Abstract
ObjectivesTo explore how married women living in low-income formal and informal neighbourhoods in Aleppo, Syria, perceived the effects of neighbourhood on their health and well-being, and the relevance of these findings to future urban rebuilding policies post-conflict.MethodsSemi-structured interviews were undertaken with eighteen married women living in informal or socioeconomically disadvantaged formal neighbourhoods in Aleppo in 2011, a year before the armed conflict caused massive destruction in all these neighbourhoods.ResultsOur findings suggest that the experience of neighbourhood social characteristics is even more critical to women’s sense of well-being than environmental conditions and physical infrastructure. Most prominent was the positive influence of social support on well-being.ConclusionsThe significance of this study lies, first, in its timing, before the widespread destruction of both formal and informal neighbourhoods in Aleppo and, second, and in its indication of the views of women who lived in marginalised communities on what neighbourhood characteristics mattered to them. Further research post-conflict needs to explore how decisions on urban rebuilding are made and their likely influence on health and well-being.
Highlights
Studying specific neighbourhood effects of living in informal settlements on health and well-being in low- and middle-income countries has received little attention withinThis article is part of the special issue “Environmental and health equity”.the wider literature on urban poverty and health (Lilford et al 2017)
Neighbourhood diversity was sought to ensure a mix of lowincome formal neighbourhoods and informal settlements
The majority of the respondents lived in their neighbourhood for 10 years or more: 6 out of 8 in the formal neighbourhoods and 7 out of 10 in informal neighbourhoods
Summary
The wider literature on urban poverty and health (Lilford et al 2017). In a seminal paper, Macintyre et al (2002) distinguish three types of explanation for geographical inequalities in health: compositional, contextual, and collective. Compositional explanations highlight the characteristics of individuals or households concentrated in particular neighbourhoods. Contextual explanations relate to the opportunities and constraints posed by the neighbourhood’s physical and social environment, encompassing access to clean air and water or housing quality, or availability of health services. Collective explanations relate to cultural and historical characteristics of neighbourhoods: the extent of community support networks, social cohesion, ethnic mix, and social participation (Macintyre et al 2002). Our paper rests on the World Health Organisation definition of health defined in Alma-Ata Declaration (1978) ‘as a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity’ (World Health Organisation 1978)
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