The Metropolitan Revolution: Next Gen Population Health

by Jordan Mueller, MPH ’16, Department of Sociomedical Sciences

Promises of a metropolitan revolution were met with equal parts hope and skepticism during the second installment of the Grand Rounds on the Future of Public Health at the Mailman School on Wednesday, October 10, 2014. Bruce Katz, JD, Vice President at the Brookings Institution and author of The Metropolitan Revolution, presented the faculty, staff, and students at Mailman with opportunities and challenges to public health in urbanization. Katz’s speech was both complemented and countered by rhetoric from Mailman professors Gina Lovasi, PhD, MPH, and Peter Muennig, MD, MPH.

“The magic happens when disciplines come together,” said Katz, opening his presentation and establishing a collaborative tone. He then outlined the fundamental components of the metropolitan revolution, emphasizing three main points of action for cities: move industry back into cities to create jobs, require that leadership promote innovative municipal projects such as extensive improvements to mass transit and neighborhood centers, and the need to identify a “game changer” to fundamentally alter the economic profile of the city.

A lawyer by trade, Mr. Katz sought to show the importance of the American city in the coming century. Not immediately apparent, the topic applies directly to the Mailman community based in one of the world’s largest cities: rapid urbanization and growing populations have extreme implications for population health. Issues that cities can impact on public health include air quality, access to healthy foods, and acceptable housing standards. Our health is both a cause and an effect of urban infrastructure.

Bruce Katz, JD

Featured speaker Bruce Katz expands on the public health implications of urbanization.

Katz advocated the power of metropolitan centers to inspire national change and grow the economy in spite of a weak and ineffective federal government. Rather than wallow in pessimism, however, Katz inspired the people to rally around the modern American city to serve as the model of new cultural, economic, and political orders. “The work of this century is the work of cities,” Katz emphatically concluded. “And I would say that the work of public health is the work of improving cities.”

His optimism was met with skepticism by Columbia’s faculty. Gina Lovasi pointed out that our metropolitan revolution cannot proceed on blind hope. The associate professor of epidemiology argued that revolutionary urban measures must be connected with longitudinal research. While it may seem like this call for evidence-based policy would stifle the progression of Katz’s ambitious proposals, the Mailman community is grounded in the importance of research and would probably be apprehensive in endorsing any movement that lacks guaranteed results. Professor Lovasi’s sentiment, was not in conflict with Mr. Katz, but simply acknowledged the importance of research in progressing with sweeping metropolitan initiatives.

Professor Peter Muennig was less apologetic in his doubts about the metropolitan revolution. The associate professor in Health Policy & Management pointed out that America is being “out-innovated” by peer nations, and that simple measures of mass transportation and minimal action to create truly “green” cities would not suffice in achieving our urban goals. Making comparisons between the US and China, Professor Muennig claimed that moves to eliminate cars and provide sustainable health systems is crucial in creating urban health.

As the three guests engaged in a dialogue moderated by Mailman’s departing chair of the Department of Epidemiology, Sandro Galea, DrPH, MD, the voices proved to be more collaborative than their earlier presentations would suggest. Katz, Govasi, and Muennig all concurred that key points of urban health are increased opportunities for physical activity through public parks and alternative modes of transportation such as walking and biking. The commentators also emphasized the importance of equity in healthcare access.

From a public health perspective, we welcome a revolution that is grounded in evidence and is equitable in health delivery. This metropolitan revolution may indeed be a population health revolution, and the Mailman community is sure to have a role.

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