Can country folk work with city dwellers

Stress in city dwellers How city life changes the psyche

Mazda Adli in conversation with Dieter Kassel

Too much traffic, too much hectic, too narrow - what are the consequences of life in the city for physical and mental health? (picture alliance / dpa / Paul Zinken)

City dwellers are more likely to suffer from mental illnesses than rural dwellers, according to a new book by psychiatrist and therapist Mazda Adli. At the same time, he notes that life in the city is still good for most people.

There is an accumulation of stress-related illnesses among city dwellers, for example Mazda Adli presents the results of his book "Stress and the City" published today on Deutschlandfunk Kultur. Depression is one and a half times higher in the city than in the country, and schizophrenia is twice as common.

If you grew up in a city, you also have "more sensitive stress antennas" than a country dweller, according to Adli:

"This is exactly what you can see in imaging procedures: If you put test subjects under stress and compare townspeople and rural dwellers with one another, you can see that the stress-processing or emotion-processing areas are more active in the city dwellers compared to rural people. That does not yet mean that they are sick, just that the brain is more sensitive to stress. "

The stress in the city is greater - and yet this life is good for most people - with the exception of risk groups - Adli has found out. There are more advantages than disadvantages, for example in relation to prosperity, easier access to education and health care and cultural diversity: "urban advantage" is the technical term.

Extroverts like to live in cities

But why are some people drawn to the city and others to the countryside? Above all, that's a question of mentality, says Adli:

"There are studies that show that extroverted people tend to live in cities and then like to live in the center of cities. People, on the other hand, who have things very precisely, very predictable - they tend to prefer suburban locations or rural surroundings."

Preventive measures for the mental health of city dwellers

According to forecasts, around 70 percent of the world's population will live in cities by 2050, and megacities will change the face of the earth. City planners have to face the challenges of a rapidly urbanizing world, says Adli. Preventive measures are necessary to protect the mental health of city dwellers:

"In my book, I also explain that the health effects of urbanization will be comparable to the effects of climate change on our health - if we do not sufficiently ensure that the cities are beneficial to our health."

Mazda Adli is head of the affective disorders research department at the Berlin Charité and chief physician at the Fliedner Klinik. In addition, the psychiatrist and therapist is one of the initiators of the interdisciplinary forum for neurourbanism. (ue)



The interview in full:

Dieter Kassel: Life in the city is hectic, stressful and cramped, so there are risks to our physical and mental health. Mazda Adli describes this in detail in his new book "Stress and the City", which is published today, and he still draws the conclusion that cities are generally good for us.

He should know, because Mazda Adli is not only a city resident out of conviction, but he is also a psychiatrist and therapist, head of the affective disorders research department at the Berlin Charité and chief physician at the Fliedner Clinic, also in Berlin, and one of the initiators of the interdisciplinary forum Neurourbanism. Now he's with us in the studio - good morning, Professor Adli!

Mazda Adli: Good Morning!

Kassel: To ask a very fundamental question: do city dwellers actually suffer demonstrably more often from mental illnesses than people who live in rural areas?

Adli: Yes, it is indeed. We find an accumulation of stress-related illnesses among city dwellers. These include, for example, depression, one and a half times as common in the city as in the country, or schizophrenia, twice as common among city dwellers.

The city dweller is developing "more sensitive stress antennas"

Kassel: You can really prove that with brain tests, with scans, that they are more sensitive to stress. Which surprised me a bit when reading the book, because as a layman I would have thought, yes, the city is hectic, it is narrow, it is sometimes aggressive, but people who live there are actually used to it.

Adli: Most of us are used to it, and we all also have more sensitive stress antennas when we grew up in the city. This is exactly what you can see in imaging procedures, if you put test subjects under stress and compare city dwellers and rural dwellers with each other, you can see that the stress-processing or emotion-processing areas are more active in the city dwellers compared to rural people. That doesn't mean they're sick, just that the brain is more sensitive to stress.

Kassel: That is an apparent contradiction when you explain, and you do in your book, that yes, mental illnesses are more common, the pressure in many respects, the stress is greater. And yet, as an expert, I say - you say - that cities are good for us, life there is actually good for us. That is actually a contradiction.

Adli: That seems like a contradiction at first, but in fact, for most of us, the city has many more advantages than disadvantages. For most of us, the city is good. There is more prosperity, there is much easier access to education and support. There is better health care, the nearest doctor, pharmacy or hospital are closer to you, there is greater cultural diversity. All of this is summarized under the English term Urban Advantage. Most of the people, residents of the city, also have adequate access to it, but there are populations at risk. There are groups of people who are rather excluded from this Urban Advantage, and we have to take care of them.

Search for oases of city life

Kassel: What surprised me in your book: It is a mixture of science, understandable but hard science, and many personal impressions from you too. You have lived in different cities yourself, Vienna, Paris, Berlin, among others, to name, I believe, the most important ones in your life, and also from some of the people you spoke to. The book also consists to a certain extent of interviews that you have conducted. And whenever the question arises, what is the favorite place of your conversation partner and of you in the cities - well, not always, but quite often rather quiet places are mentioned, parks, museums, so more of these places that one as Could designate oases in city life. That means that the skilled city dweller is looking for a bit of rural life in the city in order to stay healthy?

Adli: Indeed, of course, resting spots in the city are good for us. Green spaces, parks, small urban wastelands that we can somehow design ourselves. All of this is good for us. But that doesn't mean that a green space in the city now represents the village in the city, but it is a relaxation and a resting point between the urban hustle and bustle, and of course that is good for us. Green spaces are good for our concentration. Schoolchildren who have a green space nearby perform better on average, and we become less depressed when a park is within reach. All of this is shown.

When by 2050 two thirds of humanity live in cities

Kassel: More and more people will live in cities in the future. This trend is probably irreversible, but if you look at the area of ​​the world, that soon half, two thirds or even more people will be living in about two percent of the area of ​​this world. How do we have to think about this in the future? Does urban planning also have to think about health, physical and mental, in the future?

Adli: I am convinced of that. We live in a rapidly urbanizing world, you just mentioned the numbers. In my book, I also explain that the health impacts of urbanization will be comparable to the impacts of climate change on our health if we do not sufficiently ensure that our cities are healthy. If it is true that two-thirds of humanity will live in cities by 2050, and if it is true that urban dwellers are twice as likely to have schizophrenia as rural dwellers, then it is urgently time to find out exactly where the connection is and how we can contribute to the prevention and protection of the mental health of city dwellers.

For example: Hong Kong

Kassel: Is that also a question of mentality? You also have the example of Hong Kong in your book, where people live in almost cages, very cramped. You are describing an old factory, and you also say that it is not nice. Cities shouldn't be planned like this, but they can still take it, Europeans get horror. Is it just a matter of habit, or is it a question of mentality, because yes - well, in Asia it's narrower, for decades.

Adli: Density can certainly become a social stress that causes us trouble. However, the most important thing is how much density someone tolerates. There are definitely cultural differences. Hong Kong residents have an average of 13 square meters of living space available, and many get on well with it because they don't feel at their mercy, because it's not an uncontrollable situation, and because the city offers many other advantages.

Nonetheless, we also know at the same time that the mental health of the Hong Kong residents is not in good shape, in contrast to the physical health of the residents of this city, which actually shows relatively good results. Life expectancy in Hong Kong is also good. But the mental health of Hong Kong people is not good. There are relatively high suicide rates, and that already shows that the gap between physical and mental health is widening and that this has something to do with urban stressors.

"Mentality plays a very big role"

Kassel: There are still many aspects that also play a role in your book: traffic, crime, in short also the question, positive stress, negative stress, for which we unfortunately no longer have time, but I think there is one question that cannot be left out Without asking this question, I will not let you go now. There will be people who hear us and who say, none of that convinces me, I still prefer to live in the flat country. Is it innate? Are there any scientific findings on the question of whether the urban type and the rural type actually exist in principle?

Adli: I am convinced that it exists. And there are at least studies that show that more extroverted people live in cities, and then also like to live in the center of cities, whereas people who tend to have things very precisely, very predictable, that the more suburban locations or then maybe more prefer rural surroundings. Of course there are differences in mentality, mentality plays a very important role.

Kassel: Mazda Adli. He is a psychiatrist and psychotherapist in Berlin, and he is the author of the book "Stress and the City", which is published today by C. Bertelsmann Verlag. Mr Adli, I wish you a lot of fun in the city and, as you can learn from your book, now and then, as a change, in the countryside. Thank you for being with us!

Statements by our interlocutors reflect their own views. Deutschlandfunk Kultur does not adopt the statements of its interlocutors in interviews and discussions as its own.


Mazda Adli:Stress and the City. Why cities make us sick. And why they are still good for us
C. Bertelsmann, Munich 2017
384 pages, 19.99 euros