This chapter examines the urban health risk transition and some of its implications. It starts by examining how and why health indicators can counterbalance more conventional economic indicators in assessing the impacts of urban environmental burdens.
It goes on to examine the health and urban transitions associated with modern economic growth, arguing that they reflect the systematic tendency of urban affluence to shift environmental burdens across space and time: spatially from burdens in and around the home, towards city and regional burdens, and finally towards genuinely global burdens such as climate change; temporally from immediate health impacts towards burdens that undermine the life support systems of future generations.
However, the transitions are not simultaneous around the world, and in low income locations it is increasingly common to face environmental burdens that combine not only the local burdens of poverty, and the city-regional burdens of industrialisation and motorisation, but also the global burdens of affluence.
The chapter also examines the relevance of this complex spatial patterning of urban environmental burdens for urban politics and governance, using water and sanitation and climate change as examples.