Journal of Infectious Diseases & Preventive Medicine
Open Access

Urban Health and Sustaining Peace during and after the COVID-19 Pandemic

Ali Cheshmehzangi^{1,2* *}Correspondence: Ali Cheshmehzangi, Department of Architecture and Built Environment, University of Nottingham Ningbo China, Ningbo, China, Email:

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Introduction

In this brief paper, we mainly highlight key areas of sustaining peace and achieving urban health. These are narrated in five main areas, addressing what should be carefully considered in the next steps of achieving better urban health, maintaining healthier cities, and sustaining their daily operations. The aim of this study is to add knowledge (or some insights to the least) to areas of urban health and peace, especially during disruptive disease outbreak events, like the COVID-19 pandemic.

As our cities and communities faced - and continue to face - the ongoing COVID-19 pandemic, we recognized the flaws in the health and well-being of the built environments. In our earlier work, we look into potential paradigm shifts [1], which are also relevant to how cities could maintain and sustain their peace. Significant issues, such as health inequalities [2], community disparities [3,4], and deficiency in primary health services [5] and public services [6], already highlight some of the critical flaws in cities and communities around the world. Here, we highlight five areas for further consideration as shown below:

Health Inequalities are Widespread Around The World

Since the inception of the COVID-19 pandemic, we see significant disparities between different communities, between social groups, between different ethnicities, and more importantly, between different countries and regions. From the start of the pandemic control and the implementation of various regulations, safety and control procedures, and relevant policies, we see different directions taken by communities of different statuses. It has been proven that socio-economic aspects play a major part in controlling, managing, and safeguarding societies. We are clearly not on the same boat, and it is unclear whether we are experiencing the same storm or not. Despite the efforts of the World Health Organization (WHO) and the United Nations (UN) in mentioning such critical inequalities, we have seen them growing more into the current stage of vaccination and distribution of the vaccines amongst poorer communities, cities, and countries/regions. While some countries are hoarding vaccines (at least through purchases so far), many countries are still struggling to secure vaccines to safeguard their essential workers in the healthcare services. Not only that becomes a major issue, but also the fact that the race in developing a vaccine has now turned into a race in making the vaccine into a unique commodity. However, the problems remain in place that health inequalities are widespread, and by going to normal (if it happens any time soon), we are not able to face the realities and resolve the issues that have become more apparent than before.

Ethnic Inequalities are Hidden but are No Myth

Many studies already indicate differences between different ethnicities in various countries. There are valid shreds of evidence that show ethnic minorities are in a higher danger zone. The complex situation often is blamed on various aspects, such as cultural activities or beliefs, but the general public understands little in regards to insufficiencies that the minority ethnics often face in multi-national and/or multi-cultural societies. For instance, in most minority groups of such contexts, we see higher poverty rates, higher level of job hazards, lower education level, lower-quality living environments, etc. These are proven to be key aspects leading to a lower level of hygiene, higher risk of infection, higher rate of infection and death cases, and other associated aspects that suggest disparities between different groups of societies worldwide. Some of the issues are also rooted in our structured racism [7] that has, for a long, become the norm of the so-called multi-cultural societies. The situation also persist in the current vaccination stage, when we see different treatments are given between different ethnics of some countries.

Many Cities and Communities Lack Essential Services and Infrastructures

During the COVID-19 pandemic, we realized that many cities and communities lack essential healthcare services or even the primary infrastructures to help manage an outbreak. Unfortunately, we note that lack of inactions and preparedness is only one side of the story to date. The other issues are mainly because we lack essential services, from healthcare services all the way to safety checks, security forces, community support teams, etc. More importantly, we see many communities with non-standard infrastructures, which cannot cope with the aftermath of the pandemic. It is more surprising that such shortages are not limited to more impoverished countries alone. These issues were also seen in developed nations, where we noted many cities and communities lack critical infrastructures or the capacity to deal with the larger-scale adversity of the pandemic. As a result, many cities and communities were not able to manage the situation in time, lacking resources of various sorts, shortages in responding to the outbreak, and shortfall in their services. Even at the current vaccination stage, many countries still struggle to make a fair deal with the general public, allowing for better control and safety procedures and enhance essential services that are yet to be revised after the pandemic. Nevertheless, we have doubts whether there would be any large scale interventions, but we hope some nations could step up to revisit their infrastructures and services in a more responsive and responsible manner.

THe Decline In Social and Public Services Will Become Prolonged Issues of The After Pandemic Era

It is evident that during pandemics or outbreaks, social and public services could become weaker [6]. As a result, we see the current trend is becoming a significant challenge after the pandemic. Many countries could not cope well with the inevitable decline in their social and public services. So far, the focus has been on health and economic impacts, not realizing the social consequences are already more severe than expected. Issues of mental health, deprivation from social life, job loss, physical health impacts, and many other health-related aspects are yet to be studied further [8]. We see major issues arising from the decline in social services as the hit is mainly on the vulnerable and deprived groups of the society. The issues are expected to be prolonged, and the decline in local businesses and their closure could lead to major issues beyond just job losses, but also family losses, an increase in depression rates, anxiety cases, mental health, and associated health issues. In the current vaccination stage, we also experience the failures of social and public services, as they are yet to overcome the deficiencies in securing and distributing enough vaccine doses in their immediate and nearby communities. The whole situation contradicts the actual image of a peaceful society.

Institutional Structures Have Become Weaker In Sustaining Peace In Communities

While existing scholarly work already highlights the impact of COVID-19 on microfinance institutions [9], we see the widescale need for institutional support, mobilizing them, and even restructuring them. In most failure cases, we see a lack of proper reactions of government, which often relate to weaker institutional structures. To name an example, we can point out the lack of resilience and safe strategies in healthcare institutions, which have led to a larger scale and longer health impacts on societies. In such cases, cities and communities have failed to implement adaptive measures, set clear priorities, and implement strategies that could show strong institutions' role in controlling and managing the pandemic. Lack of clear institutional structure has become interpreted as governmental inactions. While we realize the two are interrelated, we note that a robust institutional structure is a precursor to anything at the governmental level. In most cases, the governance is short of people involvement and engagement, leading to other issues of mistrust, misinformation, disconnection between people and their governments, and social unrest. Therefore, we note that one of the significant impacts of the COVID-19 on urban health is, in fact, the impact on making the institutions weaker than before. Unfortunately, it could take much longer than expected for the governments to face such realities. It could take even longer for them to deal with them or have an attempt to resolve them.

Conclusion

This brief paper highlights just a few key areas that urban health and peace that are essential to better management and control of the pandemics. The five mentioned areas are crucial to making cities and communities healthier, maintaining their wellbeing, and sustaining peace. If the pandemic finishes anytime soon, we ought to be more reflective of the current situation, noting that the health and well-being of communities could lead to better management, responsiveness, and adaptability, especially when facing disastrous conditions and/or calamities like the ongoing COVID-19 pandemic.

Aknowledgement

The author acknowledges the National Natural Science Foundation of China (NSFC) for the provision of funding for project number 71950410760. He also acknowledges the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan Government, and the Network for Education and Research on Peace and Sustainability (NERPS), Hiroshima, Japan.

References

1. Cheshmehzangi A. Revisiting the built environment: 10 potential development changes and paradigm shifts due to COVID-19. Journal of Urban Management. 2021.
2. Geary RS, Wheeler B, Lovell R, Jespon R, Hunter R, Rodgers S. A call to action: Improving urban green spaces to reduce health inequalities exacerbated by COVID-19. Prev Med. 2021;145:106425.
3. Liu L, Xue P, Li SX, Zhang J, Zhou J, Zhang W. Urban-rural disparities in mental health problems related to COVID-19 in China. General Hospital Psychiatry. 2021;69:119-120.
4. Jenkins WD, Rodriguez C, Lee M, Van Ham B, Slomer L, Boakye EA, et al. Rural-urban Differences in Illinois Health Department Capability to Address the COVID-19 Pandemic. Ann Epidemiol. 2020;49:75-84.
5. Guida C, Carpentieri G. Quality of life in the urban environment and primary health services for the elderly during the Covid-19 pandemic: An application to the city of Milan (Italy). Cities. 2021;110: 103038.
6. Cheshmehzangi A. The city in need: Urban resilience and city management in disruptive disease outbreaks. Singapore: Springer.2020.
7. Cheshmehzangi A. Vulnerability of the UK’s BAME communities during COVID-19: The review of public health and socio-economic inequalities. J Hum Behav Soc Environ. 2021.
8. Islam S, Islam R, Mannan F, Rahman S, Islam T. COVID-19 pandemic: An analysis of the healthcare, social and economic challenges in Bangladesh. Progress in Disaster Science. 2020;8:100135.
9. Zheng C, Zhang J. The impact of COVID-19 on the efficiency of microfinance institutions. International Review of Economics & Finance. 2021;71:407-423.