Demographic and health outcomes by Degree of Urbanisation: perspectives from a new classification of urban areas

In practice, cities are typically defined using administrative and other criteria that are highly heterogeneous across countries. In this monograph, we leverage the Degree of Urbanisation concept from the Global Human Settlements Layer (GHS-SMOD) to yield a globally consistent definition of cities, towns and surburbs, and rural areas that is based on density and settlement size. Matching GHS-SMOD designations to geo-coded Demographic Health Survey (DHS) data, we explore differentials across space in a number of highly relevant policy indicators in utilities, health outcomes, educational attainment, fertility, and violence. Do cities offer a better environment for these outcomes? We report raw differences in outcomes between cities, towns, and rural areas circa 2015 for Sub- Saharan Africa, South Asia, Latin America, and Southeast Asia. With a few exceptions in health outcomes related to affluence and air pollution, outcomes improve going from rural areas to towns and suburbs, and then to cities. We restrict our sample to South Asia and Sub-Saharan Africa for in-depth analysis. We find that most outcomes improve over time, some dramatically. Even aſter accounting for sorting based on household and individual characteristics, or differences by political and administrative status, we find that most city-rural differentials persist, some key ones strongly.