Skip to Content

Why is everyone sick in Cities: Skylines? (6 Reasons)

Why is everyone sick in Cities: Skylines? (6 Reasons)

Playing City: Skylines as a newbie, you might have noticed that citizens get sick sometimes and you’re trying to figure out the underlying reasons like you’re some sort of doctor. But it all comes down to general knowledge and playing the tutorial, which you probably didn’t. So, why is everyone sick in Cities: Skylines?

Everyone might be getting sick in Cities: Skylines because the water supply might not be properly connected to the drainage pipe. Or the Medical Clinics haven’t been installed Industrial buildings could be polluting the ground. The pumping stations might be siphoning water from a drainage pipe or citizens are getting old and just dying of natural causes!

How To Get More Workers In Cities: Skylines? (4 Ways)

Reasons Why Everyone is Sick in Cities: Skylines

1. People Dying in Cities: Skylines


Despite your best efforts, citizens are bound to hit the hay eventually, presumably of old age. The only thing you can do is turn a blind eye and wait it out. This usually occurs when a lot of citizens move into an in-demand housing zone.

Just make sure you have enough death care facilities installed. Crematoriums and Cemeteries might get overwhelmed. You don’t want bodies piling up, do you? Construct an extra one or two just in case.

2. Where’s the Medical Clinic?

medical clinic

Suppose everything is fine and dandy in Cities: Skylines. You’ve got a clean supply of water, an adequate drainage system and there’s no sign of contamination. Yet, NPCs still keep getting sick. So what’s the catch?

Well, you haven’t looked at this from all angles. To be specific, your residents are missing out on healthcare facilities. You’ll always encounter the occasional sick citizen regardless of environmental cleanliness.

Disease can spread like the Plague, especially if it is the plague. So, ensure that your citizens have access to a healthcare facility. Now, the simplest healthcare facility you can add to a residential area is the medical clinic which is accessible once you achieve the Tiny Town Milestone.

As you achieve the Busy Town Milestone, you can finally get construct a hospital that allows accommodation for over 500 patients with 30 ambulances at its disposal.

3. Polluted Water

water pollution - sick in cities skylines

The worst-case scenario you can run into in Cities: Skylines is a pumping station moving water from a drainage pipe. That’s bound to get your citizens sick. It’s pretty easy to mess this one up.

To prevent this, you need to ensure that your pumping station is placed upstream from the drain pipe. It’s easy to get confused considering both lines look identical.

4. Ground Pollution

ground pollution - sick in cities skylines

Water pollution is out of the bag. What’s next? Ground Pollution! You’re bound to run into ground pollution if you construct industrial sector buildings such as garbage facilities, oil and coal power plants, and the generic industry right next to residential areas.

Also, place the drainage and pumping stations as far away as possible from each other.

5. Noise!

noise pollution - sick in cities skylines

So, you’re done with Ground and Water Pollution. But you wouldn’t believe that citizens can get sick from just Noise Pollution. While not quite sensitive to noise pollution, citizens might start to get sick from loads of noise. You can check the levels of Noise Pollution via the orange headset icon.

So, your best bet would be to zone residences far away from highways and also put up sound barriers. Highways make the most noise if you didn’t know.

Generic Industries are also a driving factor. As mentioned previously, relocate them away from zone residences.

Monuments and Unique Buildings also tend to generate a lot of noise. That goes hand in hand with the power plant and garbage facilities, so relocate them to a safe distance.

6. Clogged Sewage Lines

drainage system - sick in cities skylines

If your sewage and drainage system isn’t adequate, then your citizens are bound to get sick in Cities: Skylines. It’s pretty annoying and tedious but you’ll have to check all the water pipes and see if they’re connected to a drain pipe. Don’t forget that the drain pipe needs electricity to function at all. So connect it to your local power grid.

As your city grows, you’ll have to expand your drainage system accordingly. It’s not a one-time thing.


Your expansion and city-building are bound to run into trouble as you grow. Citizens need to be taken care of for all the other industries to run properly. So, don’t skimp out on their health, and don’t cheap out. And everything will pan out just fine!