finds significant catch-up growth in non-capital cities.
URBANIZATION THROUGH HEALTH
IMPROVEMENTS In addition to natural resource extraction and politics, urbanization in developing
countries is also driven by the discovery and dissemination of health technologies. Historically,
moving to cities required a trade-off between better economic opportunities, but lower life
expectancy. For example, large cities in the U.S. experienced very high death rates from infectious
disease and lower overall life expectancy compared to rural areas until the 1940s. The threat of
industrial pollution persisted even later with the Great London Fog of 1952-1953 contributing to
12,000 excess deaths. However, rapidly decreasing mortality rates in developing nations after World
War II shifted the balance of forces driving city growth. Instead of the “killer cities” of the past,
improved health care allowed for higher population density for a given income level. A recent study
compares mortality by city size in late-1800s England to modern day China and found that larger
English cities were more deadly than smaller ones, while bigger Chinese cities today experience
lower mortality than their smaller counterparts. In addition, the study explores the relationship
between industrial pollution and mortality, finding that the association between pollution and deaths
was much stronger in industrial England than contemporary China. Moreover, data from 73
developing nations mostly in sub-Saharan Africa shows that child health is better in urban slums than
rural areas (although substantially worse than formal settlements in urban areas). Since 2000, a
remarkable health transition has transformed mortality in sub-Saharan Africa. Infant mortality in the
region has declined by 40 percent, while the dissemination of antiretroviral therapy reduced
HIV-related mortality in the region by 48 percent between 2004 and 2014. Meanwhile, malaria
control efforts such as distribution of insecticide-treated bed nets, indoor residual spraying, and
malaria drug prophylaxis have decreased malaria-related mortality by over 50 percent. Over the
same period, the World Bank estimates that sub-Saharan Africa’s total fertility rate has decreased by
14 percent. Urban fertility rates in the region are 1-3 children per woman lower than in rural areas,
but still double replacement in eastern and western Africa. Southern Africa and select nations in east
Africa exhibit urban fertility rates trending toward replacement, but the fertility transition has
progressed slowly overall. In the past, mortality decline has played an important role in decreasing
fertility, as parents adjust their desired fertility to fewer infant deaths. Thus, the recent mortality
declines without an equivalent fertility transition have increased city population growth, pressured
rural economies, and spurred rural to urban migration.
Best models show that urbanization has some developmental benefits, including
higher fertility rates
Teye 18
Joseph Teye Centre for Migration Studies University of Ghana, Urbanisation and Migration in Africa,
Published by The UN,
[Link]
[Link])//LED
Urban living has, in a few cases, contributed to access to education, health services, lower fertility,
improved access to social services. • Informal settlements tend to boom with various forms of
entrepreneurial businesses and activities mostly in the informal sector. • Recent studies in Ghana
shows that incomes of the migrants were irregular, but higher than at places of origin.