G249 Are cities good for child health? the case of the urban poor in mumbai, india and lagos, nigeria

Abstract

Conclusion The urban poor are chronically underrepresented in both health data collection and urban and public health governance. A global commitment to the alleviation of urban poverty is much needed to negate the hazards to child health that will echo into future generations. Aims Over recent decades there has been unprecedented growth in the urban population, with the sharpest rise occurring in developing countries’ youth population. Cities are generally considered to be centres of development with an assumed advantage for health. However, there is seldom a distinction made for disadvantaged or marginalised groups such as the urban poor. Children are particularly vulnerable to urban environmental hazards and those that are born into poverty are disproportionately affected. Methods This study uses the social determinants of health model to assess the effect of the urban environment on the health outcomes of children of the urban poor. Mumbai, India and Nigeria, Lagos, two of the largest and most rapidly growing cities in the world (see Figure 1), are used as case studies. Their current and projected population growth is almost equivalent to slum growth rate (see Figure 2), this can be seen to represent rising urban poverty and inequity. These trends can be extrapolated to many other cities experiencing the same global forces of urbanisation. Results The urbanisation of poverty is evident in these case studies and is one of the strongest determinants of child health, with rising socio-economic inequality in cities endangering the health of children across many sectors of society. Mean child mortality in urban Nigeria and India is lower than in rural areas (see Figure 3); however this obscures the outcomes amongst the urban poor. Urban child morbidity, in many cases, is equivalent to or higher than rural rates; this is particularly evident in the urban prevalence of childhood infections and malnutrition, both of which are inextricably related to urban poverty.