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In this paper, we examine how economic, social and political forces impact on NCDs in Khayelitsha (a predominantly low income area in Cape Town, South Africa) through their shaping of the built environment. The paper draws on literature reviews and ethnographic fieldwork undertaken in Khayelitsha. The three main pathways through which the built environment of the area impacts on NCDs are through a complex food environment in which it is difficult to achieve food security, an environment that is not conducive to safe physical activity, and high levels of depression and stress (linked to, amongst other factors, poverty, crime and fear of crime). All of these factors are at least partially linked to the isolated, segregated and monofunctional nature of Khayelitsha. The paper highlights that in order to effectively address urban health challenges, we need to understand how economic, social and political forces impact on NCDs through the way they shape built environments.

This paper describes the linkages between low-income migrant households in Durban and their rural home areas. These relationships can be seen as a continuum, from households which regard their rural homestead as their real home to households who seem to have severed their rural ties. For a number of households, described as “multiple-home households”, maintaining both an urban and a rural base provides a safety net in times of economic hardship or political violence. In order to address the needs of these households, housing and rural development subsidy policies should take variations in household size into account and allow greater choice in the allocation of subsidies between urban and rural homes.