The Good, the Bad, and the Ugly of City Living

Cities have a reputation for being the least healthy places to live. Statistics show that half the world’s population lives in urban areas today, set to rise to three quarters by 2050. Thankfully, research suggests city living offers a myriad of mental and physical health benefits. Not only do urban dwellers live longer on average, but they also have lower rates of obesity and suicide, are less likely to die in an accident, and lead happier lives in older age.

The Good: Easier to Keep Fit

One of the biggest perks of city living? Walkability. Living somewhere walkable reduces your risk of health problems like obesity, heart disease, and high blood pressure. Only about one-fifth of Americans get the recommended amount of exercise, but opportunities for physical activity abound in metropolitan areas⁠. You have 24/7 fitness centers at every turn, yoga in the park, casual sports leagues, dance classes, and so on. Another perk? If you live where you work, that means less commuting. Long commutes correlate significantly to weight gain in adults, according to a study in the American Journal of Preventive Medicine. If you bike to work, even better ⁠— according to research published in the BMJ, an active commute reduces the risk of cancer, heart disease, and premature death.

The Good: Better Access to Healthy Food

Living near farms does not necessarily mean farm-fresh food is easy to come by. A lower population means fewer grocery stores. In cities, however, maintaining a healthy diet is easy, thanks to the abundance of fresh produce at year-round farmers’ markets and countless grocery stores and delivery services. Another bonus: you might drink less alcohol. Cities have more bars and nightlife, but the National Drug Strategy Household Survey found people living in remote locations are 11 percent more likely than urban dwellers to drink excessively.

The Good: Less Boredom

Good news: city living is good for the brain. Copious cultural attractions and endless entertainment options keep the mind active. A study by the journal Dementia revealed that regular trips to museums improved the overall well-being of adults with dementia. And if you have a hobby or unique interest, you’ll have no problem finding like-minded people who share your passion. Research shows both having an active social life and spending time on leisure activities reduce the risk of dementia.

The Good: Easy Socialization

Friendships can be easier to come by in a city, and feeling connected to others has major mental health benefits. One study found that having close friends increases the chances of survival after developing dementia. When it comes to dating, it is easier to be a small fish in a big pond than the other way around. The odds of finding Mr. or Ms. Right are higher in a city, with more prospects available. Studies suggest being in a happy relationship keeps blood pressure lower, which increases life expectancy.

The Good: More Access to Medical Care

If you’re in a major city and you need a doctor, there will be hundreds to choose from. In a rural area, there might be just a handful of medical professionals available. It is also more likely to receive prompt care if you experience a medical emergency in a metropolitan area. Odds are, there is a hospital or police station just a few minutes away. In some remote rural areas, it can take an hour for the nearest ambulance to arrive.

The Bad: Air Pollution

City residents enjoy better health on average than rural populations. However, urban air pollution comes with serious health risks, including pulmonary and cardiovascular diseases, ischemic heart disease, cancer, and asthma. Outdoor air pollution is responsible for 3.7 million deaths every year. An estimated 9,000 residents of London, England die annually as a result of poor air quality.

The Bad: Health Inequality

There are health benefits to living in the city ⁠— if you can afford it. Like many things, there is an unequal distribution of urban health risks amongst the haves and the have-nots, with the most vulnerable populations bearing most of the burden. People living in slum areas are especially affected, as well as those in neighborhoods with significant populations of migrants, children, and the elderly.

The Bad: a Shortage of Nature

While they pride themselves on their green spaces, cities are nicknamed “concrete jungles” for a reason. Spending time in nature has both mental and physical health benefits. Research finds physical activity in a natural environment, such as hiking, can help alleviate mild depression symptoms and reduce psychological stress. Being one with nature also lowers heart rate and blood pressure and enables the release of more “natural killer cells” that fight cancerous and virus-infected cells. Trees produce oxygen and help filter harmful pollution and airborne particulate matter from the air. Bodies of water also have moderate temperatures.

The Bad: Effects of Climate Change

The large expanses of paved and concrete structures in urban landscapes absorb radiant heat from the sun. Without ample green spaces to reflect this heat, the average temperature in a city can rise as much as 27°F higher than the surrounding countryside. This “urban heat island” effect worsens as climate change-related heat waves become more frequent. The spike in power demand for air conditioning during these heatwaves only adds more emissions to the environment, creating a vicious cycle. Furthermore, rises in sea level pose a serious threat to coastal cities, with increased flooding worsened by escalating storm intensity and rainfall. Major coastal cities like New York City, Buenos Aires, Tokyo, Cairo, and Shanghai are at risk.

The Ugly: Contributing to Climate Change

According to the WHO, cities are significant contributors to climate change, representing about 67 to 76% of energy use globally, according to the Intergovernmental Panel on Climate Change. About three-quarters of climate emissions result from urban energy consumption. These emissions include black carbon, methane, and CO2, a pollutant that remains in the atmosphere for hundreds of years.