Abstract

While the world has become increasingly urbanized, not all 21st century cities are following the same pattern of growth. In fact, some cities are facing the paradoxical challenge of shrinking, instead of growing. While cities have long wrestled with the challenges of expansion, overcrowding, and development, the “shrinking city” phenomenon presents a new set of challenges. These challenges include eroding tax bases, an abundance of vacant land, economic dislocation and disinvestment, concentrated poverty and disadvantage, and blighted spaces that invite crime and violence. Urban residents, planners, and others have begun to grapple with this landscape change and propose innovative strategies to restructure the landscape yet again. These strategies seek to both alleviate the harm of vacant and blighted spaces and create social and environmental assets, such as green space, that promote social interaction, help address food insecurity, and provide a buffer against stressful life events. Widespread and uneven changes in the urban landscape create challenging circumstances for a wide range of social and public health issues. In this chapter, we ask how these patterns and processes of landscape restructuring in the context of the shrinking American city impact mental health, in particular. We examine the burden of mental illness, the unique context of the shrinking American city, and potential mental health impacts of both city shrinkage and vacant land redevelopment strategies. We conclude by identifying research strategies that will cultivate an evidence base in support of the strategic structuring of the urban landscape for the promotion of equitable mental health in post-industrial cities and beyond.