This post is by Neil Bomberg, NLC’s Program Director for Human Development and Public Safety.
The first day of the Global Forum on Urbanization and Health was filled with questions that seemed unanswerable. The presentations by representatives from sub-Sahara Africa, the Middle East, North America, Latin America, Europe, East Asia and South Asia raised numerous and important questions including:
- What is the impact of poverty and social marginalization on health?
- How do we make visible those citizens who are otherwise invisible?
- How do we deal with the emerging health care needs of recent immigrants?
- What is the impact of governmental decentralization on health care?
- What must happen if we are to overcome the disparities in health that exist within urban areas?
- Why do nations and localities only act on health care after a major conflict or as the result of a manmade or natural disaster?
These questions and others were asked over and over but no answers were given and repeatedly the answers seemed out of reach. The first day of the conference would have had anyone attending believing that there are no real answers.
What I did conclude from the first day’s discussion is that these questions are not questions for the developing world alone. They apply equally to the United States and America’s cities and towns. Unless we commit to answering these questions, we Americans will be unable to solve our own health crisis — a crisis brought on by obesity, diabetes, increasing heart disease, disparities in the delivery of health care and the outcomes that result — despite the recent success realized through the passage of legislation meant to improve our health care delivery system.