In general, 4x games have used sanitation as a method of curbing rapid growth. In the civ series, you had city health as the problem which required hospitals and clean food sources. In the TW series, you build sewers and baths to help prevent an outbreak of plague which is probably one of the worst things that can happen to a city in those games as it affects stationed units as well as the populations.
With magic heavy games, healing is in arcane art
I think this is kind of a cop out. Elemental is far from "magic heavy", as every magic user in the entire game supposedly comes from the single source of the sovereign, who himself doesn't really heal people. While I understand that sanitation and health seems like it would add a large amount of undue micromanagement, most games do not implement them with this in mind. Generally, the idea is simply a method to limit city growth by using an understandable mechanic. On top of this, does heavy magic somehow make people no longer require to take baths or use the restroom?