Whether Urbanization Has Intensified the Spread of Infectious Diseases—Renewed Question by the COVID-19 Pandemic

Abstract

The outbreak of the COVID-19 epidemic has triggered adiscussion of the relationship between urbanization and the spread of infectious diseases. Namely, whether urbanization will exacerbate the spread of infectious diseases. Based on 31 provincial data from 2002 to 2018 in China, the impact of urbanization on the spread of infectious diseases from the dimensions of “population” and “land” is analyzed in this paper by using the GMM (generalized method of moments) model. The empirical study shows that the population increase brought by urbanization does not aggravate the spread of infectious diseases. On the contrary, urban education, employment and entrepreneurship, housing, medical and health care, and other basic public services brought by population urbanization can help reduce the risk of the spread of infectious diseases. The increasing density of buildings caused by land urbanization increases the risk of the spread of infectious diseases. Moreover, the impact of urbanization on the spread of infectious diseases has regional heterogeneity. Therefore, the prevention and control of disease play a crucial role.

General Commentary: Whether Urbanization Has Intensified the Spread of Infectious Diseases—Renewed Question by the COVID-19 Pandemic

“…Thus, those findings may also be applied to the scenarios of COVID-19 outbreaks in China's urban areas to some extent. In Yu's et al (1) study, population urbanization is determined by the proportion of the urban population, while the density of urban buildings measures land urbanization. Such consideration may not fully reflect the actual level and degree of the two types of urbanization.…”

“…Since most populations live in the cities, research in public health and urban studies regarding pandemic prevention and control in higher-density areas has become one of the top priorities in this new pandemic era. Studies revealed that population urbanization-introduced density growth does not increase the spread of infectious disease, while land urbanization-introduced building density growth can increase the risks of spreading infectious diseases ( 1 ). Moreover, regional heterogeneity is found in the distribution of impacts of urbanization on the spread of infectious diseases (ibid).…”

“…Moreover, regional heterogeneity is found in the distribution of impacts of urbanization on the spread of infectious diseases (ibid). Yu et al ( 1 ) found that greater population urbanization can reduce the morbidity, mortality, and spread of class A and B infectious diseases, while greater land urbanization has the opposite impact. In China, Class A only contains plague and cholera, and class B includes SARS, AIDS, anthrax, tuberculosis, typhoid, etc.…”

“…Density is often entangled with other urban geographies, suggesting how it can couple with other factors and become a major urban problem ( 5 ). Therefore, it is not accurate to jump to immediate conclusions that “ population density has no obvious impact on the spread of infectious diseases ” ( 1 ). In fact, any disease spread could be intensified with higher population density, arguing in favor of the point that unplanned urban densification could lead to unhealthy urban conditions; and hence, faster spread of infectious diseases.…”

Conflict or Coordination? Spatiotemporal Coupling of Urban Population–Land Spatial Patterns and Ecological Efficiency

“…The most important aspects of urbanization are population and land ( 11 , 12 ). The urban population–land spatial patterns (UPLSPs) is the form of spatial agglomeration of urbanization elements.…”