Article 7.docx

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Family Relations and Human Development
FRHD 3090
Michelle Preyde

Article #7 Summary Improving the Health and Lives of People Living in Slums Introduction  The number of urban dwellers will continue increasing; by 2030, 5 billion people will live in urban areas (compared to 3.17 billion in 2005) o Of these, 4 billion (80%) will be living in developing countries of Asia and Africa  Urbanization is the increase in the urban share of total population o Developing countries: urbanization not associated with industrialization like in developed countries, but characterized by:  Low to medium economic growth rate  Urban poverty  Slums  Half of world’s population living on less than $1 a day  Urbanization = slum formation in developing countries  In 2005, 1 billion people (1/3 of world’s urban population) lives in slums 1. Asia: 518 million people 2. Sub-Saharan Africa: 199 million 3. Latin America & Caribbean: 134 million  Living in slums is major cause of poor health  Social determinants of health (SDH) is an approach to health through the conditions in which people live and work o Structural SDH factors: poverty, gender, ethnicity, education, health o Intermediate SDH factors: living and working conditions, social/political exclusion, social capital, access to quality health care, violence/crime, transportation, physical environment  Millennium Development Goals focusing on health: o Goal 4: reduce mortality of children younger than 5 years o Goal 5: improve maternal health o Goal 6: combat diseases, including HIV/AIDS, malaria  Some progress has been made: o proportion of people living in extreme poverty decreased; number of extreme poor in SS. Africa has leveled off; more children in developing world going to school; women’s political participation growing; child mortality declined globally, malaria control interventions expanded; tuberculosis epidemic decreasing  Two-pronged approach to improving lives of people living in slums: o Forward-looking proactive strategies to contain new urban populations o Slum upgrading to address needs of people currently living in slums (** This article focuses on slum upgrading **) o World Health Organization adds: improving access to quality health care; targeted health promotion; integration of health, welfare, and education services  Holistic approaches to improving slum conditions prove to be best interventions for developing countries (takes intro account health, education, housing, livelihood, gender)  Some argue for empowerment strategies rather than providing basic infrastructure o Through participatory processes, however, these processes do not facilitate asset building of individuals and communities and aim at influencing efficiency of institutions that govern the development of individual and community assets Poverty: More than Lack of Money  Households whose income is less than that required to meet certain defined physical needs (ie. Diet, quality housing, health care, etc) considered poor  Income poverty: poverty defined through the use of income or consumption (Chambers) o Critiqued because it ignores: role of assets; intrahousehold differences; differences in size of households; nonmonetary income sources; large variations in living costs within and between nations o Fails to consider differences in expenditures between rural and urban areas  Urban households spend much of their incomes on urban transport, housing, access to water, healthcare, energy, child care  Various dimensions of urban poverty (Satterthwaite) 1. Poor quality, insecure, hazardous, overcrowded housing 2. Inadequate provision for infrastructure and services 3. Inadequate protection of poor groups’ rights through the law 4. Poor groups’ voicelessness/powerlessness 5. Inadequate income 6. Inadequate, unstable, risky asset base 7. Limited or no safety net  This list highlights the importance of considering poverty reduction strategies other than income Defining Slums  Lack of basic services  Substandard housing/illegal and inadequate building structures  Overcrowding and high density  Unhealthful living conditions, hazardous locations  Insecure tenure  Irregular or informal settlements  Poverty and social exclusion  Minimum settlement size Difficulty defining some of these characteristics; need to have quantitative and objective definition that can be used to can measure slums globally Extent of Deprivation and Associations Between Slum Conditions and Health Improved Water  Delivery of clean water; removal of waste water; improving sanitation  Choices and freedoms constrained by illness, poverty, vulnerability  1.1 bil people in developing countries do not have access to clean water o Use 5L a day compared to average in US 400L a day per capita  Associated with dysentery, cholera, eye infections, worm infections, diarrhea o Diarrhea and pneumonia prevalent among children in slums; 2 million children in developing world die a year Access to Sanitation  In urban context: public piped sewer, septic system, access to pour-flush or ventilated improved pit latrines  1.6 more likely to experience diarrhea without access to improved sanitation; also associated with intestinal worms  Open defecation, poor hygiene, lack of safe drinking water together contribute to 88% (1.5 bil) deaths in children younger than 5 years (diarrheal diseases)  Intestinal works risk anemia and thus childbearing issues for girls  Contaminated standing water breeding grounds for mosquitos (malaria) Durable Housing  Durable house = nonhazardous site, made of a permanent structure, can protect inhabitants from elements  Affects cardiovascular and respiratory health  Noise pollution, access to little daylight, absence of views out windows linked to depression  Breeding grounds for pests (rats, mice, flies, cockroaches) which spread diseases and cause allergens  Between 3 and 4 in every 10 nonpermanent houses in developing world located in dangerous sites o Prone to floods, landslides; near hazardous waste landfill sites (associated with low birth weight, birth defects, infectious diseases, cancers) Sufficient Living Area  Not more than 3 people should share room for sufficient living area  In overcrowding context 20% of world’s urban population residing in inadequate dwellings (2003) – nd rd Most of these people in Asia, Africa 2 , Latin America & Caribbean 3  Risks
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