Urban health in developing countries: a review

Abstract

The last major review of urban health in developing countries was published in 1992. At that time, knowledge was largely limited to crude rural-urban comparisons and some ad hoc studies of low-income urban communities. Most research was done on communicable (infectious) diseases and little was known about the relationship between urban life in developing countries and chronic illness such as mental ill-health, heart disease and cancer. This paper updates knowledge by reviewing recent research on intra-urban health inequalities, urban health-seeking behaviour and the importance of urban-rural links for health. It also presents a new model of urban health that incorporates changes in urban health research and practice.

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

“…This result is comparable to the respective frequencies of 55.6% and 58.5% observed in Ouagadougou [1] and Cotonou [10]. This practice is widespread in both rural [24,31-33] and urban areas [1,2,34]. The main reason for this practice is its affordability; it involves only the cost of the drugs that are purchased; the patient is thus exempt from other costs related to transportation, consultation of health workers, and various technical examinations [35].…”

“…Malaria and fevers of unknown origin and diseases of the respiratory and digestive tracts predominate [1,2,30]. In this study, one-third of all surveyed patients had suffered from malaria and/or fever during the study period.…”

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

“…This result is comparable to the respective frequencies of 55.6% and 58.5% observed in Ouagadougou [1] and Cotonou [10]. This practice is widespread in both rural [24,31-33] and urban areas [1,2,34]. The main reason for this practice is its affordability; it involves only the cost of the drugs that are purchased; the patient is thus exempt from other costs related to transportation, consultation of health workers, and various technical examinations [35].…”

“…Malaria and fevers of unknown origin and diseases of the respiratory and digestive tracts predominate [1,2,30]. In this study, one-third of all surveyed patients had suffered from malaria and/or fever during the study period.…”

Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings

“…[5] Consistent with Julian Tudor Hart's (1971) inverse-care law [6], evidence suggests that the better-off disproportionately benefit from urban healthcare access while poorer citizens are more likely to experience unhealthy environments and poorer health outcomes. [5] The adverse physical and social conditions of slums are inimical to the SDG Goal 3 of "ensuing healthy lives for all" [3,7], as are many barriers slum dwellers face in accessing quality health services including the high costs of care, lack of proximity, limited hours of service, overburdened facilities, as well as a perceived lack of respectful and effective treatment. [8][9][10][11] In Bangladesh, approximately 55% of the urban population live in slums.…”

Health and Mortality in the 19th‐Century Rural United States: The Second Epidemiological Transition in Madison County, New York

“…As a model, it does not fully capture the nuanced variation in the pace and nature of changes in the cause of death and demographic regimes within and between populations (Armelagos 2014;Barrett et al 1998;Gaylin and Kates 1997;Omran 1998;Santosa et al 2014;Sudharsanan et al 2022;van Doren 2023). For example, in some locations where mortality rates from infectious diseases have declined and mortality rates from non-communicable diseases have increased in general, impoverished urban residents face a double burden of both major classes of diseases, despite trends observed at the population level (Harpham and Molyneux 2001). There is also evidence that the second epidemiological transition occurs more rapidly in countries with the highest levels of urbanization, and that within populations, it occurs earlier in urban areas than in surrounding rural areas (Budnik 2014;Harpham and Molyneux 2001;Schmidt and Sattenspiel 2017).…”

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

“…This result is comparable to the respective frequencies of 55.6% and 58.5% observed in Ouagadougou [1] and Cotonou [10]. This practice is widespread in both rural [24,31-33] and urban areas [1,2,34]. The main reason for this practice is its affordability; it involves only the cost of the drugs that are purchased; the patient is thus exempt from other costs related to transportation, consultation of health workers, and various technical examinations [35].…”

“…Malaria and fevers of unknown origin and diseases of the respiratory and digestive tracts predominate [1,2,30]. In this study, one-third of all surveyed patients had suffered from malaria and/or fever during the study period.…”

Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings

“…[5] Consistent with Julian Tudor Hart's (1971) inverse-care law [6], evidence suggests that the better-off disproportionately benefit from urban healthcare access while poorer citizens are more likely to experience unhealthy environments and poorer health outcomes. [5] The adverse physical and social conditions of slums are inimical to the SDG Goal 3 of "ensuing healthy lives for all" [3,7], as are many barriers slum dwellers face in accessing quality health services including the high costs of care, lack of proximity, limited hours of service, overburdened facilities, as well as a perceived lack of respectful and effective treatment. [8][9][10][11] In Bangladesh, approximately 55% of the urban population live in slums.…”

Health and Mortality in the 19th‐Century Rural United States: The Second Epidemiological Transition in Madison County, New York

“…As a model, it does not fully capture the nuanced variation in the pace and nature of changes in the cause of death and demographic regimes within and between populations (Armelagos 2014;Barrett et al 1998;Gaylin and Kates 1997;Omran 1998;Santosa et al 2014;Sudharsanan et al 2022;van Doren 2023). For example, in some locations where mortality rates from infectious diseases have declined and mortality rates from non-communicable diseases have increased in general, impoverished urban residents face a double burden of both major classes of diseases, despite trends observed at the population level (Harpham and Molyneux 2001). There is also evidence that the second epidemiological transition occurs more rapidly in countries with the highest levels of urbanization, and that within populations, it occurs earlier in urban areas than in surrounding rural areas (Budnik 2014;Harpham and Molyneux 2001;Schmidt and Sattenspiel 2017).…”

Health-seeking behaviour in the city of Lubumbashi, Democratic Republic of the Congo: results from a cross-sectional household survey

“…This result is comparable to the respective frequencies of 55.6% and 58.5% observed in Ouagadougou [1] and Cotonou [10]. This practice is widespread in both rural [24,31-33] and urban areas [1,2,34]. The main reason for this practice is its affordability; it involves only the cost of the drugs that are purchased; the patient is thus exempt from other costs related to transportation, consultation of health workers, and various technical examinations [35].…”

“…Malaria and fevers of unknown origin and diseases of the respiratory and digestive tracts predominate [1,2,30]. In this study, one-third of all surveyed patients had suffered from malaria and/or fever during the study period.…”

Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings

“…[5] Consistent with Julian Tudor Hart's (1971) inverse-care law [6], evidence suggests that the better-off disproportionately benefit from urban healthcare access while poorer citizens are more likely to experience unhealthy environments and poorer health outcomes. [5] The adverse physical and social conditions of slums are inimical to the SDG Goal 3 of "ensuing healthy lives for all" [3,7], as are many barriers slum dwellers face in accessing quality health services including the high costs of care, lack of proximity, limited hours of service, overburdened facilities, as well as a perceived lack of respectful and effective treatment. [8][9][10][11] In Bangladesh, approximately 55% of the urban population live in slums.…”

Health and Mortality in the 19th‐Century Rural United States: The Second Epidemiological Transition in Madison County, New York

“…As a model, it does not fully capture the nuanced variation in the pace and nature of changes in the cause of death and demographic regimes within and between populations (Armelagos 2014;Barrett et al 1998;Gaylin and Kates 1997;Omran 1998;Santosa et al 2014;Sudharsanan et al 2022;van Doren 2023). For example, in some locations where mortality rates from infectious diseases have declined and mortality rates from non-communicable diseases have increased in general, impoverished urban residents face a double burden of both major classes of diseases, despite trends observed at the population level (Harpham and Molyneux 2001). There is also evidence that the second epidemiological transition occurs more rapidly in countries with the highest levels of urbanization, and that within populations, it occurs earlier in urban areas than in surrounding rural areas (Budnik 2014;Harpham and Molyneux 2001;Schmidt and Sattenspiel 2017).…”