, Ochoa JJ, Zhang X, Yi P (2013). Experience mining for decision making on implementing sustainable urbanization—An innovative approach. Automat Constr, 29: 40–49.
41. He KB, Huo H, Zhang Q (2002). Urban air pollution in China: current status, charac-teristics, and progress. Annu Rev Energy Environ, 27: 397–431.
42. Kawachi I, Berkman LF (2014). Social capi-tal, social cohesion, and health. In: Berk-man, L.F., Kawachi, I., Glymour, M.M. (Eds.), Social Epidemiology 2nd ed. Ox-ford University Press, New York, pp. 290–319.
How to Cite
WANG Q. Urbanization and Global Health: The Role of Air Pollution. IJPH. 47(11):1644-52.
Original Article(s)