Is city living making us sick?

In 2007, the global urban population exceeded the rural community for the first time in history. This ushered in a new era for humanity – the urban millennium – which has only grown more and more in the last 17 years. Today, an estimated 55% of the world’s population lives in urban cities, which is expected to grow to nearly 70% by 2050. While it seemed that urbanisation would slow down during the pandemic – when thoughts of an existentially-induced ‘urban exodus’ made some of us move to the countryside – cities continue to grow and stand stronger than ever.

However, we all know that city living can be tough. Housing and rental markets continue to make living situations stressful in a ‘how can this be legal’ way. It is exhausting working day in and day out in a job that can’t really cover your day-to-day living expenses, leading to that feeling of constantly being overwhelmed, whenever you’re at the self-checkout in Albert Heijn. Or, worse still, that dread you feel when you remember that you had – ‘no don’t worry I’ll cover the bill’ – too many drinks last night. Then, there is that sense of alienation, that ‘I cannot sit still’ feeling constantly telling you to reach for that party in the sky. Otherwise, you feel you’re not ‘embracing’ city living.

However, for many of us, this ambivalence can impact our mental health. For instance, a 2021 study found that those living in urban areas have an increased risk of developing serious mental health conditions, from schizophrenia to post-traumatic stress disorder and paranoia. Increased stress levels seem to play a significant role in this relationship; even urban birds have been found to have increased levels of oxidative stress compared to their cottage-core peers. Each day brings noise and air pollution, traffic congestion and the work-related stress that drives economic growth in our metropolitan capitals. The intensity of a city’s ebbs and flows can lead individuals to live reclusive lives, which is a well-known factor in the onset of mental health issues. Worryingly, a number of studies have also found a link between air pollution and psychotic episodes, especially since over 90% of the world’s major cities failed to reach healthy air quality standards in 2023.

In addition, studies show that those living in cities are at a 40% increased risk of depression and a 20% increased risk of experiencing anxiety at some point in our lives. And if you live near a major street or airport, you’re more likely to be stressed and aggressive. However, these findings were noted to be heavily dependent on one’s socioeconomic status, suggesting that it is less about ‘city living’ and more about how much control we feel we have over our environment and our lives. Interestingly, these studies also found that rumination (i.e. spiralling about something negative) is far more common in those of us who spend less time in nature.

However, all that being said, the countryside isn’t exactly paradise either. There is loneliness and a lack of activity there that can equally impact our mental health and well-being. Cities offer us joy, excitement and ‘aliveness’ that is impossible to find in a rural area. The culture, the conversations, the life all around you and, however much it might exhaust us, we don’t give it up on a whim. There’s opportunity and choice imbued in every aspect of one’s life in the city, from our careers to our friends and even down to our coffees. But, I suppose, therein lies the rub: how much choice you feel you have over your life – in the countryside or the city – will impact your mental health.

But then, that remains worrying all the same, given how little control any of us feel we have about the state of the world and our planet. So, all this to say, while I love to lament and reflect on all of the unconscious and internal reasons for our mental health problems, it is paramount to remember that we live in this world, and it impacts how we feel.

Written by Molly Fitz