York University researchers say the COVID-19 pandemic exposed a major blind spot in public health and are urging policymakers to look beyond urban centres when planning for future outbreaks.
A new interdisciplinary paper co-authored by the director of York University’s City Institute, Professor Harris Ali (Faculty of Liberal Arts & Professional Studies), and Professor Emeritus Roger Keil (Faculty of Environmental & Urban Change), along with Creighton Connolly of The University of Hong Kong, shows how infectious diseases like COVID-19 hit communities on the edges of cities hardest.
Published in the journal City, the research “Governing infectious disease in the urban periphery: marginality, informality and vulnerability” explores how migrant workers, First Nations reserves and informal settlements faced increased risks during the pandemic.
The researchers set out to examine how living on the urban periphery – areas where infrastructure is often limited and marginalization is common – shapes the way infectious diseases spread. Their goal was to identify practical steps for building more inclusive and responsive urban governance that responds to those most at risk.
“We wanted to show that the urban periphery isn’t just a geographic edge – it’s a social and political space where vulnerability is concentrated,” says Keil. “Ignoring these areas means missing the real story of how pandemics unfold.”
The study draws on case studies from Canada and the Global South, including interviews and fieldwork in affected communities. It found that people living and working in peripheral areas were more exposed to infection and less protected by public health measures. Poor housing, overcrowding, limited access to health care and weak governance all played a role in the lack of support during COVID-19.
“During COVID-19, we saw how essential workers and marginalized groups were often left behind by policies designed for the urban core,” says Ali. “The pandemic exposed deep inequalities that have long existed but are rarely addressed.”
Outbreak responses often fail to consider the specific circumstances of people living in peripheral communities. For example: migrant workers in Canada faced cramped living conditions and inadequate quarantine options; First Nations reserves had to set up their own checkpoints to protect elders and vulnerable residents; and in informal settlements, grassroots networks became lifelines when formal support systems failed.
“Our work shows that local knowledge and community-led responses are vital,” says Ali. “Top-down approaches alone won’t work – especially in places where trust in government is low or infrastructure is missing.”
The authors argue that urban planning and public health need to move beyond a city-centre focus and include the unique challenges of peripheral communities in planning. That means investing in infrastructure, supporting self-governance and listening to those most affected.
“If we want fairer and more resilient cities, we need to rethink how the urban periphery governs itself,” says Keil. “We can’t afford to repeat the same mistakes.”