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Is Population Density Associated with Non-Communicable Disease in Western Developed Countries? A Systematic Review

Carnegie, Elaine Ruth; Inglis, Greig; Taylor, Annie; Bak-Klimek, Anna; Okoye, Ogochukwu


Greig Inglis

Ogochukwu Okoye


Over the last three decades, researchers have investigated population density and health outcomes at differing scale. There has not been a systematic review conducted in order to synthesise this evidence. Following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, we systematically reviewed quantitative evidence published since 1990 on population density and non-communicable disease (NCD) within Westernised countries. Fifty-four studies met the inclusion criteria and were evaluated utilising a quality assessment tool for ecological studies. High population density appears to be associated with higher mortality rates of a range of cancers, cardiovascular disease and COPD, and a higher incidence of a range of cancers, asthma and club foot. In contrast, diabetes incidence was found to be associated with low population density. High and low population density are therefore risk markers for a range of NCDs, indicating that there are unidentified factors and mechanisms underlying aetiology. On closer examination, our synthesis revealed important and complex relationships between population density, the built environment, the nature of greenspace and man-made exposures. In light of increasing rates of morbidity and mortality, future research is required to investigate these associations in order to establish causative agents for each NCD.

Journal Article Type Article
Acceptance Date Feb 22, 2022
Online Publication Date Feb 24, 2022
Publication Date 2022-02
Deposit Date Feb 25, 2022
Publicly Available Date Mar 3, 2022
Journal International Journal of Environmental Research and Public Health
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 19
Issue 5
Article Number 2638
Keywords population density; environmental health; non-communicable disease; health inequalities; built environment and social environments; urban; rural environments; environmental pollution
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Is Population Density Associated With Non-Communicable Disease In Western Developed Countries? A Systematic Review (1.8 Mb)

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Copyright Statement
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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