COVID-19, Cities and Health: A View
from New York
Jo Ivey Boufford and Anthony Shih
1 Key Messages
1. Four characteristics of cities: density, diversity, complexity and disparities are
helpful for analysis of problems.
2. The COVID-19 pandemic has more publicly revealed existing vulnerabilities in
urban life when facing such an emergency.
3. A systems approach to governance across all sectors is critical to identifying
problems and developing interventions to address them.
4. A commitment to governance for health by political leadership can clarify options
for action in complex systems.
Population density is one of the defining characteristics of cities and is also one
of the dominant challenges in addressing COVID-19 and likely future pandemics.
In normal times, urban density allows for cost-effective service delivery, acts as
a magnet for jobs and the generation of wealth, and nurtures innovation. Coupled
with diversity—another core characteristic of cities—urban density also yields the
cultural variety in urban neighbourhoods, fosters global connections and makes cities
like New York attractive and exciting. However, in the midst of a pandemic, the very
thing we love about cities becomes their apparent weakness: our urban density allows
for more rapid spread of infectious disease and makes policy interventions such as
social distancing much more difficult to follow—even with the best of intentions. Our
J. I. Boufford (B)
Global Health, New York University School
of Global Health, New York, NY, USA
e-mail: jboufford@isuh.org
A. Shih
United Hospital Fund (UHF), New York, NY, USA
e-mail: ashih@uhfnyc.org
© Zhejiang University Press 2021
F. W. Gatzweiler, Urban Health and Wellbeing Programme,
Urban Health and Wellbeing,
https://doi.org/10.1007/978-981-33-6036-5_1
1
from New York
Jo Ivey Boufford and Anthony Shih
1 Key Messages
1. Four characteristics of cities: density, diversity, complexity and disparities are
helpful for analysis of problems.
2. The COVID-19 pandemic has more publicly revealed existing vulnerabilities in
urban life when facing such an emergency.
3. A systems approach to governance across all sectors is critical to identifying
problems and developing interventions to address them.
4. A commitment to governance for health by political leadership can clarify options
for action in complex systems.
Population density is one of the defining characteristics of cities and is also one
of the dominant challenges in addressing COVID-19 and likely future pandemics.
In normal times, urban density allows for cost-effective service delivery, acts as
a magnet for jobs and the generation of wealth, and nurtures innovation. Coupled
with diversity—another core characteristic of cities—urban density also yields the
cultural variety in urban neighbourhoods, fosters global connections and makes cities
like New York attractive and exciting. However, in the midst of a pandemic, the very
thing we love about cities becomes their apparent weakness: our urban density allows
for more rapid spread of infectious disease and makes policy interventions such as
social distancing much more difficult to follow—even with the best of intentions. Our
J. I. Boufford (B)
Global Health, New York University School
of Global Health, New York, NY, USA
e-mail: jboufford@isuh.org
A. Shih
United Hospital Fund (UHF), New York, NY, USA
e-mail: ashih@uhfnyc.org
© Zhejiang University Press 2021
F. W. Gatzweiler, Urban Health and Wellbeing Programme,
Urban Health and Wellbeing,
https://doi.org/10.1007/978-981-33-6036-5_1
1