Paulo Saldiva

Cities have always represented poles of attraction for man. The cultural escalation of Humanity, the consolidation of large religious currents and the extraordinary technological development of recent centuries had the urban setting as a backdrop.

Cultural products, created in cities, have them also as their largest consumer market. And it is in the shadow of urban buildings that spiral cycle of production/consumption has been accelerated to the highest point in recent decades.

Cities generate ideas, concepts and products that are consumed by urban inhabitants, at a rate which increases progressively. The strength of this process creation/consumption turned cities into centers of attraction for all who aspire to produce or consume cultural goods, find work or improve their studies.

The technology that increases the efficiency of food production in the field is developed in the cities that, at the same time, attract residents of the fields with the sophistication of the urban lifestyle. In this process, the agrarian areas become empty and cities grow more and more. With a predominantly rural population in the first half of the twentieth century, Brazil has today more than 80% of its population in urban areas.

Cities began then to be the focal point of the environmental issue of our country. It is in them that appears the pressure for food and energy that affects forests and rivers. The demand for water and other natural resources, which modifies or terminates the courses of rivers, establishing pasture in what was once savannah, plantations in what was woods, is the result of the needs of the urban man. Thus, measures that increase the sustainability of cities will have beneficial impacts that extend far beyond its boundaries.

There is however one aspect of the relationship between city and environment rarely addressed. Little is said of urban ecology with a focus in quality of human life. Take the example of Brazil. The imperative need to preserve what remains of our great forests, to avoid contamination of the waters of rivers and underground reservoirs, to prevent the extermination of wild animals has created a welcome set of laws as instruments of highly efficient protection of natural ecosystems. The destruction of forests, seas and rivers that unfortunately persists in the country, occurs by problems in the monitoring system, yet not totally efficient, and not for lack of appropriate legal framework. In short, we have a modern set of laws and a system of monitoring and enforcement of rules that need to be improved.

In cities, the situation is not the same. Let’s take as a case study the legislation governing air quality. The current accepted limits of air pollution adopted by Brazil were established in mid-1980, translating scientific knowledge available in the 1970s. In several European countries, the United States and Canada, there was a progressive reduction of acceptable levels of air pollutants, these changes generated by incorporating epidemiological and clinical studies that have demonstrated the existence of adverse effects to human health at levels much lower than previously thought. Brazil and most developing countries have maintained their standards unchanged, as if to ignore the new knowledge or prefer to increase its production capacity even at the cost of harm to human health.

In the first case – the lack of scientific information – the diagnosis is ignorance. In the second, the maintenance of the risk to humans was an option for the benefit of economic activity, each reader may coin his/her definition from what their conscience and their moral values indicate.

Some situations arise from the above. In São Paulo, it took eight years of environmental impact studies to ensure that the beltway road does not harm too much the green belt around the city. However, when constructing an avenue in a residential area, the environmental impact study is virtually nonexistent. Would not be the case for reflection if man does not deserve the same care as other living beings received?

There are many examples of dissociation between caring for the environment in general and the urban environment. The State of São Paulo adopted a series of positive measures aimed at reversing the declining trend of vegetation cover. Protocols for mechanized harvesting of cane sugar led to the replanting of vegetation in areas of greatest slope of the ground, with the consequent restoration of riparian forests. There were established fixed proportions to preserve vegetation in agricultural areas. Effective programs regained the area occupied by Atlantic.

Unfortunately, this did not occur in large metropolitan areas, at least not consistently. In them, the explosive growth created a desert periphery, in which the concrete, cement roofs, slabs and asphalt streets devoid of urban planning replaced the original vegetation. The margins of streams and their overflow areas were occupied by streets and houses that host populations socially and economically underprivileged. The hills were scaled by hovels subject to landslides.

The whole occupying process of the periphery occurred at a rate of intensity beyond the capacity of the government to provide infrastructure and environmental services, as if parts of the city have already been decrepit born, never having enjoyed the advantages of a slow maturation urban. The positive example of the 1940s and 1950s, when the City Company adopted modern urbanistic concepts to create neighborhoods that today make up the region of Jardins (the Gardens), in the state capital, has been forgotten or alternatively considered superfluous to the ends of the inhabitants of the metropolis. Nowadays, Euclides da Cunha probably would not need to travel to Brazil to meet Straws of trenches, as its inhabitants migrated and received the same treatment unworthy the outskirts of large cities. In The Barrens, he describes the disciples of Antonio Advisor found the glare of civilization in light of the shooting of guns. Today, in Sao Paulo, they are presented to modernity in heat islands and flood zones, crammed with transport.

From the foregoing, a city can be considered as a complex and fragile ecosystem. Environmental pressures are enormous. Water availability in quantity and quality acceptable to the consumer is dwindling, forcing the expansion of the search for water to progressively larger distances. Housing conditions vary under the prisms of qualitative and quantitative, quite significantly. The microclimate of cities in terms of average temperature, relative humidity and concentration of toxic pollutants is significantly heterogeneous in different parts of the urban environment. The vulnerability of the population is highly influenced by place of residence, distance between home and work addresses, mode of transportation, age, gender, underlying diseases, socioeconomic status and genetics.

These factors indicate that the study of urban ecosystems, from the point of view of quality of life and health, presents an enormous complexity, requiring for its adequate understanding an amalgamation of different areas of knowledge, as well as several levels of analysis, ie , leaving from the individual to reach the size of an entire metropolis. For cities, the pressures are felt more intensely by the fragile segments: children, the elderly, those with chronic diseases, and among all those mentioned, the poorest.

The human being is the forgotten point in the environmental issue. The environmental agencies are roughly unprepared to deal with health issues. Their attention is focused on ecosystems in remote areas, with little activity in the urban environment. Moreover, the health departments have not yet organically incorporated environmental issues in its roster of primary assignments. In this vacuum generated by the lack of an ecosystem approach to human health, arise the conditions for the deterioration of the urban environment, to the detriment of the quality of life.

It is indeed paradoxical that living in large cities has not been subject to a deeper analysis of health agencies. Who among those who now read this document is unaware of the pressure metropolises have on its inhabitants? Urban violence, the stress of traffic, traffic jams that prevent us from fulfilling our commitments, don’t they compromise, perhaps our mental health? The constant noise of millions of vehicles, doesn’t it affect our hearing? The water contamination, environmental liabilities by industries that left the city to make way for apartments where we live or by infiltration of fuels and refined products in thousands of points of contamination of gas stations, don’t they affect humans? Floods, with landslides and exposure of people who swim in the sewer to save their belongings, do they offer no health risks? Changes in regional microclimate that associated heat islands with areas of intense air pollution, don’t they represent a consensus point of injury to human health?

These issues, which represent the central point of the relationship between the environment and human health in the metropolis scenario, are the object of study of this book, analyzed in an integrated manner by researchers from various areas of expertise. In it, geographers, anthropologists, meteorologists, transport experts, members of the Civil Defense, health professionals, journalists and other scholars treat live in big cities as a determinant of the relationship between quality of life, health and disease.

Perhaps the chapters that follow this introduction constitute the basis for the creation of the concept that quality of life should be an element bounding development, allowing the man a central role in the policies of mobility, housing, land use and occupation and provision of environmental services. São Paulo, which displays the contrasts the magnitude of its problems, is a case study that evaluates broadly and integrated the challenge of living in big cities. The size of the problems of the capital city should not operate as a factor of inaction. When viewing their illnesses, this city, so complex and suffered, proposes to solve very significant questions. The current urban crisis may lead to a creative force for the development of solutions. Many life changes for the better occur when we get sick. It is likely that intensive care units propitiate many transformations as the temples of prayer, since both institutions, hospitals and religious, have the same subject: human suffering. May the disease of the town of Sao Paulo create in all of us the energy of change for the better, more sustainable and more suitable for those who live and love this huge, complex and fascinating city of Sao Paulo.

The text of this article is the Chapter 1 of the book: Environment and Health: The Challenge of Metropolis, launched by the Health and Sustainability Institute.