Abstract
Informal settlements or slums dominate the urban landscape and in 2016 were the home to almost 900 million people. Global health is now slum health. The determinants of health for slum dwellers are multi-factorial and can vary from country to country and even within the same city. This chapter reviews the definitions of informal settlements or slums and highlights the key drivers of health, disease and well-being in urban informal settlements, including: spatial segregation, insecure residential status, poverty and employment, housing structural quality, water and sanitation, energy, transport, violence, climate change and services. We highlight the evidence supporting the links between these key factors and infectious and non-communicable diseases (NCDs). The chapter also links the health issues facing informal settlements with the Sustainable Development Goals (SDGs). The chapter concludes with a discussion of how slum upgrading—a community-based process that aims to improve built and social environments, as well as economic and social conditions in slums—can be a key approach for improving the health of those living in informal settlements. We suggest that multiple features of the upgrading process, including community engagement, women’s empowerment, shelter and infrastructure improvements, tenure security, political recognition, and enhanced social and health care services, can combine to reduce the disease burden and premature mortality so frequently experienced by those living in informal settlements.
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Notes
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SDG 11 includes the target ‘By 2030, ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums’ (http://www.undp.org/content/undp/en/home/sustainable-development-goals/goal-11-sustainable-cities-and-communities/targets/).
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References
African Population and Health Research Centre (APHRC). (2014). Population and health dynamics in Nairobi’s informal settlements: Report of the Nairobi cross-sectional slums survey. Nairobi: APHRC.
Agarwal, S., & Srivastava, A. (2009). Social determinants of children’s health in urban areas in India. Journal of Health Care for the Poor and Underserved, 20(Suppl. 4), 68–89.
Agarwal, S., Bhanot, A., & Goindi, G. (2005). Understanding and addressing childhood immunization coverage in urban slums. Indian Pediatrics, 42, 653–663.
Barcellos, C., & Zaluar, A. (2014). Homicides and territorial struggles in Rio de Janeiro favelas. Revista de Saúde Pública, 48(1), 94–102. https://doi.org/10.1590/S0034-8910.2014048004822.
Bartlett, S., & Satterthwaite, D. (Eds.). (2016). Cities on a finite planet: Towards transformative responses to climate change. London: Routledge.
Bartram, J., & Cairncross, S. (2010). Hygiene, sanitation, and water: Forgotten foundations of health. PLoS Medicine, 7(11), e1000367.
Boonyabancha, S. (2009). Land for housing the poor—By the poor: Experiences from the Baan Mankong nationwide slum upgrading programme in Thailand. Environment and Urbanization, 21(2), 309–329.
Cerda, M., et al. (2012). Reducing violence by transforming neighborhoods: A natural experiment in Medellín, Colombia. American Journal of Epidemiology, 175(10), 1045–1053. https://doi.org/10.1093/aje/kwr428.
Cervero, R. (2013). Linking urban transport and land use in developing countries. Journal of Transport and Land Use, 6(1), 7–24.
Chant, S., & McIlwaine, C. (2016). Cities, slums and gender in the global south: Towards a feminised urban future. London: Routledge. 9780415721646.
Chen, M. A., & Sinha, S. (2016). Home-based workers and cities. Environment and Urbanization, 28(2), 343–358.
Cheng, J. J., Schuster-Wallace, C. J., Watt, S., Newbold, B. K., & Mente, A. (2012). An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environmental Health, 11. http://www.ehjournal.net/content/11/1/4.
Corburn, J., & Riley, L. (2016). Slum health: From the cell to the street. Berkeley: University of California Press. ISBN: 9780520281073.
Corburn, J., & Sverdlik, A. (2017). Slum upgrading and health equity. International Journal of Environmental Research and Public Health, 14(4), 342. https://doi.org/10.3390/ijerph14040342.
Corburn, J., Asari, M., Makua, J., et al. (2017). Mukuru situational analysis: Existing conditions in Nairobi’s informal settlement. Berkeley: University of California.
De Snyder, V. N., Friel, S., Fotso, J. C., Khadr, Z., Meresman, S., Monge, P., & Patil-Deshmukh, A. (2011). Social conditions and urban health inequities: Realities, challenges and opportunities to transform the urban landscape through research and action. Journal of Urban Health, 88, 1183–1193.
Dye, C. (2008). Health and urban living. Science, 319(5864), 766–769.
Egondi, T., Kyobutungi, C., Ng, N., Muindi, K., Oti, S., van de Vijver, S., Ettarh, R., & Rocklöv, J. (2013). Community perceptions of air pollution and related health risks in Nairobi slums. International Journal of Environmental Research and Public Health, 10(10), 4851–4868. https://doi.org/10.3390/ijerph10104851.
Egondi, T., Muindi, K., Kyobutungi, C., Gatari, M., & Rocklöv, J. (2016). Measuring exposure levels of inhalable airborne particles (PM2.5) in two socially deprived areas of Nairobi, Kenya. Environmental Research, 148, 500–506. https://doi.org/10.1016/j.envres.2016.03.018.
Ezeh, A., Oyebode, O., Satterthwaite, D., Chen, Y. F., Ndugwa, R., Sartori, J., Mberu, B., Melendez-Torres, G. J., Haregu, T., Watson, S. I., et al. (2016). The history, geography, and sociology of slums and the health problems of the people who live in slums. Lancet. https://doi.org/10.1016/S0140-6736(16)31650-6.
Fox, S. (2014). The political economy of slums: Theory and evidence from Sub-Saharan Africa. World Development, 54(2), 191–203.
Galiani, S., & Schargrodsky, E. (2004, July). Effects of land titling on child health. IDB Working Paper No. 194. Available at SSRN: https://ssrn.com/abstract=1814746 or https://doi.org/10.2139/ssrn.1814746
Galiani, S., & Schargrodsky, E. (2010). Property rights for the poor: Effects of land titling. Journal of Public Economics, 94, 700–729.
Gilbert, A. (2007). The return of the slum: Does language matter? International Journal of Urban and Regional Research, 31, 697–713.
Haines, A., Bruce, N., Cairncross, S., Davies, M., Greenland, K., Hiscox, A., Lindsay, S., Satterthwaite, D., & Wilkinson, P. (2013). Promoting health and advancing development through improved housing in low-income settings. Journal of Urban Health, 90, 810–831.
Harpham, T. (2009). Urban health in developing countries: What do we know and where do we go? Health & Place, 15, 107–116.
Hasan, A. (2010). Participatory development: The story of the Orangi Pilot Project-Research and Training Institute and the Urban Resource Centre, Karachi, Pakistan. Oxford: Oxford University Press.
Home, R. (2013). Of planting and planning: The making of British colonial cities (2nd ed.). Abingdon: Routledge. 272 pages.
Ibarrarán, P., Kluve, J., Ripani, L., & Rosas Shady, D. (2015). Experimental evidence on the long term impacts of a youth training program. Inter-American Development Bank.
Jaitman, L., & Brakarz, J. (2013). Evaluation of slum upgrading programs: Literature review and methodological approaches. IDB Technical Note, 60. https://publications.iadb.org/bitstream/handle/11319/6021/Evaluation%20of%20Slum%20Upgrading%20Programs.pdf?sequence=1.
JMP. (2017). Progress on drinking water, sanitation and hygiene: Joint Monitoring Programme 2017 update and SDG baselines. Geneva: WHO and UNICEF.
Khayesi, M., Monheim, H., & Nebe, J. M. (2010). Negotiating “streets for all” in urban transport planning: The case for pedestrians, cyclists and street vendors in Nairobi, Kenya. Antipode, 42(1), 103–126.
Kimani-Murage, E. W., Muthuri, S. K., Oti, S. O., Mutua, M. K., van de Vijver, S., & Kyobutungi, C. (2015). Evidence of a double burden of malnutrition in urban poor settings in Nairobi, Kenya. PLoS ONE, 10(6), e0129943. https://doi.org/10.1371/journal.pone.0129943.
Kinney, P., et al. (2011). Traffic impacts on PM2.5 air quality in Nairobi, Kenya. Environmental Science & Policy, 14(4), 369–378.
Lilford, R. J., Oyebode, O., Satterthwaite, D., et al. (2016). Improving the health and welfare of people who live in slums. Lancet. https://doi.org/10.1016/S0140-6736(16)31848-7.
Lund, F., Alfers, L., & Santana, V. (2016). Towards an inclusive occupational health and safety for informal workers. New Solutions: A Journal of Environmental and Occupational Health Policy, 26(2), 190–207.
Manda, M., & Wanda, E. (2017). Understanding the nature and scale of risks in Karonga, Malawi. Environment and Urbanization, 29(1), 15–32.
Marco Gonzalez-Navarro & Climent Quintana-Domeque. (2016, May). “Paving streets for the poor: Experimental analysis of infrastructure effects,” The Review of Economics and Statistics, MIT Press, vol. 98(2), 254–267.
Massey, K. (2011). Insecurity and shame: Exploration of the impact of the lack of sanitation on women in the slums of Kampala Uganda, LSHTM and SHARE Briefing Note, 11 pages.
Meth, P. (2017). Informal housing, gender, crime and violence: The role of design in urban South Africa. The British Journal of Criminology, 57(2), 402–421.
Muggah, R. (2014). Deconstructing the fragile city: Exploring insecurity, violence and resilience. Environment & Urbanisation, 26(2), 345–358. https://doi.org/10.1177/0956247814533627.
Niehaus, M., Moore, S., Patrick, P., Derr, L. L., Lorntz, B., Lima, A. A., et al. (2002). Early childhood diarrhoea is associated with di- minished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. American Journal of Tropical Hygiene and Medicine, 66, 590–593.
Obduho, R. A. (1997). Nairobi: National capital and regional hub. In C. Rakodi (Ed.), The urban challenge in Africa: Growth and management of its large cities. Tokyo: UN University Press.
Prüss-Ustün, A., Wolf, J., Corvalán, C., Bos, R., & Neira, M. (2016). Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. WHO.
Riley, L. W., Ko, A. I., Unger, A., & Reis, M. G. (2007). Slum health: Diseases of neglected populations. BMC International Health and Human Rights, 7. https://doi.org/10.1186/1472-698X-7-2.
Satterthwaite, D., & Bartlett, S. (2017). The full spectrum of risk in urban centres: Changing perceptions, changing priorities. Environment and Urbanization, 29(1), 3–14.
Scovronick, N., Lloyd, S. J., & Kovats, R. S. (2015). Climate and health in informal urban settlements. Environment and Urbanization, 27(2), 657–678.
SHARE (Sanitation and Hygiene Applied Research for Equity (SHARE). (2016). Emergence of community toilets as a public good: The sanitation work of Mahila Milan, NSDF and SPARC in India. http://www.shareresearch.org/research/emergence-community-toilets-public-good
Shetty, P. (2011). Health care for urban poor falls through the gap. The Lancet, 377(9766), 627–628.
Shonkoff, J., et al. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663.
Singh, R., Wang, X., Mendoza, J. C., & Ackom, E. K. (2015). Electricity (in) accessibility to the urban poor in developing countries. Wiley Interdisciplinary Reviews: Energy and Environment, 4(4), 339–353.
Sommer, M., Hirsch, J. S., Nathanson, C., & Parker, R. G. (2015). Comfortably, safely, and without shame: Defining menstrual hygiene management as a public health issue. American Journal of Public Health, 105, 1302–1311. pmid:25973831.
Sovacool, B. K. (2011). Conceptualizing urban household energy use: Climbing the “Energy Services Ladder”. Energy Policy, 39(3), 1659–1668.
Subbaraman, R., O’Brien, J., Shitole, T., Sawant, K., Bloom, D. E., & Patil-Deshmukh, A. (2012). Off the map: The health and social implications of being a non-notified slum in India. Environment and Urbanization, 24, 643–663.
Sverdlik, A. (2011). Ill health and poverty: A literature review on health in informal settlements. Environment and Urbanization, 23, 123–155.
Trujillo, H. R., Siegel, E., Clayton, M., Shapiro, G., & Elam, D. (2015). Securing cities: Innovations for the prevention of civic violence. In R. Ahn, T. F. Burke, & A. M. McGahan (Eds.), Innovating for healthy urbanization (pp. 97–122). USA: Springer.
Turley, R., Saith, R., Bhan, N., Rehfuess, E., & Carter, B. (2013). Slum upgrading strategies involving physical environment and infrastructure interventions and their effects on health and socio-economic outcomes. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010067.pub2.
UN-Habitat. (2014). Streets as tools for urban transformation in slums: A street-led approach to citywide slum upgrading, Nairobi.
UN-Habitat. (2016a). World cities report 2016: Urbanization and development emerging futures. Nairobi, Kenya: UN-Habitat. http://wcr.unhabitat.org.
UN-Habitat. (2016b). Slum almanac 2015–2016: Tracking improvement in the lives of slum dwellers. https://unhabitat.org/slum-almanac-2015-2016/
Violence Prevention Through Urban Upgrading (VPUU). (2011). A manual for safety as a public good. VPUU. http://vpuu.org.za
West, B. S., Hirsch, J. S., & El-Sadr, W. (2012). HIV and H2O: Tracing the connections between gender, water and HIV. AIDS Behavior, 17, 1675–1682.
WHO. (2016). Burning opportunity: Clean household energy for health, sustainable development, and wellbeing of women and children. Geneva: WHO.
WHO and UN-Habitat. (2016). Global report on urban health: Equitable, healthier cities for sustainable development. http://www.who.int/kobe_centre/measuring/urban-global-report/en/
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Corburn, J., Sverdlik, A. (2019). Informal Settlements and Human Health. In: Nieuwenhuijsen, M., Khreis, H. (eds) Integrating Human Health into Urban and Transport Planning. Springer, Cham. https://doi.org/10.1007/978-3-319-74983-9_9
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