Village Transformation and Emerging Health Challenges: A Comprehensive Review of Rural Urbanization and Its Public Health Impact in India

Abstract

Background

Rural urbanization—the transformation of rural areas into urban-like settlements—is accelerating in India due to

demographic shifts, government initiatives (e.g., PMAY-G, Rurban Mission), infrastructural development, and

remittance-driven investments. This systematic review explores how rural urbanization influences public health,

focusing on emerging health impacts and determinants. Two distinct models of urbanized rural areas (URAs)

were identified: proximity-based and remittance-driven. While these areas experience improved housing,

sanitation, and healthcare access compared to traditional rural areas, they also face a dual burden of disease—

rising non-communicable diseases (NCDs) alongside persistent communicable diseases—due to inadequate

infrastructure planning, environmental degradation, and lifestyle transitions. Health determinants were

analyzed using the WHO social determinants framework, revealing significant differences from traditional rural

areas across physical, economic, behavioral, and environmental dimensions. A fishbone analysis was used to

illustrate interconnected causes of health issues, including air and water pollution, dietary shifts, poor ventilation,

and socioeconomic disparities. The review concludes that rural urbanization requires differentiated health

planning, including the upgradation of PHCs, NCD screening programs, environmental monitoring, and targeted

health education. Addressing these needs with context-specific strategies is vital to ensuring equitable and

sustainable public health in transitioning rural landscapes.