Urban Public Health in the context of Geography - Understanding the link between human health and the urban socio-ecological environment

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Background: Studying urban health is of vital importance, because the majority of the world¿s population is living in urban areas. Moreover, health and environmental inequalities are significant in inner city neighbourhoods. However, most existing studies do not address urban health with the multidisciplinary and integrative approaches that are necessary to capture the complexity of socio-ecological environments in cities. Furthermore, spatial and spatio-temporal analyses of health related questions in urban settings are lacking. In order to advance science and inform public health policies, research needs to delve into the origins of health inequalities and socio-ecological exposures at multiple geographical scales. Research Goals: My overall research goal is to develop a framework that advances science concentrating on understanding the complex interactions between health and the urban environment. To do this, I will quantify the spatial distribution of urban health (health inequalities); assess the spatial patterns of exposures from the socio-ecological environment, i.e., environmental inequalities in urban neighbourhoods; and identify how environmental inequalities affect urban health. Methodology: I am proposing an integrative and spatially explicit approach for studying health-related questions by combining methodological approaches from epidemiology and geography. This health-geographical approach concentrates on the complex relationships between urban health and the socio-ecological environment at various geographical scales. The methodology includes disease mapping, exposure mapping, and spatial-epidemiological modelling using geo-processing and spatial statistics. Five different data sets will be used concentrating on rural-urban differences and urban neighbourhood characteristics with respect to public health outcomes. For example, rural-urban differences of over- and under-weight will be studied in sub-Saharan African countries. Furthermore, urban neighbourhoods with respect to mental health and cardiovascular diseases will be analysed in New York City and Framingham, MA. The findings will be integrated and synthesized in a framework for health and the urban environment. Relevance of the project: The proposed project will help consolidating geographical approaches for health related questions. Outcomes will contribute to frame strategies for reducing health-related inequalities in urban areas and inform public health policy. Project related work will lead to at least six publications in international peer-reviewed journals, book chapters, and a number of conference contributions.