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Meeting the Health Challenges of the Urban Poor
November 2, 2010 By Joshua NickellFifty percent of the world’s population now lives in cities, a figure that is predicted to rise to 60 percent by 2030, and 70 percent by mid-century, according to UN figures. The majority of this growth will occur in the Global South, where most of the world’s slums are found.
Why the rampant urban migration? Prospects for better health care, education, and employment are drawing the world’s poor out of rural areas into cities. But as the number of impoverished city-dwellers and slums grows, it is becoming increasingly important for society to consider how it will address the problems associated with this unprecedented degree of global urbanization.
At a recent event, “Meeting the Health Challenge of Urban Poverty and Slums,” co-hosted by the Wilson Center on the Hill program and the Comparative Urban Studies Project, Jacob Kumaresan, director of WHO Center for Health Development in Kobe, Japan, and Richard B. Lamporte, director of new program development, Jhpiego, discussed poverty and health challenges in rapidly growing urban slums.
The chances that the world’s rapidly growing number of city-dwellers will live a healthy and prosperous life depend on the services and opportunities cities can offer. As Kumaresan pointed out, there is currently no shortage of problems. Among other ills, he stated that 170 million urban residents currently do not have access to a latrine, while more than 1.2 million people will die from urban air pollution this year alone. As more individuals migrate to cities, these problems will be compounded.
Kumaresan also noted that cities have the “worst and the most unimaginable disparities when it comes to health.” While urban centers have more hospitals and attract many of the best doctors, the hospitals are often not managed or governed well. As a result, many poor urbanites suffer worse health care than their rural neighbors.
For instance, Kumaresan noted that tuberculosis rates in rural parts of India are half those of urban settings. Kumaresan also emphasized that these disparities are certainly not limited to the Global South: developed cities like New York and Los Angeles contend with similar inequities.
To address these issues, Kumaresan encouraged policymakers to examine the unique circumstances and conditions of their cities. “You’ve got to do analytical work to see what the problems are in each city, and to look not at the averages, but to unmask the differentials,” he said.
In Osaka, Japan, tuberculosis rates are 12 times higher than the rest of the country, said Kumaresan, primarily because of high affliction rates among its homeless population. As such, it is important for Osaka’s policymakers to address its tuberculosis problem by considering related socio-economic factors and following through with concrete policy actions.
Lamporte emphasized the importance of giving aid and development organizations flexible funding in order to allow them to better address unique local urban problems and inequities. He advised international donors to devote a certain percentage of their funding to integrated initiatives. “Certainly the goalposts could be set, but having some element of complementary funding … would be extremely useful,” he said.
As both Lamporte and Kumaresan pointed out, the future of the city is increasingly becoming the future of the world. As such, it is crucial to have “an urban optic going into the future,” according to Lamporte. If not, he argued, it will be at our own peril, as disease and unrest find increasingly sturdy footholds in urban slums. As the transformation from a rural to an urban planet continues, it will be essential for emerging and growing cities must use successful urban development techniques from both the Global North and the South.
Joshua Nickell is an intern with the Program on America and the Global Economy.
Sources: IRIN, Osaka University Graduate School of Medicine, UN, World Health Organization.
Photo Credit: “kibera_photoshow08,” courtesy of flickr user newbeatphoto.
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