Intensifying Health Risks

Since the COVID-19 epidemic, experts have warned of an increased risk of future pandemics and the need to better prepare for them. In August 2024, the World Health Organization declared mpox a public health emergency after an outbreak in the Democratic Republic of the Congo spread to neighboring countries. In the U.S., concerns grew throughout 2024 over the spread of bird flu to cattle, pigs, and people, with the first human bird-flu death reported in Louisiana in January 2025. Virus mutation and transmission between animal species signal the potential for a human outbreak, and intensive livestock farming practices could be increasing this risk.

Accompanying the increase in communicable diseases is a rise in noncommunicable diseases. According to the most recent data, chronic diseases such as cancer and diabetes are causing 75 percent of global deaths. The COVID-19 pandemic has given rise to long COVID, a chronic condition that has taken an estimated one million Americans out of the labor force. A parallel concern is the increased rate of cancer among younger generations, particularly colorectal, cervical, and breast cancers.

In the U.S., average life expectancy declined from 79 in 2019 to 76.4 in 2021 before rising back to 78.4 years in 2023, largely driven by heart disease, cancer, and COVID-19. Meanwhile, drug overdose deaths, which make up over one-third of all accidental deaths, have increased fivefold over the past two decades, though the CDC announced a predicted 24 percent decline in overdose deaths in 2024 compared to the previous year. U.S. life expectancy continues to lag other industrialized nations.

In many places, systemic and structural issues heighten disease susceptibility. Strategies of improving sewage and water systems, reducing biodiversity loss, and improving housing quality and density can help create healthier and more resilient cities. Planners can also look to successful COVID-19 responses, such as mobile health clinics and equitable vaccine rollouts. Cities can lower the risk of noncommunicable diseases by reducing noise and air pollution, allocating more resources to aid homeless populations, and making it easier to walk or bike. Through thoughtful urban design, equitable access to health care and essential services, and the creation of safe, healthy environments, planners can help shape communities that support longer, healthier lives for all residents.