Examining the paradox of urban disease ecology by linking the perspectives of Urban One Health and Ecology with Cities

Abstract

The ecology of zoonotic, including vector-borne, diseases in urban social-ecological systems is influenced by complex interactions among human and environmental factors. Several characteristics contribute to the emergence and spread of infectious diseases in urban places, such as high human population densities, favorable habitat for vectors, and humans' close proximity to animals and their pathogens. On the other hand, urban living can contribute to the improvement of public health through better access to health services and creation of ecological and technological infrastructure that reduces disease burdens. Therefore, urbanization creates a disease ecology paradox through the interplay of urban health penalties and advantages for individual and community outcomes. To address this contradiction, we advocate a holistic Urban One Health perspective for managing urban systems, especially their green spaces and animal populations, in ways that more effectively control the spread of zoonotic diseases. This view should be coupled with an Ecology with Cities approach which emphasizes actionable science needed for urban planning, management and policymaking; developing disease and vector surveillance programs using citizen and community science methods; and improving education and communication actions that help diverse stakeholders understand the complexities of urban disease ecology. Such measures will enable scholars from many disciplines to collaborate with professionals, government officials, and others to tackle challenges of the urban disease paradox and create more sustainable, health-promoting environments.

Keywords: Community science; Infectious diseases; Public health; Urban disease ecology; Vectors; Zoonosis.

Fig. 1

The paradox of urban disease ecology. Urbanization results in an urban disease ecology paradox by creating characteristics of urban social-ecological systems that both increase and decrease zoonotic disease burden through interactions among environmental, wildlife, pathogen, and human factors. The Urban One Health approach holistically considers this paradox and is therefore necessary to understand and manage infectious diseases in urban places. Key relationships within social-ecological systems to examine include, but are not limited to, the following: (A) human activities associated with urbanization change environmental conditions that directly and indirectly impact (B) environmental effects on human health including through (C) environmental effects on vector and pathogen populations & communities. (D) Ecological variables of animal populations affect environmental conditions such as distribution of and human proximity to pathogen reservoirs. (E) Humans have many direct interactions with animal vectors and pathogens, including management, which affects (F) disease transmission risk