Primary Health Care in Urban Areas

Öz

The effectiveness of primary health care (PHC), the closest and first point of access to health services for individuals in urban areas, has become increasingly critical due to rising population density and urbanization processes. As a cornerstone of public health, PHC plays a vital role in improving community health, early disease detection and prevention, reducing health inequalities, and enhancing the efficiency of healthcare systems. The World Health Organization estimates that expanding PHC in low- and middle-income countries could save 60 million lives and increase life expectancy by 3.7 years by 2030. PHC reduces unnecessary hospital admissions, lowering healthcare costs while improving care coordination and overall health outcomes. According to United Nations data, more than half of the world’s population currently resides in urban areas, and this proportion is expected to exceed two-thirds by 2050. Rapid urbanization increases the demand for healthcare services, necessitating the restructuring of healthcare systems to meet this growing need. In the context of demographic transition, the rising elderly population imposes an additional burden on urban PHC services. In 2022, individuals aged 65 and over accounted for 10% of the global population, projected to rise to 16% by 2050. An aging population particularly increases the demand for chronic disease management and long-term care services. Moreover, epidemiological transition signifies a shift from infectious diseases to non-communicable chronic diseases, requiring a reassessment of healthcare priorities. This review focuses on the challenges and potential solutions in the provision of primary health care services in urban areas.

Anahtar Kelimeler

• urbanization
• primary health care
• demographic aging
• health status disparities

Kentlerde Temel Sağlık Hizmetleri

Öz

Kentlerde bireylerin sağlık hizmetlerine en yakın ve ilk başvuru noktası olan temel sağlık hizmetlerinin (TSH) etkinliği, artan nüfus yoğunluğu ve kentleşme süreçleriyle daha da önem kazanmıştır. Birinci basamak sağlık hizmetleri, halk sağlığı açısından temel bir yapı taşıdır; toplumsal sağlığı iyileştirme, hastalıkların erken teşhisi ve önlenmesi, sağlık eşitsizliklerinin azaltılması ve sağlık sisteminin verimliliğinin artırılması açısından büyük önem taşımaktadır. Dünya Sağlık Örgütü, düşük ve orta gelirli ülkelerde birinci basamak sağlık hizmetlerinin yaygınlaştırılmasının, 60 milyon hayatı kurtarabileceği ve yaşam beklentisini 2030'a kadar 3,7 yıl artırabileceğini tahmin etmektedir. TSH, gereksiz hastane yatışlarını azaltarak sağlık sisteminin maliyetlerini düşürmekte; ayrıca, bakım koordinasyonunu da iyileştirerek genel sağlık sonuçlarını olumlu yönde etkilemektedir. Birleşmiş Milletler verilerine göre, dünya nüfusunun yarısından fazlasının kentsel alanlarda yaşadığı, bu oranın 2050 yılına kadar üçte ikiyi aşacağı tahmin edilmektedir. Bu hızlı kentleşme, sağlık hizmetlerine olan talebi artırmakta ve sağlık sisteminin bu talebi karşılayacak biçimde yeniden yapılandırılmasını zorunlu kılmaktadır. Demografik geçiş sürecinde, özellikle yaşlı nüfusun artışı, kentlerde temel sağlık hizmetleri üzerinde ek bir yük oluşturmaktadır. 2022 yılında dünya genelinde 65 yaş ve üzeri nüfusun oranı %10 iken, bu oranın 2050 yılında %16'ya çıkması beklenmektedir. Yaşlanan nüfus, özellikle kronik hastalıklar ve uzun süreli bakım hizmetlerine olan ihtiyacı artırmaktadır. Ayrıca, epidemiyolojik dönüşüm, bulaşıcı hastalıklardan bulaşıcı olmayan kronik hastalıklara doğru bir geçişi ifade ederken, bu da sağlık hizmetlerinin önceliklerinin yeniden belirlenmesini gerektirmektedir. Bu derleme; kentsel alanlarda birinci basamak sağlık hizmetlerinin sunumunda göz önüne alınması gereken zorluklar ve çözüm önerileri üzerinde durmaktadır.

Anahtar Kelimeler

• kentleşme
• temel sağlık hizmeti
• demografik yaşlanma
• sağlık durumu eşitsizlikleri

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