Intra-urban Inequalities Research Articles

Decomposing the Gap in Childhood Undernutrition between Poor and Non–Poor in Urban India, 2005–06

BackgroundDespite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India.MethodsWe used cross-sectional data from the third round of the National Family Health Survey conducted during 2005–06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder–Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India.ResultConsiderable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005–06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty.ConclusionsThe findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition.

Trends in Socioeconomic Inequalities in Ischemic Heart Disease Mortality in Small Areas of Nine Spanish Cities from 1996 to 2007 Using Smoothed ANOVA

The aim of this study was to analyze the evolution of socioeconomic inequalities in mortality due to ischemic heart diseases (IHD) in the census tracts of nine Spanish cities between the periods 1996-2001 and 2002-2007. Among women, there are socioeconomic inequalities in IHD mortality in the first period which tended to remain stable or even increase in the second period in most of the cities. Among men, in general, no socioeconomic inequalities have been detected for this cause in either of the periods. These results highlight the importance of intra-urban inequalities in mortality due to IHD and their evolution over time.

Trends in socio-economic inequalities in injury mortality among men in small areas of 26 Spanish cities, 1996–2007

ObjectiveTo analyse trends in socio-economic inequalities in mortality due to all injuries, as well as, suicide and motor vehicle injuries, in men in the census tracts of 26 Spanish cities for the periods 1996–2001 and 2002–2007. MethodsEcological study of trends based on two periods (1996–2001 and 2002–2007). The study population consisted of male residents in each city during the period 1996–2007. We fitted a hierarchical Bayesian model which takes into account the spatial structure of the data in order to obtain relative risks (RRs), and their 95% credible intervals (CIs), between mortality and a socio-economic deprivation index, in each period. ResultsIn most of the cities, mortality due to total injuries presents the same geographical pattern as the deprivation index in the two periods. Moreover, inequalities remained stable. In contrast, socio-economic inequalities in mortality due to motor vehicle injuries tended to diminish in the second period in the majority of the cities, particularly Castellón (first period: RR1=2.56; 95%CI: 1.19–4.84; second period: RR2=1.06; 95%CI: 0.45–2.12), whereas in the case of suicides, the inequalities remain stable but are only significant in large cities. ConclusionThis study has demonstrated that socio-economic inequalities in mortality due to all injuries in small areas of 26 Spanish cities remain stable over time. These results highlight the importance of intra-urban inequalities in mortality due to injuries and their evolution over time.

The presence of the past: a retrospective view of the politics of urban water management in Accra, Ghana

Since the 1990s there has been an explosion of literature on the topic of commercialisation of water services in low-income cities. However, relatively little of this research analyzes a longer time perspective. This article historicizes contemporary policy debates on urban water supply and sanitation provision. By examining Ghana’s urban history from British colonial rule to the immediate post-independence era, the article demonstrates that many of the critical issues and arguments that appeared in past debates on water are echoed in contemporary discussions. The much debated issue of pricing of water sparked heated discussions in colonial Accra, thus these debates are not new. Second, whereas much of the literature in the area focuses on commodification of water services in the context of neo-liberalism and economic globalisation since the 1970s, this article points to the important role played by historically conditioned concerns about democracy, representation and trust in deepening our understanding of contemporary protests against private sector participation in urban water management. Third, the article argues that a colonial legacy from the past tends to continue normalising intra-urban inequality in consumption and access to urban water services in Ghana. Taken together this shows the role of history as a highly present and operating force in the shaping of our present-day politics.

Socio-economic inequalities in mortality due to injuries in small areas of ten cities in Spain (MEDEA Project)

Objectives To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996–2003. Methods This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996–2003. For each census tract we obtained an index of socio-economic deprivation, and estimated standardized mortality ratios using hierarchical Bayesian models which take into account the spatial structure of the data. Results In the majority of the cities, the geographical pattern of total mortality from injuries is similar to that of the socio-economic deprivation index. There is an association between mortality due to injuries and the deprivation index in the majority of the cities which is more important among men and among those younger than 45 years. In these groups, traffic injuries and overdoses are the causes most often associated with deprivation in the cities. The percentage of excess mortality from injuries related to socio-economic deprivation is higher than 20% in the majority of the cities, the cause with the highest percentage being drug overdose. Conclusions In most cities, there are socio-economic inequalities in mortality due to overdose and traffic injuries. In contrast, few cities have found association between suicide mortality and deprivation. Finally, no association was found between deprivation and deaths due to falls. Inequalities are higher in men and those under 45 years of age. These results highlight the importance of intra-urban inequalities in mortality due to injuries.

Are neighborhood education levels associated with BMI among adults in Cairo, Egypt?

This study examined the association between area-level education and BMI among adults in Cairo, Egypt. A sample of 3993 households including 1990 men and 2003 women were analyzed from the 2007 Cairo Urban Inequity Study, a study which aimed to identify potential intra-urban inequities in health related to the environment and living conditions in Cairo.Using multilevel analysis, we found that residents of high education neighborhoods were significantly less likely to be obese compared to low education neighborhoods. An inverse association between neighborhood education and individual BMI was observed whereby each unit increase in percentage of households with greater than a high school education was associated with a 0.036 kg/m2 decrease in BMI of individuals. This translated into a difference between high and low education neighborhoods of 6.86 kg (15.1 lb) for women based on an average height of 1.65 m and 6.10 kg (13.4 lb) for men based on an average height of 1.75 m after adjusting for sociodemographic, socioeconomic, health and environmental factors.These findings suggest that programs aiming to reduce BMI among adults in this setting may be well-served by focusing on education since it appears to have an effect at the neighborhood level over and above the impact it has at the individual level. This may be due to several factors such as greater access to knowledge and information regarding health and nutrition, greater food availability, and shifting cultural perceptions of beauty away from an ideal body shape of plumpness in favor of thinness in high education neighborhoods. The cross-sectional nature of our study does not allow for causal interpretations, however, so further studies exploring why the neighborhood education-BMI association is so significant is warranted.

Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities

BackgroundIntra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities.MethodsIt is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation.ResultsIn the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95%CI 1.42-1.67), Madrid (RR = 1.57 95%CI 1.49-1.65) and Seville (RR = 1.53 95%CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women.ConclusionThis study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment.

Urban health in Johannesburg: The importance of place in understanding intra-urban inequalities in a context of migration and HIV

Developing country urban contexts present multiple challenges to those responsible for ensuring the good health of urban populations. These include urban growth, migration, informal settlements, intra-urban inequalities and - in some cases - high HIV prevalence. Using Johannesburg as a case study, this paper explores the complexities of the urban context by comparing the social determinants of urban health between migrant groups residing in the inner-city and a peripheral urban informal settlement. It is argued that any attempt to improve the health of urban populations in the context of migration and HIV requires understanding that 'place matters'.

Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project)

The objectives of this study are to identify inequalities in mortality among census tracts of 11 Spanish cities in the period 1996-2003 and to analyse the relationship between these geographical inequalities and socioeconomic deprivation. It is a cross-sectional ecological study where the units of analysis are census tracts. We obtained an index of socioeconomic deprivation and estimated SMR by each census tract using hierarchical Bayesian models which take into account the spatial structure. In the majority of the cities geographical patterns in total mortality were found in both sexes, which were similar to those for the index of socioeconomic deprivation. Among men, four specific causes of death (lung cancer, ischemic heart diseases, respiratory diseases and cirrhosis) were positively associated with deprivation in the majority of cities. Among women the specific causes diabetes and cirrhosis were positively associated, while lung cancer was negatively associated with deprivation. The excess of mortality related with deprivation was 59,445 deaths among men and 23,292 among women. These results highlight the importance of intra-urban inequalities in health.

The use of GIS and indicators to monitor intra-urban inequalities. A case study in Rosario, Argentina

This article presents a methodology that combines the use of urban indicators and Geographical Information Systems (GIS) as a valid diagnostic and prescriptive tool to generate policy relevant information on the complex and multidimensional aspects of spatial inequalities. This methodology allows the systematic monitoring of the most relevant aspects of intra-urban inequalities through an indicator matrix and an approach to incorporate a geographical component into the participatory budget allocation. GIS-based indicators are constructed combining different data sources such as census and administrative data. This methodology is applied in a case study in Rosario (Argentina) and demonstrates how urban indicators and GIS combined are a valuable tool to describe and monitor inequality aspects such as quality-of-life conditions and access to services in order to better target resources.

Ethnic Residential Patterns as Predictors of Intra-Urban Child Mortality Inequality in Accra, Ghana

As cities of developing nations absorb an increasing fraction of the world's population increase, questions have arisen about the potential for emerging inequalities in health within places that are already suffering from inadequate infrastructure. In this paper we explore the pattern of child mortality inequalities (as a proxy for overall health levels) within a large sub-Saharan African city—Accra, Ghana—and then we examine the extent to which existing residential patterns by ethnicity may be predictive of any observed intra-urban inequalities in child mortality. We find that the spatial variability in child mortality in Accra is especially associated with the pattern of residential separation of the Ga from other ethnic groups, with the Ga having higher levels of mortality than other ethnic groups. Being of Ga ethnicity exposes a woman and her children to characteristics of the places in Accra where the Ga live, in which one-room dwellings and poor infrastructure predominate. At the individual level, we find that regardless of where a woman lives, if she is of Ga ethnicity and/or is non-Christian, and if she is not married, her risks of having lost a child are elevated.

Spatial Competition within Urban Areas: Hotelling and Bertrand Reconciled

In this paper, I assume the existence of distribution of urbanamenities having its maximum at the city center. These amenities are viewed as a surrogate for all kinds of outside opportunities taht consumers encounter within urban areas. Using the Hotelling model, I study the impact of these amenities on independent location and pricing decisions of duopolists. Consumers patronize the firm where the amount of aminities is larger, ceteris paribus. If this demand externality is strong at the midpoint then minimum differentiation occurs without moderation of price competition, in contrast to mainstream results in the literature. For intermediate values of the ration of transportation cost to spatial concentration of amenities, firms tacitly play an asymmetric equilibrium with one firm near (or at) the midpoint and its rival at a more suburban location. This causes intra-urban inequalities since some consumers are induted to patronize the decentralized marketplace where they encounter less urban life opportunities.

The Environmental Dimensions of Sustainable Development for Cities

This article compares and contrasts the environmental problems faced by low-, middle- and high-income cities and what this implies for each in meeting the environmental goals of sustainable development. It reviews the evidence in regard to how air, water and waste Problems differ according to cities' average incomes. This shows that household and neighbourhood level problems such as indoor air pollution and inadequate provision for household water supplies, sanitation and waste removal are most severe in low-income cities, and that their burdens fall primarily on the urban poor. Affluent cities contribute much more to global stresses such as carbon emissions and aggregate waste generation, whose burdens fall far more widely and are more likely to affect future generations. The article also discusses other important influences on the severity of cities' environmental burdens – in Particular intra-urban inequality and the quality of governance. The article ends with a discussion of whether the environmental interests of the currently deprived are complementary to or in conflict with those of future generations, and the potential role of an environmental justice framework in reconciling these interests.

Intra-urban Inequalities and Planning Strategies: A Case Study of Be'er Sheva, Israel

Intra-urban distribution of different income groups of population is arguably a function of four major determinants: (a) overall income, (b) housing expenses, (c) commuting expenses and (d) other outlays, conditionally independent of a particular location. These factors are likely to cause a patched distribution of different population groups, with predominant concentration of low-income residents in inner-city fringes, along the major transport lines. The validity of this supposition is tested using statistical data available for the city of Be'er Sheva, Israel. Hierarchical cluster analysis is used to determine the underlying patterns of intra-urban inequalities at a neighbourhood level. A number of development strategies are proposed, aimed at reducing the extent of intra-urban development disparities. These include: (i) enhancing the development of inner-city fringes as a mean of facilitating intra-urban commuting; (ii) more even distribution of public housing construction across urban areas; and (iii) establishing a system of special-purpose grants, aimed at assisting low- and medium-income residents in either renting or purchasing apartments and houses outside inner-city suburbs. It is also suggested that the distribution of property tax burden should reflect the neighbourhoods' development and welfare of residents and not be based only on physical size and structural conditions of the building, as often reflected in current practice.

Analysis of infant mortality in coverage areas of health centers in Belo Horizonte, Minas Gerais, Brazil (1994-1996)

Geographic analysis of health conditions highlights regional and intra-urban inequalities. This study aims to identify intra-urban discrepancies in the city of Belo Horizonte, studying the infant mortality coefficients (IMC) in the various areas of the metropolitan area and evaluating their evolution from 1994 to 1996. The study uses data from 1994 to 1996 regarding birth and death records (from the SINASC and SIM registries). It also uses "thematic maps" related to geographic coverage areas of municipal health centers to demonstrate differences in infant mortality coefficients. The empirical Bayesian method was applied to correct possible random fluctuation in IMC due to small and unstable numbers. A 24.4% reduction in the overall coefficient was observed in the city from 1994 to 1996. Decreases also occurred in the health center coverage areas. In 1994, eight areas presented an IMC above 50/1,000, while in 1996 no area reached that coefficient. In 1994, 29 areas presented an IMC from 35 to 50/1,000, as compared to only four areas in 1996. In 1996 there were more areas with IMC below 35/1,000 as compared to 1994. In 1996, more homogeneity was observed in IMC distribution and hence a reduction in intra-urban inequalities.

Full Circle or Spiralling Out of Control? State Violence and the Control of Urbanisation in Papua New Guinea

There is an administrative reluctance to recognise the permanency of urban settlement in Papua New Guinea. This reluctance, evident since the 1960s, has been characteristic of both the colonial and post-colonial administrations. Opposition to some facets of urbanisation continues today, despite growing population and land pressures in most rural areas and real problems of landlessness emerging in particular rural areas. Colonial control of urban populations has been replicated in contemporary times, often in more draconian form. Eviction of urban settlers has been tied to issues of crime and urban respectability, and lingering perceptions that Melanesians should be rural residents. The growth of informal settlements and urbanisation are not seen as issues of urban planning, nor is the context of urban migration linked to socioeconomic inequality, hence other forms of urban policy are largely absent. Strengthening alliances between land-owners and the state (especially police and provincial administrations) have thus emphasised intraurban inequality and hampered national development.

La commercialisation du service d'eau potable à Windhoek (Namibie) : inégalités urbaines et logiques marchandes

The commercialization of the Namibian Department of Water Affairs is an institutional answer to a double problem: the shortage of both water and public funds in the face of increasing urban demand. This practice aims at bringing the legal statutes and the practices of bulk water supply management into compliance with the commercial principles of this sector of activity. However, in a context characterized by increasing and evolving post-apartheid intra-urban inequalities, in which a small Black elite does not yet possess the technical control of the major urban services, combined with disparities in the implementation process of recent decentralization, this institutional reform seems inadequate to contend with two sizeable challenges: managing water shortage as well as sharing the resource among users in a sustainable and thrifty way; providing the urban poor with an adequate supply for which the technical and financial arrangements remain to be invented.

Social and economic imbalances in the metropolitan area of Monterrey

The paper describes social and economic differences between Monterrey’s eight municipalities, including housing conditions and basic service provision, and how these changed between 1970 and 1990. It also describes the social and economic differences for 1990 between the 710 micro-areas into which Monterrey was divided, which allows a more precise and detailed picture of intra-urban inequalities. It also reveals the limitations of an intra-urban analysis based on municipal boundaries by showing many clusters of micro-areas with very low levels of socio-economic development in some of the better off municipalities.

El equipamiento urbano de la Educación Superior en la ZMCM

Street furniture is the material support for the provision of basic health services, education, trade, recreation, sport, etc. Street furniture is considered as an important factor of social welfare and support economic development and regional planning and internal structure of human settlements; and the lack of it shows the intra-urban inequalities. The distribution of enrollment in the metropolitan area is an important aspect that complements the vision of the situation of social welfare, it also helps to delineate the intra-urban structure. It is urgent that higher education institutions are modernized from a real institutional evaluation, criticism and whose referent of effectiveness and validity are the requirements of society and the productive apparatus.

City Size and Income Distributions: The Canadian Experience

Recent US studies generally conclude that city size contributes to greater intra-urban income inequality, while higher average income levels contribute to equality. We argue that Canadian cities and the Canadian urban system are in some ways different from those in the US, and that American results may not therefore be transferable to Canada. This is confirmed by our testing with 1971 Census data; we find that city size does not affect urban income distributions in Canada, although higher levels of income do add to equality, as in the US. We conclude that American findings may be due to the particularities of US cities, and that long term growth of Canadian cities, while perhaps of some concern for other reasons, does not appear to threaten existing levels of income equality.