Urbanisation is one of the defining demographic shifts of the modern era. Cities concentrate opportunity, innovation, healthcare, and economic growth - yet they also amplify inequality, environmental exposure, injury risk, communicable disease transmission, and chronic disease burden.

This chapter examines the determinants of health within urban environments: housing quality, sanitation, transport systems, air pollution, green space, social cohesion, informal settlements, and governance structures. It explores both the benefits of urban density - access to services, education, and employment - and the vulnerabilities associated with overcrowding, slums, violence, and infrastructure strain.

Urban health is presented as a systems challenge. Effective strategies require integrated planning across sectors: housing, transport, environmental regulation, safety, and social protection. The city becomes both risk and remedy.

Key Takeaways

* Urban populations are growing rapidly, particularly in low- and middle-income countries.

* Cities concentrate both health opportunity and health risk.

* Social and spatial inequalities are often magnified in urban settings.

* Environmental exposures such as air pollution and unsafe housing drive morbidity.

* Informal settlements pose unique public health challenges.

* Integrated urban planning and cross-sector governance are central to improving urban health.

* Healthy cities require structural, not merely clinical, interventions.

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