Detroit, Cleveland and Buffalo keep shrinking, leaving leaders no choice but to re-imagine them. It turns out that adaptation to The Incredible Shrinking City includes making it healthier for people: designing with nature, establishing local food sources (urban farming, community gardening), and re-aggregating communities on a livable scale.

U.S. cities aren’t likely to ever be what they used to be, and for good reason. The industrial cycle drove urban growth. Factories needed workers close by, and hierarchically structured corporations did too. U.S. industry and the structure of corporate life have shifted/are shifting dramatically, so the notion of the city needs to adapt.

While we’re at it, let’s recognize that urban centers have been great for business, but not necessarily for health. Public Health fortunately made dense urban living possible – without it, cities would’ve been assaulted by disease and infection – but that didn’t mean city life was intrinsically healthy.

We can only confront our health and health care issues by addressing the structure of where and how we live and work. The experiences of shrinking rust belt cities should be canaries singing in Arizona’s ears: the goal can’t be growth and quantity of life, it’s got to be quality of life. Otherwise, what’s a city worth in the future?