"Is urbanization really bad?" asked George Martine, lead author of the UN Population Fund's (UNFPA) recent report, State of World Population 2007: Unleashing the Potential of Urban Growth. "In reality, cities provide great potential for social development, for economic development, demographic improvement, and [progress on] environmental issues." At a Wilson Center event, cosponsored by the Environmental Change and Security Program, the Comparative Urban Studies Project, and the Global Health Initiative, Martine presented the key findings of the report, highlighting seven common misconceptions surrounding urbanization.
Martine began with the most general and widespread misconception: urbanization is inherently bad. "A key question you have to ask: would anything really improve if the population were more dispersed: My answer is no." In the last few decades, cities have gained an enormous advantage over rural areas. Eighty to ninety percent of GNP growth occurs in cities, and therefore, explained Martine, the development of urban centers better equips a country to compete in the global economy. Urban areas also possess more extensive resources and service-delivery systems, explained Martine: "Concentration and density make it easier to provide social services, or services of any kind; education, health, sanitation, water, electrical power…everything is so much easier, much cheaper on a per capita basis." Additionally, the report found that social change—such as the expansion of women's rights—tends to occur in cities. Furthermore, although it may seem counterintuitive that population density is beneficial to the environment, Martine noted: "[C]oncentration [of populations] is actually necessary, particularly if you think of the preservation of rural biodiversity."
Another common misconception about urbanization is that most urban growth is occurring in "mega-cities," urban centers with populations of 5 million or more. In fact, cities with 500,000 citizens or fewer are experiencing 53 percent of overall urban growth, while mega-cities account for only 9 percent. This trend is politically important, Martine explained, because local authorities in smaller cities are obtaining more power, leading to decentralization and increased transparency in the central government. If they were to invest in smaller cities now, NGOs and donor nations could have a significant positive impact on the development of these growing, but currently resource-poor, areas.
A third misconception is that the majority of urban growth is due to migration from rural areas. While rural to urban migration still dominates in Vietnam and China, over two-thirds of urban growth is due to natural increase, with urban births far exceeding migration from rural areas. Ignoring this reality, policymakers are increasingly set against urbanization and urban growth, with over 70 percent of countries enacting anti-urban migration policies over the last 10 years. These actions are reflective of the fourth widespread misconception that rural-to-urban migration can and should be stopped. However, Martine continued, only draconian policies could stop rural-to-urban migration, and even they would succeed only for a short time. Policies aimed at preventing migration have the adverse effect of increasing poverty in rural and urban areas. "It is important," Martine said, "to consider urban and rural development together, as one concept. It is not because we are promoting urban growth that we are against rural growth or vice versa. Successful migration to cities promotes rural development because remittances are sent back to rural areas, and also because prosperous cities increase demand for agriculture products. These things work together."
The fifth misconception, the report states, is the perception that the poor are a "small, marginal minority" of urban populations. The unfortunate reality, Martine said, is that the poor are now the largest segment of urban society around the world, with urban poverty increasing at a faster rate than rural poverty. One billion people currently live in urban slums, due to previous periods of rapid migration and a lack of planning on the part of city and country officials. In the past, cities were planned with the middle and upper classes in mind; now, the poor are falling through the cracks of a system that was not built to support them. The health of the urban poor is often worse than that of the rural poor, due to the introduction of various public health projects in rural areas, in contrast to the limited outreach of urban health services.
Rapidly expanding urban populations have caused many to believe the sixth and seventh most common misconceptions, that cities occupy too much land and are bad for the environment. In reality, explained Martine, half of the world's population occupies only 2.8 percent of the world's land area. While cities do often rise up in areas with rich biodiversity, the concentration of consumption could actually reduce, not increase, environmental degradation, he explained: "Protection of biodiversity and natural ecosystems eventually requires reducing rural density." The UNFPA report does not deny the damaging effects cities can have on the environment, but it also points out that cities contain high concentrations of technological resources that could help decrease consumption and find alternative forms of energy. What we need to guard against now, explained Martine, is urban sprawl. Better transportation has encouraged urban populations to become more dispersed, and as cities merge into suburbs, the benefits of urban density may be lost.
The seven misconceptions about urbanization and urban growth, Martine concluded, have led to the development of futile policies that have prevented the "potential advantages of urbanization from being fulfilled." To reverse poor urban planning, policymakers must first accept the inevitability of urban growth, he said. Additionally, steps must be taken to build sturdy housing for the urban poor: "Having a secure shelter, having an address, having a place to put your stuff, is absolutely essential to benefiting from what the city has to offer."
A More Nuanced Idea of Urban Poverty
In order to better illustrate the situation of urban poor, Anthony Kolb, urban health adviser at USAID, presented research derived from USAID's Demographic Health Survey (DHS). Data collected in India and the Philippines indicate that even when services are available, the poor are often limited by income and social class from accessing them. Surveys revealed mutual dissatisfaction and misunderstanding between providers and clients. Providers reported frustration that their clients seemed to be incapable of following their instructions, while patients felt that their concerns were minimized or ignored. Kolb explained that these results highlight the particular challenges of the urban environment. Cities are largely cash-based economies, and in order to improve access to care among the underserved, new health financing schemes must be developed with the needs of the urban poor in mind. Additionally, there is a vital need for improved communication and outreach to the urban poor. Although providers often see slums as chaotic, explained Kolb, there is actually often a very developed, albeit untraditional, organization system in place, particularly in well-established slum neighborhoods. A clear understanding of these social systems will be an important asset for the development of urban health programs.
However, in order to provide services to the urban poor, one must be able to locate them—a task that is less straightforward than it would seem. Kolb and his team analyzed DHS data to determine how the poor are distributed in various urban centers and how this affects efforts to provide them with health and social services. Looking at seven cities around the world, Kolb and his team found that there is no universal definition of a "slum." Often, the word slum connotes cities like Nairobi, with large, unincorporated areas surrounding the city proper. But in Lima, Peru, people across the spectrum of wealth live in slum and non-slum areas. "Slums and poverty are not the same," explained Kolb. Researchers and providers must further study the variety of urban poor groupings and living situations in order to implement effective programming. He recommended using income level and socioeconomic status as a way to identify urban poor populations, rather than residence in "slum" areas.
Kolb concluded with examples of positive shifts toward addressing problems of urbanization and urban growth. Policymakers in India have slowly begun to acknowledge the desperate situation of the urban poor, developing a unique office to study and address urban health. Most importantly, all levels of government are working to improve the flow of resources to India's urban poor. In Bangladesh, government agencies are utilizing new mapping technologies, such as GIS, to locate slums and understand how the poor are distributed throughout the city. Instead of large slum areas, they have found many small pockets of slum populations. This dispersal of slum areas will make programming more difficult to implement, but also more effective in reaching its target population. In Ghana, where urban child mortality and malnutrition rates have remained constant while rural rates have improved, the government is finally focusing on the needs of the urban poor by developing a Community-Based Health Planning and Service program.
USAID's program goals for sustainable urban development include: continued improvements in the health characterization of urban poor; support of urban health champions in Asia; and expansion and innovation of USAID urban health and development missions in Africa. These activities will make a significant contribution to the realization of George Martine's challenge to all in attendance: to develop a "long term vision for both the social and sustainable use of urban space."
Drafted by Michaela Hoffman.