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IMPACT ON HEALTH
source: www.ehproject.org/PDF/Activity
_Reports/AR109ANEUrbHlthweb.pdf
www.careinternational.org.uk/
resource_centre/urban/urbanisation
_of_poverty.doc
www.nhb.org.in/Publications/
hNews_jun2003_Articles.htm
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On average, the health of urban residents in developing countries is better than that of rural dwellers (at least in terms of access to basic services). However, health conditions for the urban poor are sometimes even worse than for those living in rural areas…- the World Health Organization (WHO) and the UN Center for Human Settlements have endorsed a 1990 estimate based on dozens of national and city studies that 600 million urban dwellers - or 42% of the 1990 urban population - lived in ‘life and health threatening’ homes or neighbourhoods. Since then, the situation - in some cases - has even worsened;
- the number of urban residents without access to improved water sources rose from 113 million in 1990 (5% of the total urban population) to 173 million in 2000 (6% of the total urban population);
- in some countries of South and Southeast Asia most urban households still do not have immediate access to drinking water. At least 1/3 of urban water supplies in Latin America operate only intermittently. In 2001, less than 20% of urban households in Africa were connected to piped water and only 40% have access to water within 200 meters of their house (African city dwellers only use 50 litres of water per person per day. On average, the price of water is highest in Africa then the rest of the world); (1)
- few cities in developing countries have adequate sewerage systems which are usually limited to more advantaged areas. Purification and recycling of wastewater in sewage treatment plants is rare. In Asia, for example, treatment plants process only an estimated 35% of wastewater and in Latin America and the Caribbean, about 14% only. Worldwide, about 2.3 billion people suffer from diseases that are linked to water problems;
- poor areas of Latin American cities in general have better utilities than South Asia, which, in turn, usually have minimum urban services, like water and electricity, that many African slums lack;
- the World Bank estimates that in 1994 roughly 450 million urban dwellers - or 25% of the less developed world's 1994 urban population - lacked access even to the simplest latrines. Nowadays, an estimated 57% of urban Africans still lack access to basic sanitation and in cities like Nairobi the poor must rely on ‘flying toilets’ (defecation into a plastic bag);
- as in early Victorian London, the contamination of water by human and animal waste remains the cause of the chronic diarrhoeal diseases that kill at least 2 million urban babies and small children each year;
- in Mumbai, the sanitation problem is defined by ratios of 1 toilet seat per 500 inhabitants in the poorer districts. Only 11% of poor neighbourhoods in Manila and 18% in Dhaka have formal means to dispose of sewage;
- motor vehicles are a significant environmental threat to urban residents. Vehicle fleet size in less developed countries has been growing exponentially. By 2020, traffic accidents in urban areas are projected to be the 3rd largest cause of death and disability in the world, ahead of war and infectious diseases, including HIV/AIDS. The main victims of crashes are pedestrians, not motorists.
- more than 70% of deaths from outdoor air pollution occur in the developing world. In India alone air pollution causes an estimated 40,000 premature deaths each year;
- the air in large cities is often un-breathable. Many Latin American cities struggle with high levels of ozone. The ozone concentration in Mexico City, measured in 1995, was 10 times the natural atmospheric concentration. Ozone is a main component of atmospheric smog. Many Asian cities face similar pollution problems;
- lead levels in Shanghai and Bangkok are already high enough to impair the mental development of children. The World Bank estimates that lead exposure causes up to 500,000 cases of hypertension a year in Bangkok, and that more than 800 infants die annually in Cairo because their mothers had been exposed to lead;
- indoor air pollution is particularly a health problem in rural areas. However, some estimates suggest that, worldwide, urban indoor air pollution kills about 600,000 people annually. Indoor air pollution is a major health problem because, worldwide, almost 3 billion people rely on biomass fuels - mostly wood, charcoal, and animal dung for household cooking and heating. In China, India and sub-Saharan Africa more than 80% of households use biomass fuels for cooking. These fuels do not burn cleanly. They emit large amounts of smoke often directly inside dwellings without adequate ventilation (almost all the poorest ones);
- on average, the health of urban residents in developing countries is better than that of rural dwellers, mainly because urban areas usually offer better health care than most rural areas. Infant and child mortality rates are lower in urban areas than in the countryside. However, health conditions for the urban poor are sometimes even worse than the rural poor. In large cities of developing countries, child mortality is highest among children whose mothers recently migrated from rural areas and those who live in low-quality housing;
- the urban poor are more vulnerable to poor health and environmental hazards because it is more likely that they will lack adequate housing, sanitation and other basic services (municipal authorities do not recognise many informal settlements for political and administrative reasons and thus these areas are not eligible for services);
- for the poor, the cost of healthcare is disproportionately high relative to their income and access to health care is closely linked to a person’s social status. Cities of less developed countries are - not by chance - also prime locations of newly emerging killers, notably HIV/AIDS.
(1) In highly industrialised countries, almost 100% of households are connected to piped water. The average water consumption for these households is 215 litres per person daily.
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