By 2050, with 70 per cent of the global population expected to live in cities, engaging youth in shaping sustainable urban future is more crucial than ever

Urbanisation, an engine for economic prosperity and resources, sits at the centre of modernity and impacts health outcomes. With rapid urbanisation, the UN projects that by 2050, 7 of 10 people will live in cities, and the youth will likely be the most dominant population. The future will be forged by the ever-increasing global youth, who are integral to playing a dynamic and revolutionary role in creating and building strong, prosperous, sustainable, and vibrant societies. In recent years, international organisations have emphasised the meaningful involvement of youth as vital to accelerating progress towards the SDGs while development continues to grow globally.

The approach also coincides with this year’s message of World Habitat Day, which focuses on “engaging youth to create a better urban future.” However, while we work towards engaging the new generation in planning their urban present and future through participatory processes and local leadership opportunities, ensuring their healthy livelihood is imperative. Urbanisation’s positive attributes also mask the inequalities that exist within it. Not all city residents experience or can access these benefits equally. For instance, 40 per cent of India’s population will reside in the urban setup by 2030, with 24 per cent being the youth (15-29), making it a relatively young country. Although rapid urbanisation will continue to improve India’s average household socio-economic condition and child health status, it is expected to disproportionately affect the health of urban youth, who are likely to become more vulnerable to health challenges.

Urbanisation without accounting for the primary healthcare amenities results in significant health disparities. As gentrification grows with urbanisation, a large chunk of the youth is likely to reside in urban slums and low-income areas. These areas carry distinct health challenges that are influenced by broader socio-economic determinants such as poverty, education and employment.

Youth from low-income families and areas are more likely to face barriers to accessing education, which in turn limits job opportunities and perpetuates a cycle of poor health outcomes.

These informal settlements may sit adjacent to an affluent neighbourhood. Still, the people living there lack access to safe water and sanitation infrastructure, becoming hotspots for waterborne and vector-borne diseases due to flooding, open sewers, and overcrowding. With such poor hygiene, increased rates of malnutrition among children and young adults worsen the burden of diseases.

In addition to infectious diseases, urban youth in lower-income areas are increasingly exposed to non-communicable diseases such as diabetes and hypertension, which are often exacerbated by poor diet, stress, and lack of access to early diagnosis or regular health checkups.

These substantial regional disparities affecting urban youth’s living and health conditions are also caused by the inequitable distribution of clinics and healthcare centres, which limits care options. According to NFHS-3, only 39.9 per cent of urban poor children get full immunisation compared to 65.4 per cent of urban non-poor children. Lower vaccination rates and a lack of awareness of ongoing health issues negatively impact school attendance and cognitive development.

The National Urban Health Mission (NUHM), launched in 2013, has been instrumental in meeting the regulatory, reformatory, and developmental public health priorities for urban settings.

Over the years, NUHM has improved access to healthcare, allowing the urban poor to choose public over costly private services. Among the other initiatives to focus on urban youth health, the National Youth Policy (NYP) 2021 outlines a 10-year vision for youth development by 2030, aligning with the United Nations’ SDGs. 

The NYP prioritises youth health as essential for India’s holistic growth and progress by addressing critical health components of urban youth and acknowledging mental health. Further, India’s pioneering step towards building inclusive health that benefits all and focuses on the youth also found prominence in the recent G20 New Delhi Leaders’ Declaration in 2023.

The report encompasses ways to eliminate hunger and malnutrition and advance with more health collaborations, especially when facing challenging mental health. While policies like NUHM and NYP have made strides in addressing urban youth health, more needs to be done and implemented to improve primary healthcare.

Many urban healthcare centres still struggle with understaffing, lack of resources, and accessibility issues for slum-dwelling youth. To ensure that India’s urban youth thrive, it is crucial to increase investments in health services, prioritise mental health care, and continue engaging youth in the decision-making process for urban development.

(The writer is the Founder and Managing Director of IPE Global; views expressed are personal)