The Concentration of Disadvantage and the Rise of an Urban Penalty: Urban Slum Prevalence and the Social Production of Health Inequalities in the Developing Countries

Abstract

Urban slums are proliferating in the developing countries. A corollary of this structural transformation is the increasing recognition of an urban penalty wherein slum populations exhibit notable inequalities in health relative to non-slum urban residents and even rural populations. The built urban environment, in turn, is a crucial context within which the social production of disproportionate morbidity and mortality is enacted. The authors develop this assertion and use bivariate and partial correlation analysis to highlight the association of urban slum prevalence, or proportion of the total population living in urban slum conditions, with indicators of mortality and gender parity, measured at the national level. Data for 99 developing countries show that greater urban slum prevalence is strongly correlated with higher levels of infant, child, and maternal mortality. Further, urban slum prevalence exhibits strong, deleterious correlations with gender parity (measured by the gender development index) and fertility rate, factors that have a crucial direct impact in shaping variant mortality levels. Future research is warranted on the social inequalities in health and illness derived from the expansion of urban slum conditions in the developing countries.

Uncovering Coverage: Utilisation of the Universal Health Insurance Scheme, Chhattisgarh by Women in Slums of Raipur

“…While the 'urban advantage' is seen in better aggregate health indicators for these populations, they are often worse off than the rural poor (NUHM, 2013;TRG for NUHM, 2014). The urban poor and vulnerable groups pay the 'urban penalty' (Rice & Rice, 2009). They often incur a relatively higher health care expenditure or are pushed towards untrained and unlicenced providers (Das & Hammer, 2007).…”

Urban–rural disparities in adult mortality in sub-Saharan Africa

“…Our results suggest that contemporary SSA may be facing similar challenges with high urban population densities and insufficient health and sanitation infrastructure (Konteh 2009;Szreter 1997). Urban populations may face higher mortality in part due to factors related to natural resistance to disease (Johansson and Mosk 1987) -including the high proportion of poverty in urban areas (Gould 1998;Ravallion, Chen, and Sangraula 2007) and growing urban slums (Fink, Günther, and Hill 2014;Rice and Rice 2009). Indeed, a narrowing gap in urban-rural child mortality differentials is attributed to the conditions in urban slums (Kimani-murage et al 2014).…”

Complexity and Dynamism from an Urban Health Perspective: a Rationale for a System Dynamics Approach

“…6 This is congruent with the perspectives of urban planners and other urban scholars. 10 The complexity is framed as both positive and negative, 6,7,9 with scholars articulating both urban health advantages and penalties, [11][12][13][14][15] and ordered complexity 16 and disorder and chaos. 17 Scholars from a variety of disciplines have long conceptualized cities as systems.…”