Metropolitan health in a neoliberalizing world

The chapter begins by foregrounding the importance of the ‘epidemiological worlds’ concept and argues that ‘urban health’ must be understood with reference to the larger regional economies and state/provincial or national political units in which cities are embedded. Methodological points relate to the importance and limits of place-based approaches to health inequalities, and to the need for explanations to include a temporal dimension. Increased economic inequality within metropolitan areas will be a major influence on future health outcomes - for example, through gentrification and the financialization of housing. The chapter then turns to the auto-centred nature of the contemporary metropolis, which has both direct and indirect health impacts, while noting some promising initiatives. Austerity programs have had a destructive and locally unequal impact on social determinants of health in the metropolis, dramatically so in the UK. The chapter concludes with recommendations for theory and policy.