Revisiting the Virtuous City: Learning from the Past to Improve Modern Urban Mental Health

  • Carolyn Stephens
  • Alfredo Gutierrez Carrizo
  • Abbas Ostadtaghizaddeh
Reference work entry
Part of the Mental Health and Illness Worldwide book series (MHIW)


This chapter looks at the evidence on current urban mental health in the context of rapid global change, both environmentally and socially. We summarize relevant epidemiological evidence on urban mental health, looking particularly at studies from Asia, Latin America, and Africa. We then look at two complementary major philosophical ideas from urban thinkers of the past – the Ideal or Utopian City and the Garden City, and discuss how these ideas are relevant for the urban mental health in the twenty-first century. We conclude with the importance of incorporating all human wisdom from the past millennia to deal with the future challenge of creating mentally healthy and sustainable cities.


Urban equity Urban-rural differences Philosophy and architecture Urban design Climate change and mental health Garden City Utopian City Sustainable cities 


  1. Abe Y, Fujise N, Fukunaga R, Nakagawa Y, Ikeda M (2012) Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan. Int Psychogeriatr 24(8):1235–1241. doi: 10.1017/S1041610212000099 CrossRefPubMedGoogle Scholar
  2. Akhouchekian A (2009) From philosophic utopia to developmental utopia. Paper presented at the The first conference on Islamic Utopia, IsfahanGoogle Scholar
  3. Amoran O, Lawoyin T, Lasebikan V (2007) Prevalence of depression among adults in Oyo state, Nigeria: a comparative study of rural and urban communities. Aust J Rural Health 15(3):211–215. doi: 10.1111/j.1440-1584.2006.00794.x CrossRefPubMedGoogle Scholar
  4. Arjmandi M, Tahir M, Shabankareh H, Shabani MM, Mazaheri F (2011) Psychological and spiritual effects of light and color from Iranian traditional houses on dwellers. J Soc Sci Humanit 6(2):288–301Google Scholar
  5. Barber N (2011) Depression stalks the city – why is urban life so depressing? Psychology Today.
  6. Battuta I, Lee S (2013) The travels of Ibn Battuta: in the near east, Asia and Africa, 1325–1354. Dover Publications, MineolaGoogle Scholar
  7. Breslau J, Marshall GN, Pincus HA, Brown RA (2014) Are mental disorders more common in urban than rural areas of the United States? J Psychiatr Res 56:50–55. doi: 10.1016/j.jpsychires.2014.05.004 CrossRefPubMedGoogle Scholar
  8. Coleman N (ed) (2005) Utopias and architecture. Routledge, New YorkGoogle Scholar
  9. Cortina MA, Sodha A, Fazel M, Ramchandani PG (2012) Prevalence of child mental health problems in sub-Saharan Africa: a systematic review. Arch Pediatr Adolesc Med 166(3):276–281. doi: 10.1001/archpediatrics.2011.592 CrossRefPubMedGoogle Scholar
  10. Decker MR, Peitzmeier S, Olumide A, Acharya R, Ojengbede O, Covarrubias L, Gao E, Cheng Y, Delany-Moretlwe S, Brahmbhatt H (2014) Prevalence and health impact of intimate partner violence and non-partner sexual violence among female adolescents aged 15–19 years in vulnerable urban environments: a multi-country study. J Adolesc Health 55(6 Suppl):S58–S67. doi: 10.1016/j.jadohealth.2014.08.022 CrossRefPubMedGoogle Scholar
  11. Diez Roux AV, Green Franklin T, Alazraqui M, Spinelli H (2007) Intraurban variations in adult mortality in a large Latin American city. J Urban Health 84(3):319–333. doi: 10.1007/s11524-007-9159-5 CrossRefPubMedPubMedCentralGoogle Scholar
  12. Dinizulu SM, Grant KE, McIntosh JM (2014) The influence of nondisclosure on the mental health of urban African-American adolescents exposed to community violence. J Prev Interv Community 42(3):208–220. doi: 10.1080/10852352.2014.916583 CrossRefPubMedGoogle Scholar
  13. Echeverria SE, Luan Kang A, Isasi CR, Johnson-Dias J, Pacquiao D (2014) A community survey on neighborhood violence, park use, and physical activity among urban youth. J Phys Act Health 11(1):186–194. doi: 10.1123/jpah.2012-0023 CrossRefPubMedGoogle Scholar
  14. Fourier C (1902) Doctrina social, el Falansterio. E. Rodríguez Serra, MadridGoogle Scholar
  15. Fryers T, Melzer D, Jenkins R (2003) Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol 38(5):229–237. doi: 10.1007/s00127-003-0627-2 CrossRefPubMedGoogle Scholar
  16. Havenaar JM, Geerlings MI, Vivian L, Collinson M, Robertson B (2008) Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors. Soc Psychiatry Psychiatr Epidemiol 43(3):209–215. doi: 10.1007/s00127-007-0294-9 CrossRefPubMedGoogle Scholar
  17. Hesketh T, Ding QJ (2005) Anxiety and depression in adolescents in urban and rural China. Psychol Rep 96(2):435–444. doi: 10.2466/pr0.96.2.435-444 CrossRefPubMedGoogle Scholar
  18. Howard E (1965) Garden cities of to-morrow. MIT Press, MassachusettsGoogle Scholar
  19. Kadra G, Dean K, Hotopf M, Hatch SL (2014) Investigating exposure to violence and mental health in a diverse urban community sample: data from the South East London Community Health (SELCoH) survey. PLoS One 9(4):e93660. doi: 10.1371/journal.pone.0093660 CrossRefPubMedPubMedCentralGoogle Scholar
  20. Kim JM, Stewart R, Shin IS, Yoon JS, Lee HY (2004) Lifetime urban/rural residence, social support and late-life depression in Korea. Int J Geriatr Psychiatry 19(9):843–851CrossRefPubMedGoogle Scholar
  21. Kliewer W, Lepore SJ (2015) Exposure to violence, social cognitive processing, and sleep problems in urban adolescents. J Youth Adolesc 44(2):507–517. doi: 10.1007/s10964-014-0184-x CrossRefPubMedGoogle Scholar
  22. Lang S (1972) Sforzinda, Filarete and Filelfo. J Warburg Courtauld Inst 35:391–397. doi: 10.2307/750940 CrossRefGoogle Scholar
  23. Law CK, Snider AM, De Leo D (2014) The influence of deprivation on suicide mortality in urban and rural Queensland: an ecological analysis. Soc Psychiatry Psychiatr Epidemiol 49(12):1919–1928. doi: 10.1007/s00127-014-0905-1 CrossRefPubMedGoogle Scholar
  24. Lea J, Courtney J (1985) Cities in conflict: studies in the planning and management of Asian cities. World Bank, Washington. Google Scholar
  25. Leach N (ed) (1997) Rethinking architecture: a reader in cultural theory, 1st edn. Routledge, LondonGoogle Scholar
  26. McMichael A (2005) Global environmental changes, climate change and human health. In: Lee K, Collin J (eds) Global change and health. Understanding public health, 1st edn. Open University Press, MaidenheadGoogle Scholar
  27. Middleton N, Gunnell D, Frankel S, Whitley E, Dorling D (2003) Urban-rural differences in suicide trends in young adults: England and Wales, 1981–1998. Soc Sci Med 57(7):1183–1194CrossRefPubMedGoogle Scholar
  28. Mojs E, Warchol-Biedermann K, Glowacka MD, Strzelecki W, Ziemska B, Marcinkowski JT (2012) Are students prone to depression and suicidal thoughts? Assessment of the risk of depression in university students from rural and urban areas. Ann Agric Environ Med 19(4):770–774PubMedGoogle Scholar
  29. Nepomuceno BB, Cardoso AA, Ximenes VM, Barros JP, Leite JF (2016) Mental health, well-being, and poverty: a study in urban and rural communities in northeastern Brazil. J Prev Interv Community 44(1):63–75. doi: 10.1080/10852352.2016.1102590 CrossRefPubMedGoogle Scholar
  30. North CS, Pfefferbaum B (2013) Mental health response to community disasters: a systematic review. JAMA 310(5):507–518. doi: 10.1001/jama.2013.107799 CrossRefPubMedGoogle Scholar
  31. Parker G, Lie D, Siskind DJ, Martin-Khan M, Raphael B, Crompton D, Kisely S (2016) Mental health implications for older adults after natural disasters – a systematic review and meta-analysis. Int Psychogeriatr 28(1):11–20. doi: 10.1017/S1041610215001210 CrossRefPubMedGoogle Scholar
  32. Paykel E, Abbott R, Jenkins R, Brugha T, Meltzer H (2003) Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey. Int Rev Psychiatry 15(1–2):97–107. doi: 10.1080/0954026021000046001 CrossRefPubMedGoogle Scholar
  33. Peen J, Schoevers RA, Beekman AT, Dekker J (2010) The current status of urban-rural differences in psychiatric disorders. Acta Psychiatr Scand 121(2):84–93. doi: 10.1111/j.1600-0447.2009.01438.x CrossRefPubMedGoogle Scholar
  34. Razvodovsky Y, Stickley A (2009) Suicide in urban and rural regions of Belarus, 1990–2005. Public Health 123(1):27–31. doi: 10.1016/j.puhe.2008.10.003 CrossRefPubMedGoogle Scholar
  35. Reeves WC, Lin JM, Nater UM (2013) Mental illness in metropolitan, urban and rural Georgia populations. BMC Public Health 13:414. doi: 10.1186/1471-2458-13-414 CrossRefPubMedPubMedCentralGoogle Scholar
  36. Richter D, Berger K, Reker T (2008) Are mental disorders on the increase? A systematic review. Psychiatr Prax 35(7):321–330. doi: 10.1055/s-2008-1067570 CrossRefPubMedGoogle Scholar
  37. Rostami R, Lamit H, Khoshnava S, Rostami R, Rosley M (2015) Sustainable cities and the contribution of historical urban green spaces: a case study of historical Persian gardens. Sustainability 7(10):13290CrossRefGoogle Scholar
  38. Sengupta P, Benjamin AI (2015) Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public Health 59(1):3–8. doi: 10.4103/0019-557X.152845 CrossRefPubMedGoogle Scholar
  39. Siskind DJ, Sawyer E, Lee I, Lie DC, Martin-Khan M, Farrington J, Crompton D, Kisely S (2016) The mental health of older persons after human-induced disasters: a systematic review and meta-analysis of epidemiological data. Am J Geriatr Psychiatry 24(5):379–388. doi: 10.1016/j.jagp.2015.12.010 CrossRefPubMedGoogle Scholar
  40. Steiert R (2002) The ideal city: utopias and projects: a historical sketch. Soz Wiss Inf 3(1):38–47PubMedGoogle Scholar
  41. Stephens C (2012) Urban inequities; urban rights: a conceptual analysis and review of impacts on children, and policies to address them. J Urban Health 89(3):464–485. doi: 10.1007/s11524-011-9655-5 CrossRefPubMedPubMedCentralGoogle Scholar
  42. Stephens C, Satterthwaite D (2008) Urban health in developing countries. In: Heggenhougen K, Quah S (eds) International encyclopaedia of public health, vol 1. Elsevier, Oxford, pp 452–463CrossRefGoogle Scholar
  43. Tanabayeva A, Massalimova A, Mukhatova O, Alikbayeva M, Alikbayeva Z (2015) Al-Farabi’s humanistic principles and “virtuous city”. Eur Proc Soc Behav Sci. doi:
  44. Toronto Public Health (2015) Green city: why nature matters to health – an evidence review. Toronto Public Health, TorontoGoogle Scholar
  45. UN Habitat (2010) State of the world’s cities 2010/2011: bridging the urban divide. Earthscan, London. Google Scholar
  46. UNEP (2012) One planet, how many people? A review of Earth’s carrying capacity. A discussion paper for the year of Rio+20 (2012), UNEP, Nairobi. Accessed 12 Nov 2013Google Scholar
  47. United Nations DoEaSA, Population Division (2014) World urbanization prospects: the 2014 revision, highlights (ST/ESA/SER.A/352)Google Scholar
  48. Walker ER, McGee RE, Druss BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiat 72(4):334–341. doi: 10.1001/jamapsychiatry.2014.2502 CrossRefGoogle Scholar
  49. Wallis L (2015) Rural youths commit suicide almost twice as often as urban counterparts. Am J Nurs 115(6):15. doi: 10.1097/01.NAJ.0000466301.39777.65 CrossRefGoogle Scholar
  50. World Health Organization (2014a) Mental health atlas 2014. Accessed 12 May 2016
  51. World Health Organization (2014b) Preventing suicide: a global imperative. Accessed 12 May 2016

Copyright information

© Springer Science+Business Media Singapore 2017

Authors and Affiliations

  • Carolyn Stephens
    • 1
    • 2
    • 3
  • Alfredo Gutierrez Carrizo
    • 4
  • Abbas Ostadtaghizaddeh
    • 5
  1. 1.UCL Institute of Health EquityLondonUK
  2. 2.London School of Hygiene and Tropical MedicineLondonUK
  3. 3.Universidad Nacional de TucumánTucumánArgentina
  4. 4.ArtechTucumánArgentina
  5. 5.Department of Disaster and Public HealthSchool of Public Health, Tehran University of Medical SciencesTehranIran

Personalised recommendations