Out of the frying pan into the fire? Urban penalty of the poor and multiple barriers to climate change adaptation in Cambodia and Tanzania

Abstract

Coastal cities face significant impacts from climate change, with potentially serious consequences for human health especially for the urban poor and other vulnerable groups. As part of a larger study in the Indian Ocean world, this paper assesses the joint effect of urbanicity and wealth status on reported number of barriers to climate change adaptation. Negative binomial regression models were fitted to cross-sectional survey data on 1823 and 1253 individuals in coastal Cambodia and Tanzania, respectively. In the pooled multivariate analysis, there exists an urban poor penalty regarding the total number of reported barriers to climate change adaptation. This relationship persists even when biosocial, socio-cultural, and contextual factors are taken into account. Also, there are differentials in self-ratings on health status by the rural poor, rural non-poor; urban poor, and urban nonpoor. Only 20 % of urban poor and rural poor individuals rated their health status as either very good or excellent compared with 25 and 33 % of rural non-poor and urban non-poor individuals, respectively. Quite unexpectedly, individuals who considered their health status as either fair or good were more likely to report higher number of barriers to climate change adaptation compared with those with poor self-rated health. Individuals in only one age category (more than 65 years) in Cambodia and five age categories (26-30, 31-34, 35-40, 41-45, and 56-60 years) in Tanzania had lower incidence rates of reporting higher number of barriers to climate change adaptation compared with 18-25-year olds. Compared with femalecentered households, extended family in Cambodia and malecentered households in Tanzania had lower incidence rates of reporting higher number of barriers to adaptation. Although in Tanzania, there was no relationship between relative household quality and number of barriers to adaptation, in Cambodia, individuals who rated their household quality as better had lower incidence rates of reporting higher number of barriers to adaptation compared with those who rated their household quality as worst in the neighborhood. A policy implication of this study is that sustaining and improving human settlements and health in the face of ongoing global climate change should become an important lens for coastal cities in both countries.

Access to improved water and sanitation in sub-Saharan Africa in a quarter century

“…Urban poor was chosen as the reference group for the key predictor, urbanicity wealth status. Urban poor are considered as vulnerable, marginalized and dwell in slums as well as lack access to improved water and sanitation ( Armah et al., 2017a , 2017b ; Hawkins et al., 2013 ). The reference group selected for the sex was “male”.…”

Organizational safety culture perceptions of healthcare workers in Ghana: A cross-sectional interview study

“…In this study, the compositional factors considered were age in years (20–29, 30–39, above 39) sex (male, female), marital status (single, married), and educational attainment (certificate, diploma, and degree). Contextual factors refer to geographical location or local environmental conditions ( Armah et al., 2017 ). The contextual factors considered in this study were the number of working years in the healthcare sector (below 3 years, 3–5 years, above 5 years) and district (KEEA, Mfantseman, Cape Coast).…”

“…For this reason, negative binomial regression model was employed for the multivariate analyses. Stata 14 makes it possible to select a more flexible model that allows for the variance to be larger than the mean, for example by adding an over-dispersion parameter to model the extra variance or by assuming that the response/outcome variable follows a negative binomial distribution ( Armah et al., 2017 ). For analytical purposes, the incidence rate ratios (IRR) were estimated.…”

Self‐reported disease symptoms of stone quarry workers exposed to silica dust in Ghana

“…This study evaluated the joint effect of work‐post (distance to main dust source—crusher) and the use of required PPE on self‐reported disease symptoms of stone quarry workers in Ghana. Armah et al, 34 posited that health outcomes can be measured as subjective or perceived health status (self‐rated health). Adverse effects of silica dust exposure on the health of workers in silica‐exposed work environments are a matter of importance, particularly in developing countries like Ghana where workers may be subjected to high exposure levels at industrial sites.…”

“…Eye irritation (42% no, 58% yes), breathing difficulty (26% no, 74% yes), coughing (19% no, 81% yes), and common cold (20% no, 80% yes). The regression models used in this study are built under the assumption of independence of subjects, but the cross‐sectional survey has a hierarchical structure with respondents nested within the survey clusters, which could potentially bias the standard errors (SE) 32‐34 …”