Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India

PubMed Central

Mohan, Indu; Gupta, Rajeev; Misra, Anoop; Sharma, Krishna Kumar; Agrawal, Aachu; Vikram, Naval K.; Sharma, Vinita; Shrivastava, Usha; Pandey, Ravindra M.

2016-01-01

Objective Urbanization is an important determinant of cardiovascular disease (CVD) risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations. Methods Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35–70y) were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites) for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported. Results Mean levels of body mass index (BMI), waist circumference, waist-hip ratio (WHR), systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p <0.001). Age-adjusted prevalence of diabetes and risk factors among rural, urban-poor and urban-middle class women, respectively was, diabetes (2.2, 9.3, 17.7%), overweight BMI ≥25 kg/m2 (22.5, 45.6, 57.4%), waist >80 cm (28.3, 63.4, 61.9%), waist >90 cm (8.4, 31.4, 38.2%), waist hip ratio (WHR) >0.8 (60.4, 90.7, 88.5), WHR>0.9 (13.0, 44.3, 56.1%), hypertension (31.6, 48.2, 59.0%) and hypercholesterolemia (13.5, 27.7, 37.4%) (Mantel Haenszel X2 ptrend <0.01). Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%). There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89–0.99). Conclusions There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural. PMID:26881429

The rural-to-urban migrant population in China: gloomy prospects for tuberculosis control.

PubMed

Tobe, Ruoyan Gai; Xu, Lingzhong; Song, Peipei; Huang, Yong

2011-12-01

The migrant population is a population with a high risk of tuberculosis (TB) infection and transmission. Globally, migration is likely to have a significant impact on TB epidemiology, particularly in countries that receive substantial numbers of migrants from countries with a high infection burden. China, a country with the world's second highest TB burden, faces a considerable increase in the number of rural-to-urban migrants. This population has a significant impact on urban TB epidemics and is specifically targeted by national guidelines for TB control. TB control among the migrant population has had relatively poor outcomes. Barriers to detection and treatment have both financial and non-financial aspects, such as the "migratory" nature of the migrant population, their marginalized working and living environment, poor financial status, little awareness of TB, inadequate referral to TB dispensaries, and potential social stigma in the workplace. Currently, the free TB treatment policy has limited ability to relieve the financial burden on most migrant TB patients as would allow optimal outcomes of TB detection and treatment. Universal health insurance coverage and fostering of personnel in community-based primary health care for the rural-to- urban migrant population represent two pillars of successful TB control.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya

PubMed Central

J. Madise, Nyovani; Ziraba, Abdhalah K.; Inungu, Joseph; Khamadi, Samoel A.; Ezeh, Alex; Zulu, Eliya M.; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-01-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. PMID:22591621

The Rise of Syria’s Urban Poor: Why the War for Syria’s Future Will Be Fought Over the Country’s New Urban Villages

DTIC Science & Technology

2014-01-01

those urban poor living in the slums sprouting up around Syria’s cities. This “village-izing” of Syria’s ancient cit- ies has changed the complexion...1986 to 20.8 million in 2010.6 This population rose predominantly in the slums surrounding Syria’s cities. From 2000 to 2010, Syria grew by 4.92...opposition activity. Baba Amr, a slum of Homs adjacent to the orchards that once fed the city, is synonymous with the THE RISE OF SYRIA’S POOR

The food, fuel, and financial crises affect the urban and rural poor disproportionately: a review of the evidence.

PubMed

Ruel, Marie T; Garrett, James L; Hawkes, Corinna; Cohen, Marc J

2010-01-01

The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

Rural-urban migration and child survival in urban Bangladesh: are the urban migrants and poor disadvantaged?

PubMed

Islam, M Mazharul; Azad, Kazi Md Abul Kalam

2008-01-01

This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.

Urban poor program launched.

PubMed

1991-01-01

The government of the Philippines has launched a program to deal with the rapidly growing urban poor population. 60 cities (including Metro Manila) are expected to increase their bloated population by 3.8% over 1990 which would be 27.7 million for 1991. Currently there is an exodus of people from the rural areas and by 2000 half the urban population will be squatters and slum dwellers. Basic services like health and nutrition are not expected to be able to handle this type of volume without a loss in the quality of service. The basic strategy of the new program is to recruit private medical practitioners to fortify the health care delivery and nutrition services. Currently the doctor/urban dweller ration is 1:9000. The program will develop a system to pool the efforts of government and private physicians in servicing the target population. Barangay Escopa has been chosen as the pilot city because it typifies the conditions of a highly populated urban area. The projects has 2 objectives: 1) demonstrate the systematic delivery of health and nutrition services by the private sector through the coordination of the government, 2) reduce mortality and morbidity in the community, especially in the 0-6 age group as well as pregnant women and lactating mothers.

Stochasticity in Natural Forage Production Affects Use of Urban Areas by Black Bears: Implications to Management of Human-Bear Conflicts

PubMed Central

Baruch-Mordo, Sharon; Wilson, Kenneth R.; Lewis, David L.; Broderick, John; Mao, Julie S.; Breck, Stewart W.

2014-01-01

The rapid expansion of global urban development is increasing opportunities for wildlife to forage and become dependent on anthropogenic resources. Wildlife using urban areas are often perceived dichotomously as urban or not, with some individuals removed in the belief that dependency on anthropogenic resources is irreversible and can lead to increased human-wildlife conflict. For American black bears (Ursus americanus), little is known about the degree of bear urbanization and its ecological mechanisms to guide the management of human-bear conflicts. Using 6 years of GPS location and activity data from bears in Aspen, Colorado, USA, we evaluated the degree of bear urbanization and the factors that best explained its variations. We estimated space use, activity patterns, survival, and reproduction and modeled their relationship with ecological covariates related to bear characteristics and natural food availability. Space use and activity patterns were dependent on natural food availability (good or poor food years), where bears used higher human density areas and became more nocturnal in poor food years. Patterns were reversible, i.e., individuals using urban areas in poor food years used wildland areas in subsequent good food years. While reproductive output was similar across years, survival was lower in poor food years when bears used urban areas to a greater extent. Our findings suggest that bear use of urban areas is reversible and fluctuates with the availability of natural food resources, and that removal of urban individuals in times of food failures has the potential to negatively affect bear populations. Given that under current predictions urbanization is expected to increase by 11% across American black bear range, and that natural food failure years are expected to increase in frequency with global climate change, alternative methods of reducing urban human-bear conflict are required if the goal is to prevent urban areas from becoming population sinks. PMID:24416350

Stochasticity in natural forage production affects use of urban areas by black bears: implications to management of human-bear conflicts.

PubMed

Baruch-Mordo, Sharon; Wilson, Kenneth R; Lewis, David L; Broderick, John; Mao, Julie S; Breck, Stewart W

2014-01-01

The rapid expansion of global urban development is increasing opportunities for wildlife to forage and become dependent on anthropogenic resources. Wildlife using urban areas are often perceived dichotomously as urban or not, with some individuals removed in the belief that dependency on anthropogenic resources is irreversible and can lead to increased human-wildlife conflict. For American black bears (Ursus americanus), little is known about the degree of bear urbanization and its ecological mechanisms to guide the management of human-bear conflicts. Using 6 years of GPS location and activity data from bears in Aspen, Colorado, USA, we evaluated the degree of bear urbanization and the factors that best explained its variations. We estimated space use, activity patterns, survival, and reproduction and modeled their relationship with ecological covariates related to bear characteristics and natural food availability. Space use and activity patterns were dependent on natural food availability (good or poor food years), where bears used higher human density areas and became more nocturnal in poor food years. Patterns were reversible, i.e., individuals using urban areas in poor food years used wildland areas in subsequent good food years. While reproductive output was similar across years, survival was lower in poor food years when bears used urban areas to a greater extent. Our findings suggest that bear use of urban areas is reversible and fluctuates with the availability of natural food resources, and that removal of urban individuals in times of food failures has the potential to negatively affect bear populations. Given that under current predictions urbanization is expected to increase by 11% across American black bear range, and that natural food failure years are expected to increase in frequency with global climate change, alternative methods of reducing urban human-bear conflict are required if the goal is to prevent urban areas from becoming population sinks.

Urban adolescent sexual and reproductive health in low-income and middle-income countries.

PubMed

Mmari, Kristin; Astone, Nan

2014-08-01

One of the most important aspects of adolescent health is sexual and reproductive health (SRH). Currently, sexually transmitted infections (STIs) threaten the health of adolescents more than any other age group, and as many as 2.2 million adolescents are living with HIV. Understanding adolescents' SRH needs and how to invest in improving their health can be best addressed by knowing more about the contexts that increase their vulnerability to poor sexual health outcomes. Recent evidence has highlighted an increasingly marginalised segment of the adolescent population--and that is the urban poor adolescent population in low and middle income countries (LMIC). Using an urban health framework, this paper examines the contextual factors within an urban community that influence the SRH of adolescents in LMIC. Findings show that while there is substantial research that has explored factors within the social environment, there is limited research that has explored factors within the physical environment, as well as research that has specifically explored urban adolescents' use of SRH services and how such services can be best provided to this vulnerable population. This paper highlights the need for further research to understand the relationships between the urban poor environment and the SRH risks that adolescents face while living in such environments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The link between poverty, environment and development. The political challenge of localizing Agenda 21.

PubMed

Wichmann, R

1995-11-01

This article discusses the links between poverty, development, the environment, and implementing Agenda 21. The poor in large cities experience greater health risks and threats from environmental hazards. The poor also face inadequate housing, poor sanitation, polluted drinking water, and lack of other basic services. Many poor live in marginalized areas more susceptible to environmental degradation. During 1990-2030, population size may reach 9.7 billion, or 3.7 billion more than today. 90% may be urban residents. Already a large proportion of urban population live in a decaying urban environment with health and life threatening conditions. At least 250 million do not have easy access to safe piped water. 400 million lack proper sanitation. The liberalization of the global economy is fueling urbanization. The cycle of poverty and environmental decline requires rapid economic growth and closing of the infrastructure gaps. Policy initiatives of Agenda 21 occur at the local urban level. At this level, policies directly affect people. The future success of Agenda 21 will depend on local initiatives. Management approaches may need to change in order to achieve sustainable development. The poor will be more vocal and heard from in the future. Critical areas of management include waste management, pollution control, traffic, transportation, energy, economic development, and job creation. Society must be able to participate in setting priorities. About 1500 local authorities are involved in Agenda 21 planning initiatives. Curitiba, Brazil, is an example of how cities can solve community problems.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

PubMed

Madise, Nyovani J; Ziraba, Abdhalah K; Inungu, Joseph; Khamadi, Samoel A; Ezeh, Alex; Zulu, Eliya M; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-09-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. Copyright © 2012 Elsevier Ltd. All rights reserved.

Social Consequences of Alcohol Use among Urban Poor: A Cross-sectional Study in Kathmandu Valley.

PubMed

Thapa, P; Mishra, S R; Bista, B; Dhungana, R R; Adhikari, N; Soti, L; Puri, S; Aryal, K K

2015-01-01

Nepal is not an exception to alcohol use; urban poor are more prone than the general population. The question of social consequences of alcohol use among urban poor remains largely unanswered in Nepal. Study explored the alcohol linked social consequences among the urban poor of Kathmandu Valley. Taking 422 urban poor from four squatter settlements of Kathmandu Valley, a cross-sectional study was carried out. A series of univariate and bivariate analysis were performed in R version 3.1.2. Four out of 10 current drinkers (42.86%, 95% CI: 31.4-54.3) encountered various social consequences. The number one consequence hitting 23.19% drinkers was money loss. Male drinkers were 4.43 times (95% CI: 1.810.8) more likely to face social consequences than their female counterparts. Being male frequent drinker increased the odds of social consequence 3.80 times (95% CI:1.3-11.0) than that of female frequent drinker. A behaviour change communication campaign needs initiation; male populace and frequent drinkers being the target.

Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

PubMed

Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

2017-07-18

In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted, including measures such as alcohol control.

Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System.

PubMed

Emina, Jacques; Beguy, Donatien; Zulu, Eliya M; Ezeh, Alex C; Muindi, Kanyiva; Elung'ata, Patricia; Otsola, John K; Yé, Yazoumé

2011-06-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

Urbanization drives the evolution of parallel clines in plant populations

PubMed Central

Renaudin, Marie; Johnson, Marc T. J.

2016-01-01

Urban ecosystems are an increasingly dominant feature of terrestrial landscapes. While evidence that species can adapt to urban environments is accumulating, the mechanisms through which urbanization imposes natural selection on populations are poorly understood. The identification of adaptive phenotypic changes (i.e. clines) along urbanization gradients would facilitate our understanding of the selective factors driving adaptation in cities. Here, we test for phenotypic clines in urban ecosystems by sampling the frequency of a Mendelian-inherited trait—cyanogenesis—in white clover (Trifolium repens L.) populations along urbanization gradients in four cities. Cyanogenesis protects plants from herbivores, but reduces tolerance to freezing temperatures. We found that the frequency of cyanogenic plants within populations decreased towards the urban centre in three of four cities. A field experiment indicated that spatial variation in herbivory is unlikely to explain these clines. Rather, colder minimum winter ground temperatures in urban areas compared with non-urban areas, caused by reduced snow cover in cities, may select against cyanogenesis. In the city with no cline, high snow cover might protect plants from freezing damage in the city centre. Our study suggests that populations are adapting to urbanization gradients, but regional climatic patterns may ultimately determine whether adaptation occurs. PMID:28003451

Urbanization drives the evolution of parallel clines in plant populations.

PubMed

Thompson, Ken A; Renaudin, Marie; Johnson, Marc T J

2016-12-28

Urban ecosystems are an increasingly dominant feature of terrestrial landscapes. While evidence that species can adapt to urban environments is accumulating, the mechanisms through which urbanization imposes natural selection on populations are poorly understood. The identification of adaptive phenotypic changes (i.e. clines) along urbanization gradients would facilitate our understanding of the selective factors driving adaptation in cities. Here, we test for phenotypic clines in urban ecosystems by sampling the frequency of a Mendelian-inherited trait-cyanogenesis-in white clover (Trifolium repens L.) populations along urbanization gradients in four cities. Cyanogenesis protects plants from herbivores, but reduces tolerance to freezing temperatures. We found that the frequency of cyanogenic plants within populations decreased towards the urban centre in three of four cities. A field experiment indicated that spatial variation in herbivory is unlikely to explain these clines. Rather, colder minimum winter ground temperatures in urban areas compared with non-urban areas, caused by reduced snow cover in cities, may select against cyanogenesis. In the city with no cline, high snow cover might protect plants from freezing damage in the city centre. Our study suggests that populations are adapting to urbanization gradients, but regional climatic patterns may ultimately determine whether adaptation occurs. © 2016 The Author(s).

Closing the poor-rich gap in contraceptive use in urban Kenya: are family planning programs increasingly reaching the urban poor?

PubMed

Fotso, Jean Christophe; Speizer, Ilene S; Mukiira, Carol; Kizito, Paul; Lumumba, Vane

2013-08-27

Kenya is characterized by high unmet need for family planning (FP) and high unplanned pregnancy, in a context of urban population explosion and increased urban poverty. It witnessed an improvement of its FP and reproductive health (RH) indicators in the recent past, after a period of stalled progress. The objectives of the paper are to: a) describe inequities in modern contraceptive use, types of methods used, and the main sources of contraceptives in urban Kenya; b) examine the extent to which differences in contraceptive use between the poor and the rich widened or shrank over time; and c) attempt to relate these findings to the FP programming context, with a focus on whether the services are increasingly reaching the urban poor. We use data from the 1993, 1998, 2003 and 2008/09 Kenya demographic and health survey. Bivariate analyses describe the patterns of modern contraceptive use and the types and sources of methods used, while multivariate logistic regression models assess how the gap between the poor and the rich varied over time. The quantitative analysis is complemented by a review on the major FP/RH programs carried out in Kenya. There was a dramatic change in contraceptive use between 2003 and 2008/09 that resulted in virtually no gap between the poor and the rich in 2008/09, by contrast to the period 1993-1998 during which the improvement in contraceptive use did not significantly benefit the urban poor. Indeed, the late 1990s marked the realization by the Government of Kenya and its development partners, of the need to deliberately target the poor with family planning services. Most urban women use short-term and less effective methods, with the proportion of long-acting method users dropping by half during the review period. The proportion of private sector users also declined between 2003 and 2008/09. The narrowing gap in the recent past between the urban poor and the urban rich in the use of modern contraception is undoubtedly good news, which, coupled with the review of the family program context, suggests that family planning programs may be increasingly reaching the urban poor.

Does conurbation affect the risk of poor mental health? A population based record linkage study.

PubMed

Maguire, A; O'Reilly, D

2015-07-01

To determine if urban residence is associated with an increased risk of anxiety/depression independent of psychosocial stressors, concentrated disadvantage or selective migration between urban and rural areas, this population wide record-linkage study utilised data on receipt of prescription medication linked to area level indicators of conurbation and disadvantage. An urban/rural gradient in anxiolytic and antidepressant use was evident that was independent of variation in population composition. This gradient was most pronounced amongst disadvantaged areas. Migration into increasingly urban areas increased the likelihood of medication. These results suggest increasing conurbation is deleterious to mental health, especially amongst residents of deprived areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.

PubMed

Magadi, Monica A

2013-06-01

The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects the situation in the rural areas where the majority of the SSA populations reside.

Prevalence, awareness, treatment and control of hypertension in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael B; Anarfi, John K; Agyemang, Charles; Ogedegbe, Gbenga; Aikins, Ama de-Graft

2014-06-01

Hypertension is a major public health problem in many sub-Saharan African countries including Ghana, but data on urban poor communities are limited. The aim of this study was therefore to assess the prevalence, awareness, management and control of hypertension among a young adult population in their reproductive ages living in urban poor communities in Accra. Cross-sectional, population-based survey of 714 young adults in their reproductive ages (women aged 15-49 years, men aged 15-59 years) living in three urban poor suburbs of Accra, Ghana. The overall prevalence of hypertension in all three communities was 28.3% (women 25.6% and men 31.0%). Among respondents who had hypertension, 7.4% were aware of their condition; 4% were on antihypertensive medication while only 3.5% of hypertensive individuals had adequate blood pressure (BP) control (BP <140/90  mmHg). The level of awareness and treatment was lower in men than in women (3.1 and 1.3% for men and 11.9 and 6.5% for women, respectively). Among individuals with hypertension, the rate of control was higher among women than among men (5.0 and 2.1%, respectively). Although about a quarter of the young adult population in these low-income communities of Accra have hypertension, the levels of awareness, treatment and control are abysmally low. We recommend community-specific primary and secondary prevention interventions that draw on existing resources, specifically implementing cardiovascular disease (CVD) interventions in faith-based organizations and task-shifting CVD care through the national Community-based Health Planning and Services (CHPS) programme.

Unequal household carbon footprints in China

NASA Astrophysics Data System (ADS)

Wiedenhofer, Dominik; Guan, Dabo; Liu, Zhu; Meng, Jing; Zhang, Ning; Wei, Yi-Ming

2017-01-01

Households' carbon footprints are unequally distributed among the rich and poor due to differences in the scale and patterns of consumption. We present distributional focused carbon footprints for Chinese households and use a carbon-footprint-Gini coefficient to quantify inequalities. We find that in 2012 the urban very rich, comprising 5% of population, induced 19% of the total carbon footprint from household consumption in China, with 6.4 tCO2/cap. The average Chinese household footprint remains comparatively low (1.7 tCO2/cap), while those of the rural population and urban poor, comprising 58% of population, are 0.5-1.6 tCO2/cap. Between 2007 and 2012 the total footprint from households increased by 19%, with 75% of the increase due to growing consumption of the urban middle class and the rich. This suggests that a transformation of Chinese lifestyles away from the current trajectory of carbon-intensive consumption patterns requires policy interventions to improve living standards and encourage sustainable consumption.

Suburban poverty, public transit, economic opportunities, and social mobility : final report.

DOT National Transportation Integrated Search

2015-12-30

Recent demographic trends suggest an increasing suburbanization of poor populations. Given that poor : households are often unable to afford increasing housing prices in many urban areas they are increasingly : moving to the suburbs. At the same time...

High-resolution maps of forest-urban watersheds present an opportunity for ecologists and managers

EPA Science Inventory

Dense populations of people and abundant impervious surfaces contribute to poor water quality and increased flooding in forest-urban watersheds. Green infrastructure mitigates these effects, but precisely quantifying benefits is difficult because most land cover maps rely on coar...

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

PubMed Central

Ezeh, Alex; Oronje, Rose

2008-01-01

In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility- and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya’s Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services. PMID:18389376

Urban waterfowl population: Ecological evaluation of management and planning

NASA Astrophysics Data System (ADS)

Greer, David M.

1982-05-01

An urban population of ducks in Puyallup, Washington, USA was studied for 14 consecutive months beginning in November 1978. Observations were made weekly from four study sites where ducks would congregate at early morning hours. Factors contributing to the presence of waterfowl in Puyallyup included abundant food supplies and a creek corridor that connected fragmented habitats in the urban area to the larger rural populations of waterfowl. Mallards ( Anas platyrhynchos) were the most abundant of the 13 species observed and were the only ducks remaining during the nesting season. Habitat size and complexity were important factors influencing the species diversity of a particular site. Nesting success of mallards was poor due to limited distribution of nesting habitat, intraspecific aggression, and human disturbance. Both site-specific and more broad-based strategies are suggested for managing and planning for duck populations in urban areas.

Trapped within the city: integrating demography, time since isolation and population-specific traits to assess the genetic effects of urbanization.

PubMed

Lourenço, André; Álvarez, David; Wang, Ian J; Velo-Antón, Guillermo

2017-03-01

Urbanization is a severe form of habitat fragmentation that can cause many species to be locally extirpated and many others to become trapped and isolated within an urban matrix. The role of drift in reducing genetic diversity and increasing genetic differentiation is well recognized in urban populations. However, explicit incorporation and analysis of the demographic and temporal factors promoting drift in urban environments are poorly studied. Here, we genotyped 15 microsatellites in 320 fire salamanders from the historical city of Oviedo (Est. 8th century) to assess the effects of time since isolation, demographic history (historical effective population size; N e ) and patch size on genetic diversity, population structure and contemporary N e . Our results indicate that urban populations of fire salamanders are highly differentiated, most likely due to the recent N e declines, as calculated in coalescence analyses, concomitant with the urban development of Oviedo. However, urbanization only caused a small loss of genetic diversity. Regression modelling showed that patch size was positively associated with contemporary N e , while we found only moderate support for the effects of demographic history when excluding populations with unresolved history. This highlights the interplay between different factors in determining current genetic diversity and structure. Overall, the results of our study on urban populations of fire salamanders provide some of the very first insights into the mechanisms affecting changes in genetic diversity and population differentiation via drift in urban environments, a crucial subject in a world where increasing urbanization is forecasted. © 2017 John Wiley & Sons Ltd.

Beyond urban penalty and urban sprawl: back to living conditions as the focus of urban health.

PubMed

Freudenberg, Nicholas; Galea, Sandro; Vlahov, David

2005-02-01

Researchers have long studied urban health, both to describe the consequences of urban living and to design interventions to promote the health of people living in cities. Two approaches to understanding the impact of cities on health have been dominant, namely, urban health penalty and urban sprawl. The urban penalty approach posits that cities concentrate poor people and expose them to unhealthy physical and social environments. Urban sprawl focuses on the adverse health and environmental effects of urban growth into outlying areas. We propose a model that integrates these approaches and emphasizes urban living conditions as the primary determinant of health. The aim of the model is to move beyond describing the health-related characteristics of various urban populations towards identifying opportunities for intervention. Such a shift in framework enables meaningful comparisons that can inform public health activities at the appropriate level and evaluate their effectiveness in improving the health of urban populations. The model is illustrated with two examples from current urban public health practice.

Promotive Factors and Psychosocial Adjustment among Urban Youth

ERIC Educational Resources Information Center

O'Neal, LaToya J.; Cotten, Shelia R.

2016-01-01

Background: Urban youth are often exposed to compounded risk factors which make them more vulnerable to negative outcomes. Research examining promotive factors which may reduce vulnerabilities to poor psychosocial adjustment among this population is limited. Objective: The current study addresses this limitation by examining the impact of…

Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals.

PubMed

Cheng, Ming-Fang; Chen, Wan-Ling; Huang, I-Fei; Chen, Jung-Ren; Chiou, Yee-Hsuan; Chen, Yao-Shen; Lee, Susan Shin-Jung; Hung, Wan-Yu; Hung, Chih-Hsin; Wang, Jiun-Ling

2016-08-01

Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management. A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012. Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations. The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural-urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.

Are urban children really healthier? Evidence from 47 developing countries.

PubMed

Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

2007-11-01

On average, child health outcomes are better in urban than in rural areas of developing countries. Understanding the nature and the causes of this rural-urban disparity is essential in contemplating the health consequences of the rapid urbanization taking place throughout the developing world and in targeting resources appropriately to raise population health. Using micro-data on child health taken from the most recent Demographic and Health Surveys for 47 developing countries, the purpose of this paper is threefold. First, we document the magnitude of rural-urban disparities in child nutritional status and under-5 mortality across all 47 developing countries. Second, we adjust these disparities for differences in population characteristics across urban and rural settings. Third, we examine rural-urban differences in the degree of socioeconomic inequality in these health outcomes. The results demonstrate that there are considerable rural-urban differences in mean child health outcomes in the entire developing world. The rural-urban gap in stunting does not entirely mirror the gap in under-5 mortality. The most striking difference between the two is in the Latin American and Caribbean region, where the gap in growth stunting is more than 1.5 times higher than that in mortality. On average, the rural-urban risk ratios of stunting and under-5 mortality fall by, respectively, 53% and 59% after controlling for household wealth. Controlling thereafter for socio-demographic factors reduces the risk ratios by another 22% and 25%. We confirm earlier findings of higher socioeconomic inequality in stunting in urban areas and demonstrate that this also holds for under-5 mortality. In a considerable number of countries, the urban poor actually have higher rates of stunting and mortality than their rural counterparts. The findings imply that there is a need for programs that target the urban poor, and that this is becoming more necessary as the size of the urban population grows.

Transformation of the Urban Health Care Safety Net: The Devolution of a Public Responsibility.

PubMed

Kulesher, Robert

2015-01-01

Reduced spending in both federal and state programs and the closure of public hospitals have serious consequences for the health of urban dwellers, especially the poor and uninsured. Through a combination of economic factors, many municipalities have formed public-private partnerships and launched community initiatives to preserve some of the elements of the health care safety net. What once was a responsibility of municipal governments, the provision of health care to poor and uninsured populations, is now posing challenges for private-sector providers. This article identifies several factors that have contributed to the incremental demise of the publicly funded urban health care safety net and how local entities and the federal government are responding to the care of the poor and uninsured.

Food (In)Security in Rapidly Urbanising, Low-Income Contexts.

PubMed

Tacoli, Cecilia

2017-12-11

Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

Food (In)Security in Rapidly Urbanising, Low-Income Contexts

PubMed Central

2017-01-01

Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space. PMID:29232936

Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

PubMed Central

2014-01-01

Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. PMID:24977099

Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water.

PubMed

Fotso, Jean-Christophe; Ezeh, Alex Chika; Madise, Nyovani Janet; Ciera, James

2007-08-28

Improvements in child survival have been very poor in sub-Saharan Africa (SSA). Since the 1990 s, declines in child mortality have reversed in many countries in the region, while in others, they have either slowed or stalled, making it improbable that the target of reducing child mortality by two thirds by 2015 will be reached. This paper highlights the implications of urban population growth and access to health and social services on progress in achieving MDG 4. Specifically, it examines trends in childhood mortality in SSA in relation to urban population growth, vaccination coverage and access to safe drinking water. Correlation methods are used to analyze national-level data from the Demographic and Health Surveys and from the United Nations. The analysis is complemented by case studies on intra-urban health differences in Kenya and Zambia. Only five of the 22 countries included in the study have recorded declines in urban child mortality that are in line with the MDG target of about 4% per year; five others have recorded an increase; and the 12 remaining countries witnessed only minimal decline. More rapid rate of urban population growth is associated with negative trend in access to safe drinking water and in vaccination coverage, and ultimately to increasing or timid declines in child mortality. There is evidence of intra-urban disparities in child health in some countries like Kenya and Zambia. Failing to appropriately target the growing sub-group of the urban poor and improve their living conditions and health status - which is an MDG target itself - may result in lack of improvement on national indicators of health. Sustained expansion of potable water supplies and vaccination coverage among the disadvantaged urban dwellers should be given priority in the efforts to achieve the child mortality MDG in SSA.

A household-based survey of knowledge, attitudes and practices towards dengue fever among local urban communities in Taiz Governorate, Yemen.

PubMed

Alyousefi, Thaker A A; Abdul-Ghani, Rashad; Mahdy, Mohammed A K; Al-Eryani, Samira M A; Al-Mekhlafi, Abdulsalam M; Raja, Yahia A; Shah, Shamusul Azhar; Beier, John C

2016-10-07

Yemen has witnessed several dengue fever outbreaks coincident with the social unrest and war in the country. The aim of the present study was to describe the knowledge, attitudes and practices (KAPs) of at-risk urban populations residing in Taiz, southwest of Yemen. In addition, factors possibly associated with poor preventive practices were investigated. A household-based, cross-sectional survey was conducted in three urban districts encompassing 383 households. Data on the socio-demographic characteristics and KAPs of the participating household heads were collected using a pre-designed, structured questionnaire. The association of socio-demographic characteristics, knowledge and attitudes of the population with poor preventive practices against dengue fever was then analyzed using logistic regression. More than 90.0 % of respondent household heads had correct knowledge about fever, headache and joint pain as common signs and symptoms of dengue fever. Moreover, muscular pain and bleeding were perceived by more than 80.0 % of the respondents as being associated with dengue fever; however, only 65.0 % of the respondents reported skin rash as a sign of dengue fever. More than 95.0 % of respondents agreed about the seriousness and possible transmission of dengue fever; however, negative attitudes regarding the facts of being at risk of the disease and that the infection is preventable were expressed by 15.0 % of respondents. Despite the good level of knowledge and attitudes of the respondent population, poor preventive practices were common. Bivariate analysis identified poor knowledge of dengue signs and symptoms (OR = 2.1, 95 % CI = 1.24-3.68; P = 0.005) and its vector (OR = 2.1, 95 % CI = 1.14-3.84; P = 0.016) as factors significantly associated with poor preventive practices. However, multivariable analysis showed that poor knowledge of the vector is an independent predictor of poor preventive practices of the population (adjusted OR = 2.1, 95 % CI = 1.14-3.84; P = 0.018). The majority of people in urban communities of Taiz have a clear understanding of most signs/symptoms of dengue fever as well as positive attitudes towards the seriousness and possible transmissibility of dengue fever. However, negative attitudes regarding their perception of the risk and possible prevention of the infection are prevailing among a small proportion of the population and need to be targeted by educational campaigns. It appears that the good level of the population knowledge of the signs/symptoms of dengue fever and the factors contributing to the spread and control of its vectors did not translate into good practices.

Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal.

PubMed

Kennedy, Gina; Nantel, Guy; Brouwer, Inge D; Kok, Frans J

2006-04-01

The purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas. Anthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0-59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting. In all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively. This paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

A new methodology for dynamic modelling of health risks arising from wastewater influenced urban flooding

NASA Astrophysics Data System (ADS)

Jørgensen, Claus; Mark, Ole; Djordjevic, Slobodan; Hammond, Michael; Khan, David M.; Erichsen, Anders; Dorrit Enevoldsen, Ann; Heinicke, Gerald; Helwigh, Birgitte

2015-04-01

Indroduction Urban flooding due to rainfall exceeding the design capacity of drainage systems is a global problem and it has significant economic and social consequences. While the cost of the direct flood damages of urban flooding is well understood, the indirect damages, like the water borne diseases is in general still poorly understood. Climate changes are expected to increase the frequency of urban flooding in many countries which is likely to increase water borne diseases. Diarrheal diseases are most prevalent in developing countries, where poor sanitation, poor drinking water and poor surface water quality causes a high disease burden and mortality, especially during floods. The level of water borne diarrhea in countries with well-developed water and waste water infrastructure has been reduced to an acceptable level, and the population in general do not consider waste water as being a health risk. Hence, exposure to wastewater influenced urban flood water still has the potential to cause transmission of diarrheal diseases. When managing urban flooding and planning urban climate change adaptations, health risks are rarely taken into consideration. This paper outlines a novel methodology for linking dynamic urban flood modelling with Quantitative Microbial Risk Assessment (QMRA). This provides a unique possibility for understanding the interaction between urban flooding and the health risks caused by direct human contact with flood water and provides an option for reducing the burden of disease in the population through the use of intelligent urban flood risk management. Methodology We have linked hydrodynamic urban flood modelling with quantitative microbial risk assessment (QMRA) to determine the risk of infection caused by exposure to wastewater influenced urban flood water. The deterministic model MIKE Flood, which integrates the sewer network model in MIKE Urban and the 2D surface model MIKE21, was used to calculate the concentration of pathogens in the flood water, based on either measured waste water pathogen concentrations or on assumptions regarding the prevalence of infections in the population. The exposure (dosage) to pathogens was estimated by multiplying the concentration with literature values for the ingestion of water for different exposure groups (e.g. children, adults). The probability of infection was determined by applying dose response relations and MonteCarlo simulation. The methodology is demonstrated on two cases, i.e one case from a developing country with poor sanitation and one case from a developed country, where climate adaptation is the main issue: The risk of cholera in the City of Dhaka, Bangladesh during a flood event 2004, and the risk of bacterial and viral infections of during a flood event in Copenhagen, Denmark in 2011. Results PIC The historical flood events in Dhaka (2004) and Copenhagen (2011) were successfully modelled. The urban flood model was successfully coupled to QMRA. An example of the results of the quantitative microbial risk assessment given as the average estimated risk of cholera infection for children below 5 years living in slum areas in Dhaka is shown in the figure. Similarly, the risk of infection during the flood event in Copenhagen will be presented in the article. Conclusions We have developed a methodology for the dynamic modeling of the risk of infection during waste water influenced urban flooding. The outcome of the modelling exercise indicates that direct contact with polluted flood water is a likely route of transmission of cholera in Dhaka, and bacterial and viral infectious diseases in Copenhagen. It demonstrates the applicability and the potential for linking urban flood models with QMRA in order to identify interventions to reduce the burden of disease on the population in Dhaka City and Copenhagen.

Planning Science Instruction for Critical Thinking: Two Urban Elementary Teachers' Responses to a State Science Assessment

ERIC Educational Resources Information Center

Mangiante, Elaine Silva

2013-01-01

Science education reform standards have shifted focus from exploration and experimentation to evidence-based explanation and argumentation to prepare students with knowledge for a changing workforce and critical thinking skills to evaluate issues requiring increasing scientific literacy. However, in urban schools serving poor, diverse populations,…

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Why women choose to give birth at home: a situational analysis from urban slums of Delhi

PubMed Central

Devasenapathy, Niveditha; George, Mathew Sunil; Ghosh Jerath, Suparna; Singh, Archna; Negandhi, Himanshu; Alagh, Gursimran; Shankar, Anuraj H; Zodpey, Sanjay

2014-01-01

Objectives Increasing institutional births is an important strategy for attaining Millennium Development Goal -5. However, rapid growth of low income and migrant populations in urban settings in low-income and middle-income countries, including India, presents unique challenges for programmes to improve utilisation of institutional care. Better understanding of the factors influencing home or institutional birth among the urban poor is urgently needed to enhance programme impact. To measure the prevalence of home and institutional births in an urban slum population and identify factors influencing these events. Design Cross-sectional survey using quantitative and qualitative methods. Setting Urban poor settlements in Delhi, India. Participants A house-to-house survey was conducted of all households in three slum clusters in north-east Delhi (n=32 034 individuals). Data on birthing place and sociodemographic characteristics were collected using structured questionnaires (n=6092 households). Detailed information on pregnancy and postnatal care was obtained from women who gave birth in the past 3 months (n=160). Focus group discussions and in-depth interviews were conducted with stakeholders from the community and healthcare facilities. Results Of the 824 women who gave birth in the previous year, 53% (95% CI 49.7 to 56.6) had given birth at home. In adjusted analyses, multiparity, low literacy and migrant status were independently predictive of home births. Fear of hospitals (36%), comfort of home (20.7%) and lack of social support for child care (12.2%) emerged as the primary reasons for home births. Conclusions Home births are frequent among the urban poor. This study highlights the urgent need for improvements in the quality and hospitality of client services and need for family support as the key modifiable factors affecting over two-thirds of this population. These findings should inform the design of strategies to promote institutional births. PMID:24852297

Why women choose to give birth at home: a situational analysis from urban slums of Delhi.

PubMed

Devasenapathy, Niveditha; George, Mathew Sunil; Ghosh Jerath, Suparna; Singh, Archna; Negandhi, Himanshu; Alagh, Gursimran; Shankar, Anuraj H; Zodpey, Sanjay

2014-05-22

Increasing institutional births is an important strategy for attaining Millennium Development Goal -5. However, rapid growth of low income and migrant populations in urban settings in low-income and middle-income countries, including India, presents unique challenges for programmes to improve utilisation of institutional care. Better understanding of the factors influencing home or institutional birth among the urban poor is urgently needed to enhance programme impact. To measure the prevalence of home and institutional births in an urban slum population and identify factors influencing these events. Cross-sectional survey using quantitative and qualitative methods. Urban poor settlements in Delhi, India. A house-to-house survey was conducted of all households in three slum clusters in north-east Delhi (n=32 034 individuals). Data on birthing place and sociodemographic characteristics were collected using structured questionnaires (n=6092 households). Detailed information on pregnancy and postnatal care was obtained from women who gave birth in the past 3 months (n=160). Focus group discussions and in-depth interviews were conducted with stakeholders from the community and healthcare facilities. Of the 824 women who gave birth in the previous year, 53% (95% CI 49.7 to 56.6) had given birth at home. In adjusted analyses, multiparity, low literacy and migrant status were independently predictive of home births. Fear of hospitals (36%), comfort of home (20.7%) and lack of social support for child care (12.2%) emerged as the primary reasons for home births. Home births are frequent among the urban poor. This study highlights the urgent need for improvements in the quality and hospitality of client services and need for family support as the key modifiable factors affecting over two-thirds of this population. These findings should inform the design of strategies to promote institutional births. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

PubMed Central

2012-01-01

Introduction In recent years, the country of Mongolia (population 2.8 million) has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy) to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons from Mongolia mirror other international studies which point to the need to measure and take action on the social determinants of health at the local area level in order to adequately reduce persistent inequities in health care access for the urban poor. PMID:22429615

The World Bank and poverty.

PubMed

Lipton, M; Shakow, A

1982-06-01

During the 1970s it was World Bank policy to use its funds to raise the productivity and living standards of the poor. It has increased its lending for sector and subsectors considered to offer the most direct benefits to the poor such as rural development, population, health, and nutrition. Projects with particular emphasis on poverty have benefitted large numbers of poor people and have had good economic rates of return. Lending for rural projects increased in the 1970s from US$2.6 billion in 1969-73 to over US$13 billion in 1978-81; rural development projects audited in 1979 benfitted 660 small farmers for every US$1 million loaned compared with 47 farmers/US$1 million in other agricultural projects. Some problems are: 1) low-risk technical packages appropriate for poor farmers in semi-arid rainfed areas are not readily available; 2) the Bank's rural development strategy seeks mainly to raise the production of small farms, but other aspects need to be emphasized; 3) domestic pricing and postharvest policies often undermine the success of projects aimed at the rural poor; and 4) success in rural development often rests on sociological and cultural factors, difficult areas that deserve more attention. For urban areas the Bank has strongly endorsed providing "sites and sources" instead of structures; since 1972, 52 Bank projects centered on urban shelter involving US$1.6 billion have been undertaken. Cost recovery is established at 66-95%. About 5% of Bank lending is for education and despite the importance of population, health, and nutrition, these areas absorb less than 1% of the Bank's total lending program. Only US$400 million in population loans were made to 13 countries in the 1970s and only recently have separate health projects been started. Emphasis for the 1980s must be on rural development, urban shelter, primary education, health, education, and population.

Development of quality of life instrument for urban poor in the northeast of Thailand.

PubMed

Surit, Phrutthinun; Laohasiriwong, Wongsa; Sanchaisuriya, Pattara; Schelp, Frank Perter

2008-09-01

Measuring the quality of life is important for evaluation and prediction of life and social care needs. To evaluate Quality of Life (QOL) in an urban poor population in northeast of Thailand, the Urban Poor Quality of Life (UPQOL) instrument was developed To develop an initial instrument to measure urban poor QOL. The development was started with literature review and investigated in urban poor communities. The results were transformed into the items required to build a structured questionnaire. Five hundred twenty three subjects, representatives of urban poor, were selected to test this instrument. Descriptive statistics described feature of items and the samples, exploratory factor analysis conducted the items score, and confirmatory factor analysis conducted the construct validity. The result found that the UPQOL instrument consisted of nine domains (education, income and employment, environment, health, infrastructure, security and safety, shelter and housing, civil society and political, and human rights domains) with egien value rank from 1.5 to 4.2 and 61 items with the factor loading rank from 0.41 to 0.82. The internal consistency was 0.92. The correlation between items to domain ranged from 0.30 to 0.72 and domains to overall QOL ranged from 0.27 to 0.84. Confirmatory factor analysis showed that the structure fit all domains well. Domains and overall structure were good with CFI (> 0.95). The internal consistency value ranged from 0.73-0.93. UPQOL scores were able to discriminate groups of subjects with differences levels of QOL. The UPQOL instrument is conceptually valid. The results support good validity and reliability. It forms the basis for future testing and application in other settings.

The Health Challenges of Urban Latino College Students as Revealed through Student Journaling

ERIC Educational Resources Information Center

Rowland, Amy L.

2008-01-01

Because of the unique health risks faced by the Hispanic population and the notoriously poor health habits of college students, this study examines the health challenges faced by Latino college students enrolled at an urban commuter institution. A thematic analysis reveals the top themes for males and females as healthy eating, weight management,…

Nutritional disparities among women in urban India.

PubMed

Agarwal, Siddharth; Sethi, Vani

2013-12-01

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/ severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban population. Receipt of pre- and postnatal nutrition and health education and compliance to iron folic acid tablets during pregnancy was low across all quartiles. One-fourth (24.5%) of households in the lowest urban quartile consumed salt with no iodine content, which was 2.8 times higher than rest of the urban population (8.7%). The study highlights the need to use poor-specific urban data for planning and suggests (i) routine field assessment of maternal nutritional status in outreach programmes, (ii) improving access to food subsidies, subsidized adequately-iodized salt and food supplementation programmes, (iii) identifying alternative iron supplementation methods, and (iv) institutionalizing counselling days.

Nutritional Disparities among Women in Urban India

PubMed Central

Sethi, Vani

2013-01-01

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban population. Receipt of pre- and postnatal nutrition and health education and compliance to iron folic acid tablets during pregnancy was low across all quartiles. One-fourth (24.5%) of households in the lowest urban quartile consumed salt with no iodine content, which was 2.8 times higher than rest of the urban population (8.7%). The study highlights the need to use poor-specific urban data for planning and suggests (i) routine field assessment of maternal nutritional status in outreach programmes, (ii) improving access to food subsidies, subsidized adequately-iodized salt and food supplementation programmes, (iii) identifying alternative iron supplementation methods, and (iv) institutionalizing counselling days. PMID:24592595

Poverty in Rural America: Trends and Demographic Characteristics. Chapter 1.

ERIC Educational Resources Information Center

Hoppe, Robert

This chapter examines recent trends in rural poverty and discusses some characteristics of the rural poor compared to the urban poor. Sources of poverty data for 1967-90 include the income supplement of the Census Bureau's annual Current Population Survey and personal income data compiled by the Bureau of Economic Analysis. "Rural" and…

Environment, wealth, inequality and the burden of disease in the Accra metropolitan area, Ghana.

PubMed

Boadi, Kwasi Owusu; Kuitunen, Markku

2005-06-01

The study examines environmental problems and adverse impacts on the health of urban households in the Accra metropolitan area, Ghana. Accra is faced with severe inadequacy of urban infrastructure in the face of rapid population growth in the metropolis. More than half of the city's population do not have access to solid waste collection services. Only 39.8% of households have indoor pipe and over 35.0% of households depend on unsanitary public latrines whilst 2.5% do not have access to toilet facilities. Human excrement, garbage and wastewater are usually deposited in surface drains, open spaces and streams in poor neighbourhoods. The resultant poor sanitation has serious health impacts as more than half of reported diseases are related to poor environmental sanitation. The majority of households depend on solid fuels for cooking and this leads to indoor air pollution and high incidence of respiratory infections. Poor households bear a disproportionately large share of the burden of environmental health hazards than their wealthy counterparts, due to their particular vulnerability resulting from inadequate access to environmental health facilities and services.

Gambling participation and problem gambling severity among rural and peri-urban poor South African adults in KwaZulu-Natal.

PubMed

Dellis, Andrew; Spurrett, David; Hofmeyr, Andre; Sharp, Carla; Ross, Don

2013-09-01

Poor South Africans are significantly poorer and have lower employment rates than the subjects of most published research on gambling prevalence and problem gambling. Some existing work suggests relationships between gambling activity (including severity of risk for problem gambling), income, employment status and casino proximity. The objective of the study reported here is to establish the prevalence of gambling, including at risk and pathological gambling, and the profile of gambling activities in two samples of poor South African adults living in a rural and a peri-urban community. A total of 300 (150 male, 150 female) adults in KwaZulu-Natal, South Africa in communities selected using census data, completed the Problem Gambling Severity Index and a survey of socioeconomic and household information, and of gambling knowledge and activity. It was found that gambling was common, and-except for lottery participation-mostly informal or unlicensed. Significant differences between rural and peri-urban populations were found. Peri-urban subjects were slightly less poor, and gambled more and on a different and wider range of activities. Problem and at risk gamblers were disproportionately represented among the more urbanised. Casino proximity appeared largely irrelevant to gambling activity.

"Too much moving...there's always a reason": Understanding urban Aboriginal peoples' experiences of mobility and its impact on holistic health.

PubMed

Snyder, Marcie; Wilson, Kathi

2015-07-01

Urban Indigenous peoples face a disproportionate burden of ill health compared to non-Indigenous populations, and experience more frequent geographic mobility. However, most of what is known about Indigenous health is limited to rural, northern, or in the case of Canada, reserve-based populations. Little is known about the complexities of urban Indigenous health, and the differential impacts of residential mobility and urban migration remain poorly understood. Drawing upon interviews with Aboriginal movers and service providers in Winnipeg, Canada, we apply a critical population health lens, informed by holistic health, to examine these impacts. The results demonstrate mobility is an intergenerational phenomenon, influenced by colonial practices. While migration can contribute to positive health experiences, residential mobility, which is largely involuntary, and linked to stressors such as neighborhood safety, results in negative health effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity.

PubMed

Tatem, Andrew J; Guerra, Carlos A; Kabaria, Caroline W; Noor, Abdisalan M; Hay, Simon I

2008-10-27

The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP) global database of Plasmodium falciparum parasite rate (PfPR) surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately. First, an existing population surface was examined to determine if it was sufficiently detailed to be used reliably as a mask to identify areas of very low and very high population density as malaria free regions. Second, the potential of international travel and health guidelines (ITHGs) for identifying malaria free cities was examined. Third, the differences in PfPR values between surveys conducted in author-defined rural and urban areas were examined. Fourth, the ability of various global urban extent maps to reliably discriminate these author-based classifications of urban and rural in the PfPR database was investigated. Finally, the urban map that most accurately replicated the author-based classifications was analysed to examine the effects of urban classifications on PfPR values across the entire MAP database. Masks of zero population density excluded many non-zero PfPR surveys, indicating that the population surface was not detailed enough to define areas of zero transmission resulting from low population densities. In contrast, the ITHGs enabled the identification and mapping of 53 malaria free urban areas within endemic countries. Comparison of PfPR survey results showed significant differences between author-defined 'urban' and 'rural' designations in Africa, but not for the remainder of the malaria endemic world. The Global Rural Urban Mapping Project (GRUMP) urban extent mask proved most accurate for mapping these author-defined rural and urban locations, and further sub-divisions of urban extents into urban and peri-urban classes enabled the effects of high population densities on malaria transmission to be mapped and quantified. The availability of detailed, contemporary census and urban extent data for the construction of coherent and accurate global spatial population databases is often poor. These known sources of uncertainty in population surfaces and urban maps have the potential to be incorporated into future malaria burden estimates. Currently, insufficient spatial information exists globally to identify areas accurately where population density is low enough to impact upon transmission. Medical intelligence does however exist to reliably identify malaria free cities. Moreover, in Africa, urban areas that have a significant effect on malaria transmission can be mapped.

Republic of Senegal. Country profile.

PubMed

Gold, D

1985-04-01

The demographic and economic characteristics and some of the cultural traditions of the Republic of Senegal are described. Senegal obtained its independence from France in 1960. Despite the fact that the majority of the population derives its living from agriculture, the country must import additional food staples to feed its population. Conditions contributing to poor crop yields in recent years include 1) the frequent occurrence of droughts, 2) soil depletion caused by overintensive cultivation practices, and 3) land dessication caused by poor forestry management. In 1984 crop yields were only 10% of the normal crop yields. The government under the leadership of the president, Adbou Diouf, is currently developing plans to improve agricultural conditions and to encourage the industrial development of the country. The tourist industry is also growing. In 1976 Senegal conducted it 1st national census. According to the census the total population was 5,068,741 and the population growth rate was 2.6%. The US Census Bureau estimates that the population growth rate is now 3.2% and that 654,000 people were added to the population between 1976 and 1985. 27% of the population is urban, and the majority of the urban population resides in Dakar. In recent years, the rate of rural to urban migration increased rapidly as a result of the deteriorating agricultural conditions. The population is unevenly distributed throughout the country; 82% of the population lives in 39% of the country's territory. In 1977, 18% of the population lived in housing with electricity, and in 1983, 37% of the population lived in housing with running water. Most rural residents live in villages consisting of clusters of clay structures with thatched roofs and dirt floors. Most of the urban poor live in crowded shantytowns, which lack urban services. More than 1/2 of the population is under the age of 18. According to the 1978 World Fertility Survey, 83% of all women of reproductive age are married, and 48% of these women live in polygamous unions. Children are viewed as gifts form God, and 53% of the respondents in the fertility study said that the ideal family size was 9 or more. In 1976, the literacy rate was 28% for males and 17% for females. Radio is the most popular form of mass media. French is the official language, but only 15% of the population can speak or write French. 80% of the population speaks Wolof, a native dialect. Predominant ethnic groups are the Wolof, Serer, Peul, and Tuouleur. The country has a relatively high foreign population, and Islam is the religion of 80% of the population. 69% of the country's active male population is engaged in agriculture, fishing, or hunting, 14% are laborers or machine operators, and 4% are employed in the commercial sector. Approximately 800,000 women are gainfully employed, primarily as domestic servants. This document also provides the names and addresses of a number of organizations and agencies from which additional information on Senegal can be obtained.

Urbanization influences on aquatic communities in northeastern Illinois streams

USGS Publications Warehouse

Fitzpatrick, F.A.; Harris, M.A.; Arnold, T.L.; Richards, K.D.

2004-01-01

Biotic indices and sediment trace element concentrations for 43 streams in northeastern Illinois (Chicago area) from the 1980s and 1990s were examined along an agricultural to urban land cover gradient to explore the relations among biotic integrity, sediment chemistry, and urbanization. The Illinois fish Alternative Index of Biotic Integrity (AIBI) ranged from poor to excellent in agricultural/rural streams, but streams with more than 10 percent watershed urban land (about 500 people/mi2) had fair or poor index scores. A macroinvertebrate index (MBI) showed similar trends. A qualitative habitat index (PIBI) did not correlate to either urban indicator. The AIBI and MBI correlated with urban associated sediment trace element concentrations. Elevated copper concentrations in sediment occurred in streams with greater than 40 percent watershed urban land. The number of intolerant fish species and modified index of biotic integrity scores increased in some rural, urbanizing, and urban streams from the 1980s to 1990s, with the largest increases occurring in rural streams with loamy/sandy surficial deposits. However, smaller increases also occurred in urban streams with clayey surficial deposits and over 50 percent watershed urban land. These data illustrate the potentially complex spatial and temporal relations among biotic integrity, sediment chemistry, watershed urban land, population density, and regional and local geologic setting.

Assessing gaps and poverty-related inequalities in the public and private sector family planning supply environment of urban Nigeria.

PubMed

Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S

2014-02-01

Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study

PubMed Central

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-01-01

Objectives Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Setting Urban poor community in the Southeast district of Delhi, India. Participants We randomly sampled 1849 children aged 1–3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria–pertussis–tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers’ recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Results Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Conclusions Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. Trial registration number CTRI/2011/091/000095. PMID:27566644

[Trends and characteristics of urbanization in the Third World, the day before yesterday to the day after tomorrow (1900-2025)].

PubMed

Bairoch, P

1983-01-01

This article reviews the history of Third World urbanization, examines the evolution of the urban population from 1970-80 based on the 1st results of the 1980 round of censuses, and examines the prospects for urbanization through the end of the century and the year 2025. From 1910 to World War II the urban population in all Third World countries grew more rapidly than the total population. Both rates of growth were moderate compared to subsequent rates. Total Third World population grew by about .9%/year while the urban population grew at 2.2%/year. From 1950-80 total population grew at 2.2% and the urban population by 4.6%. The urban growth took place in the absence of economic developments capable of explaining or justifying it. Urban growth accounted in large part for the extraordinary increase in cereal importation to the Third World. In 1980 it was estimated that 26.5% of the population if Africa, 63.1% in Latin America, and 25.4% in Asian countries excluding China were urban. A characteristic of third World urbanization is the strong concentration of population in large cities; 43% of the urban population currently lives in cities with population of over 500,000. In Third World market countries, total population growth from 1970-80 is provisionally estimated at 2.5-2.6%/year, while according to UN estimates urban population growth amounted to 4.2%/year and other estimates place population growth amounted to 4.2%/year and other estimates place it at 4.4%/year. The growth of the urban population in China from 1970-80 was estimated at 3.3%/year by the UN. During the 75 years from 1950-2025, the Third World urban population is expected to multiply by a factor of 16, from less than 200 million to over 3 billion. The urban population in 2025 projected by the UN amounts to 837 million in Africa, 724 million in Latin America, and 1.6 billion in Asian market countries, but there is some suggestion that the projection errs on the low side. Increases in food production on the order of 1.9%/year will be required through 2025 to feed the new urban population at the current level. Around the year 2000, cities of 1 million or more will contain about 46% of the urban population and 21% of the total population. The largest Third World cities will continue to grow despite their poor living conditions and lack of economic justification, and the low incomes of the inhabitants will increase the difficulty of improving living standards. Predictions as far ahead as 2025 are hazardous, but it is likely that the rate of growth of the largest cities will have abated somewhat.

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

PubMed Central

Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

1997-01-01

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

Soil-transmitted helminth infection and urbanization in 880 primary school children in Nicaragua, 2005.

PubMed

Rosewell, Alexander; Robleto, Guillermo; Rodríguez, Guillermo; Barragne-Bigot, Philippe; Amador, Juan José; Aldighieri, Sylvain

2010-07-01

The prevalence of soil-transmitted helminthiasis is close to half the population in Central America, with the marginalized peri-urban poor disproportionately affected. Previous single province helminth surveys conducted in Nicaragua have shown Ascaris lumbricoides to be the predominant species. In 2005, we conducted a cross-sectional study of 880 children in 10 Nicaraguan primary schools located in four provinces. We aimed to establish the prevalence and intensity of soil-transmitted helminth infections and to investigate the factors associated with helminthiasis. Almost half (46%) of the children were infected with soil-transmitted helminths. Tichuris trichiura was the most common infective species (34.7%). The prevalence and intensity of helminthiasis was heterogeneous in the provinces, with children educated in peri-urban schools most affected. Healthy policies are required that favour the peri-urban poor who have inadequate and declining access to water and sanitation.

Overweight and obesity prevalence among Indian women by place of residence and socio-economic status: Contrasting patterns from 'underweight states' and 'overweight states' of India.

PubMed

Sengupta, Angan; Angeli, Federica; Syamala, Thelakkat S; Dagnelie, Pieter C; van Schayck, C P

2015-08-01

Evidence from developing countries demonstrates a mixed relationship of overweight/obesity with socioeconomic status (SES) and place of residence. Theory of nutrition transition suggests that over the course of development, overweight first emerges among rich and urban people before spreading among rural and poor people. India is currently experiencing a rapid rise in the proportion of overweight and obese population especially among adult women. Under the backdrop of huge socio-economic heterogeneity across the states of India, the inter-state scenario of overweight and obesity differs considerably. Hence, this paper investigates the evolution over time of overweight and obesity among ever-married Indian women (15-49 years) from selected 'underweight states' (Bihar, Orissa and Madhya Pradesh, where underweight proportion is predominant) and 'overweight states' (Kerala, Delhi and Punjab, where overweight is the prime concern), in relation to a few selected socio-economic and demographic indicators. This study analysed National Family Health Surveys- NFHS-2 (1998-99) and NFHS-3 (2005-06) following Asian population specific BMI cut-offs for overweight and obesity. The results confirm that within India itself the relationship of overweight and obesity with place of residence and SES cannot be generalized. Results from 'overweight states' show that the overweight problem has started expanding from urban and well-off women to the poor and rural people, while the rural-urban and rich-poor difference has disappeared. On the other hand in 'underweight states' overweight and obesity have remained socially segregated and increasing strongly among urban and richer section of the population. The rate of rise of overweight and obesity has been higher in rural areas of 'OW states' and in urban areas of 'UW states'. Indian policymakers thus need to design state-specific approaches to arrest the rapid growth of overweight and its penetration especially towards under-privileged section of the society. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rural-urban disparity in oral health-related quality of life.

PubMed

Gaber, Amal; Galarneau, Chantal; Feine, Jocelyne S; Emami, Elham

2018-04-01

The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes, specifically for rural residents. Further studies are needed to confirm these results. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Challenges to achieving sustainable sanitation in informal settlements of Kigali, Rwanda.

PubMed

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-12-10

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city's population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements.

Geographically pervasive effects of urban noise on frequency and syllable rate of songs and calls in silvereyes (Zosterops lateralis).

PubMed

Potvin, Dominique A; Parris, Kirsten M; Mulder, Raoul A

2011-08-22

Recent studies in the Northern Hemisphere have shown that songbirds living in noisy urban environments sing at higher frequencies than their rural counterparts. However, several aspects of this phenomenon remain poorly understood. These include the geographical scale over which such patterns occur (most studies have compared local populations), and whether they involve phenotypic plasticity or microevolutionary change. We conducted a field study of silvereye (Zosterops lateralis) vocalizations over more than 1 million km(2) of urban and rural south-eastern Australia, and compared possible effects of urban noise on songs (which are learned) and contact calls (which are innate). Across 14 paired urban and rural populations, silvereyes consistently sang both songs and contact calls at higher frequencies in urban environments. Syllable rate (syllables per second) decreased in urban environments, consistent with the hypothesis that reflective structures degrade song and encourage longer intervals between syllables. This comprehensive study is, to our knowledge, the first to demonstrate varied adaptations of urban bird vocalizations over a vast geographical area, and to provide insight into the mechanism responsible for these changes.

Social Construction of a Segregated Urban Space and Its Effects on Education: A Case Study of the Balmikis of Delhi

ERIC Educational Resources Information Center

Ganguly, Sriti

2018-01-01

While segregation of Dalit habitations is assumed to be a characteristic primarily of the rural, studies indicate that a similar spatial organisation is reproduced in urban spaces as well where large populations, particularly of poor Dalits, continue to live in segregated settlements. This article draws on an exploratory study conducted in one…

Civil society organizations: capacity to address the needs of the urban poor in Nairobi.

PubMed

Ekirapa, Akaco; Mgomella, George S; Kyobutungi, Catherine

2012-11-01

We conducted a needs assessment that describes the landscape of civil society organizations (CSOs) in three informal settlements around Nairobi, Kenya. The numbers of CSOs have rapidly increased in areas underserved by governments including poor urban neighbourhoods but little is known about CSOs capacity to meet the priority health needs of the urban poor. It is also unclear why, despite a proliferation of CSOs, residents still experience unimproved health outcomes. We collected data on core activities, financial management, and governance structures. Of the 952 CSOs assessed, 47 per cent reported HIV/AIDS counselling, prevention, and treatment as their core activity. Most CSOs reported good financial management systems and governance structures but responses were not validated. Representation in district health stakeholder fora was low; most CSOs did not have the capacity to effectively deliver services that would have impact. For CSOs to realize the desired goal to improve the well-being of low-income populations, programmes to build their management capacity are essential.

Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Allen, Elizebeth; Sharma, Saket; Shankar, Anuraj H; Zodpey, Sanjay

2015-09-08

Disparity in utilization of reproductive healthcare services between the urban poor and the urban non-poor households in the developing nations is well known. However, disparity may also exist within urban poor households. Our objective was to document the extent of disparity in reproductive healthcare utilization among the urban poor and to identify the socio-demographic determinants of underutilization with a view to characterizing this vulnerable subpopulation. A survey of 16,221 households was conducted in 39 clusters from two large urban poor settlements in Delhi. From 13,451 consenting households, socio-demographic data and information on births, maternal and child deaths within the previous year was collected. Details of antenatal care (ANC) was collected from 597 pregnant women. Information on ANC and postnatal care was also obtained from 596 recently delivered (within six months) mothers. All data were captured electronically using a customized and validated smart phone application. Households were categorized into quintiles of socio-economic position (SEP) based on dwelling characteristics and possession of durable assets using principal component analysis. Potential socio-demographic determinants of reproductive healthcare utilization were examined using random effects logistic regression. The prevalence of facility based birthing was 77% (n = 596 mothers). Of the 596 recently delivered mothers only 70% had an ANC registration card, 46.3% had ANC in their first trimester, 46% had visited a facility within 4 weeks post-delivery and 27% were using modern contraceptive methods. Low socio-economic position was the most important predictor of underutilization with a clear gradient across SEP quintiles. Compared to the poorest, the least poor women were more likely to be registered for ANC (OR 1.96, 95%CI 0.95-4.15) and more likely to have made ≥ 4 ANC visits (OR 5.86, 95%CI 2.82-12.19). They were more likely to have given birth in a facility (OR 4.87, 95%CI 2.12-11.16), to have visited a hospital within one month of childbirth (OR 3.18, 95%CI 1.62-6.26). In general, government funded health insurance and conditional cash transfers schemes were underutilized in this community. The poorest segment of the urban poor population utilizes reproductive healthcare facilities the least. Strategies to improve access and utilization of healthcare services among the poorest of the poor may be necessary to achieve universal health coverage.

Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

PubMed

Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

2006-01-01

Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

Challenges to Achieving Sustainable Sanitation in Informal Settlements of Kigali, Rwanda

PubMed Central

Tsinda, Aime; Abbott, Pamela; Pedley, Steve; Charles, Katrina; Adogo, Jane; Okurut, Kenan; Chenoweth, Jonathan

2013-01-01

Like most cities in developing countries, Kigali is experiencing rapid urbanisation leading to an increase in the urban population and rapid growth in the size and number of informal settlements. More than 60% of the city’s population resides in these settlements, where they experience inadequate and poor quality urban services including sanitation. This article discusses the issues and constraints related to the provision of sustainable sanitation in the informal settlements in Kigali. Two informal settlements (Gatsata and Kimisagara) were selected for the study, which used a mixed method approach for data collection. The research found that residents experienced multiple problems because of poor sanitation and that the main barrier to improved sanitation was cost. Findings from this study can be used by the city authorities in the planning of effective sanitation intervention strategies for communities in informal settlements. PMID:24336021

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-08-26

Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Urban poor community in the Southeast district of Delhi, India. We randomly sampled 1849 children aged 1-3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria-pertussis-tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers' recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. CTRI/2011/091/000095. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

How mid-sized cities can avoid strangulation.

PubMed

O'meara, M

1998-01-01

This article illustrates the success of two cities--Portland, Oregon, and Curitiba, Brazil--in managing urban growth and the problems that accompany growth (traffic congestion, pollution, psychological stress, and chaotic development). The world's 14 megacities are home to 7.6% of the global urban population, while the 195 mid-sized cities are inhabited by 31% of the global urban population. The above two cities (1-2.5 million inhabitants) resisted the destruction of old neighborhoods for new highways. Portland and Curitiba are global models of successful management and livability and demonstrate economic viability, social cohesiveness, and environmental health. These cities used unique approaches to social and economic inequities. In Curitiba, the poor have the same purchasing power as in Sao Paulo, but life is bearable because of its level of services. Portland has avoided a concentration of poor in the central city. Both cities have active streets with a mix of shops, factories, offices, and houses. Cities deteriorate when geographic layouts reduce social interaction between rich and poor, people and services, and internal building viability vs. external building decay. Both cities enhance public space and cut urban sprawl. Transportation and other systems accommodate fringe settlements and restrict growth in environmentally sensitive areas. Parks and trees make each city visually attractive. Portland has laws limiting housing growth. Planning minimizes private car use and maximizes pedestrian welfare. Portland's political system was key to planning. Curitiba suffers from lack of coordination with other cities and is at the mercy of state and federal funding. Curitiba has succeeded by making practical policy decisions.

Climate change and developing-country cities: implications for environmental health and equity.

PubMed

Campbell-Lendrum, Diarmid; Corvalán, Carlos

2007-05-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity.

The contribution of poor and rural populations to national trends in reproductive, maternal, newborn, and child health coverage: analyses of cross-sectional surveys from 64 countries.

PubMed

Victora, Cesar G; Barros, Aluisio J D; França, Giovanny V A; da Silva, Inácio C M; Carvajal-Velez, Liliana; Amouzou, Agbessi

2017-04-01

Coverage levels for essential interventions aimed at reducing deaths of mothers and children are increasing steadily in most low-income and middle-income countries. We assessed how much poor and rural populations in these countries are benefiting from national-level progress. We analysed trends in a composite coverage indicator (CCI) based on eight reproductive, maternal, newborn, and child health interventions in 209 national surveys in 64 countries, from Jan 1, 1994, to Dec 31, 2014. Trends by wealth quintile and urban or rural residence were fitted with multilevel modelling. We used an approach akin to the calculation of population attributable risk to quantify the contribution of poor and rural populations to national trends. From 1994 to 2014, the CCI increased by 0·82 percent points a year across all countries; households in the two poorest quintiles had an increase of 0·99 percent points a year, which was faster than that for the three wealthiest quintiles (0·68 percent points). Gains among poor populations were faster in lower-middle-income and upper-middle-income countries than in low-income countries. Globally, national level increases in CCI were 17·5% faster than they would have been without the contribution of the two poorest quintiles. Coverage increased more rapidly annually in rural (0·93 percent points) than urban (0·52 percent points) areas. National coverage gains were accelerated by important increases among poor and rural mothers and children. Despite progress, important inequalities persist, and need to be addressed to achieve the Sustainable Development Goals. UNICEF, Wellcome Trust. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Freshwater mussels in an urban watershed: Impacts of anthropogenic inputs and habitat alterations on populations.

PubMed

Gillis, Patricia L; McInnis, Rodney; Salerno, Joseph; de Solla, Shane R; Servos, Mark R; Leonard, Erin M

2017-01-01

The substantial increase in urbanization worldwide has resulted in higher emissions of wastewater to riverine systems near urban centers, which often impairs aquatic populations and communities. This study examined the effect of urbanization on freshwater mussel populations, including Species at Risk in two rivers receiving wastewater. The influence of anthropogenic activities was assessed in a watershed in the Laurentian Great Lakes basin, one that historically supported one of the most diverse mussel faunas in Canada. In the Grand River (ON), four sites along a 60km reach spanning from an upstream reference site to an urban-impacted downstream area were examined. In the Speed River, mussel populations at six sites along a 10km reach, selected to bracket specific anthropogenic inputs and structures were assessed. A semi-quantitative visual search method revealed that catch per unit effort in the Grand River declined by >60% from the upstream reference site to the area downstream of an urban center. The size (length) frequency distribution of the most abundant species, Lasmigona costata, was significantly (p≤0.008) different upstream of the majority of urban inputs (45-130mm) compared to downstream of the cities (85-115mm). In the Speed River, impoundments and wastewater treatment plants (WWTP) reduced both the diversity and catch per effort. Most striking were 84 and 95% changes in the number of mussels found on either side of two impoundments, and a 98% drop in mussels immediately downstream of a WWTP outfall. These population level effects of decreased abundance and underrepresentation of smaller mussels downstream of the urban area correspond to previously documented impacts at the biochemical and whole organism level of biological organization in wild mussels at this location. Our results demonstrate that poor water quality and physical barriers in urban environments continue to impair susceptible populations and communities of aquatic animals. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Geochemical Legacies and the Future Health of Cities: An Analysis of two Neurotoxins in Urban Soils

NASA Astrophysics Data System (ADS)

Filippelli, G. M.; Risch, M.

2015-12-01

The past and future of cities are inextricably linked, a linkage that can be seen clearly in the long-term impacts of urban geochemical legacies. As loci of population as well as the means of employment and industry to support these populations, cities have a long history of co-locating contaminating practices and people, sometimes with negative implications for human health. Working at the intersection between geochemical processes, communities, and human health is critical to grapple with environmental legacies and to support healthy, sustainable, and growing urban populations. An emerging area of environmental health research is to understand the impacts of chronic exposures and exposure mixtures—these impacts are very poorly studied, yet have materialized as perhaps the greatest threat to large-scale population health. Acute exposure to lead (Pb), a powerful neurotoxin to which children are particularly susceptible, has largely been eliminated in the U.S. and other countries through policy-based restrictions on leaded gasoline and lead-based paints. But these legacy Pb sources are still around in the form of surface soil Pb contamination, a common problem in cities and one that has only recently emerged as a pernicious and widespread chronic exposure mechanism in cities. Some urban soils are also contaminated with another neurotoxin, mercury (Hg), although very little work has been done to understand human exposures to low levels of this element in soils. The most documented human exposure to Hg is through fish consumption, so eating fish caught in urban areas presents risks for above average dietary Hg exposure. The potential double impact of chronic exposure to these two neurotoxins is pronounced in cities. Many aspects of the dose-response curves for individual elements and mixtures are poorly understood, especially at lower levels, leaving unanswered several interesting and provocative questions about environmental impacts on neurological and developmental disorders.

Effects of urbanization on host-pathogen interactions, using Yersinia in house sparrows as a model

PubMed Central

Strubbe, Diederik; Teyssier, Aimeric; Salleh Hudin, Noraine; Van den Abeele, Anne-Marie; Cox, Ivo; Haesendonck, Roel; Delmée, Michel; Haesebrouck, Freddy; Pasmans, Frank; Lens, Luc; Martel, An

2017-01-01

Urbanization strongly affects biodiversity, altering natural communities and often leading to a reduced species richness. Yet, despite its increasingly recognized importance, how urbanization impacts on the health of individual animals, wildlife populations and on disease ecology remains poorly understood. To test whether, and how, urbanization-driven ecosystem alterations influence pathogen dynamics and avian health, we use house sparrows (Passer domesticus) and Yersinia spp. (pathogenic for passerines) as a case study. Sparrows are granivorous urban exploiters, whose western European populations have declined over the past decades, especially in highly urbanized areas. We sampled 329 house sparrows originating from 36 populations along an urbanization gradient across Flanders (Belgium), and used isolation combined with ‘matrix-assisted laser desorption ionization- time of flight mass spectrometry’ (MALDI-TOF MS) and PCR methods for detecting the presence of different Yersinia species. Yersinia spp. were recovered from 57.43% of the sampled house sparrows, of which 4.06%, 53.30% and 69.54% were identified as Y. pseudotuberculosis, Y. enterocolitica and other Yersinia species, respectively. Presence of Yersinia was related to the degree of urbanization, average daily temperatures and the community of granivorous birds present at sparrow capture locations. Body condition of suburban house sparrows was found to be higher compared to urban and rural house sparrows, but no relationships between sparrows’ body condition and presence of Yersinia spp. were found. We conclude that two determinants of pathogen infection dynamics, body condition and pathogen occurrence, vary along an urbanization gradient, potentially mediating the impact of urbanization on avian health. PMID:29281672

Effects of urbanization on host-pathogen interactions, using Yersinia in house sparrows as a model.

PubMed

Rouffaer, Lieze Oscar; Strubbe, Diederik; Teyssier, Aimeric; Salleh Hudin, Noraine; Van den Abeele, Anne-Marie; Cox, Ivo; Haesendonck, Roel; Delmée, Michel; Haesebrouck, Freddy; Pasmans, Frank; Lens, Luc; Martel, An

2017-01-01

Urbanization strongly affects biodiversity, altering natural communities and often leading to a reduced species richness. Yet, despite its increasingly recognized importance, how urbanization impacts on the health of individual animals, wildlife populations and on disease ecology remains poorly understood. To test whether, and how, urbanization-driven ecosystem alterations influence pathogen dynamics and avian health, we use house sparrows (Passer domesticus) and Yersinia spp. (pathogenic for passerines) as a case study. Sparrows are granivorous urban exploiters, whose western European populations have declined over the past decades, especially in highly urbanized areas. We sampled 329 house sparrows originating from 36 populations along an urbanization gradient across Flanders (Belgium), and used isolation combined with 'matrix-assisted laser desorption ionization- time of flight mass spectrometry' (MALDI-TOF MS) and PCR methods for detecting the presence of different Yersinia species. Yersinia spp. were recovered from 57.43% of the sampled house sparrows, of which 4.06%, 53.30% and 69.54% were identified as Y. pseudotuberculosis, Y. enterocolitica and other Yersinia species, respectively. Presence of Yersinia was related to the degree of urbanization, average daily temperatures and the community of granivorous birds present at sparrow capture locations. Body condition of suburban house sparrows was found to be higher compared to urban and rural house sparrows, but no relationships between sparrows' body condition and presence of Yersinia spp. were found. We conclude that two determinants of pathogen infection dynamics, body condition and pathogen occurrence, vary along an urbanization gradient, potentially mediating the impact of urbanization on avian health.

[The urbanized societies of Latin America and the Caribbean: some dimensions and observations].

PubMed

Ebanks, G E

1993-06-01

A demographic perspective on urbanization patterns in Latin America and the Caribbean is provided. The level and rate of urbanization and the hierarchies of urban places are considered, along with the determinants and consequences of these trends. Latin America and the Caribbean are the most urbanized of the developing regions, with almost 70% of the population classified as urban in 1991. Most Latin American and Caribbean countries have rural populations capable of maintaining continuous growth of the urban population for some time through internal migration and reclassification of localities. Latin American societies are urban in nature, and it is unlikely that decentralization and deconcentration policies will have significant repercussions. The Latin American urban population is estimated to have increased from 164 million in 1970 to 320 million in 1990, while the rural population increased from 122 to 128 million in the same years. Most governments of the region are preoccupied by the size of the urban population. There are too many urban residents to be absorbed in productive activities, but all require public services generally financed through taxation. The small tax bases result in frequent decisions to finance services through deficit spending. The size of the population and the level of urbanization may not be the principal agents of ecological deterioration or the greatest obstacles to development, but they play a significant role in these problems. Incorporating millions of urban residents into the productive sector of the economy is an important challenge for the development of these societies. The urban population in Latin America and the Caribbean is expected to continue growing at significant rates until well into the next century. In most countries of the region, internal migration accounted for 30-40% of urban growth between 1950 and 1970, but its contribution loses importance as the level of urbanization exceeds 70% or so. The number of urban places as well as the sizes of cities have been increasing. From the end of World War II to the 1970s, the principal urban centers grew most rapidly, but in the 1980s and early 1990s the medium sized cities experienced the most rapid growth. Latin America and the Caribbean are a region of high urban primacy, in which one city, generally the capital, is several times larger than the second city or cities. Mexico City, Sao Paulo, Buenos Aires, and Rio de Janeiro are megalopolises. Latin America's population is excessively concentrated in three ways: into urban localities, into a small area of the national territory, and into megalopolises. Excessive concentration is associated with severe environmental problems. Most have possible solutions, but costs will be high and great political will is required. The quality of life is poor for a large segment of urban dwellers and poverty is pervasive. Urgent action is needed to improve the quality of life and protect the environment.

An introspective qualitative report on dietary patterns and elevated levels of dental decay in a deprived urban population in northern Mexico.

PubMed

Maupomé, G

1998-01-01

Disorganized urbanization in Latin America has led to masses of impoverished people to become squatters in the larger urban areas. Using a community development network in the outskirts of Tijuana, in Northern Mexico, this investigation assessed the dental health situation, aiming to establish the underlying behavioral causes of poor oral health in these slums. Using quantitative and qualitative tools, fifty-six mothers (mean age 30.1 +/- 7.2) with their accompanying children (n = 56; mean age 6.1 +/- 3.3; 46.4 percent female) were interviewed and examined. Dental health was poor and characterized by vast unmet treatment needs in adults and children. 22.2 percent of children under three years of age suffered from Early Childhood Caries, strongly linked to inappropriate patterns of bottle use. Dietary patterns for the overall child population included many cariogenic snacks and beverages. A straightforward model to explain behavioral structures incorporates these findings against the background of living in a highly-deprived environment, whereby the allure of more affordable gratifications for self and family is often translated in the form of tokens such as junk food.

Cardiovascular Disease Risk Factors in Ghana during the Rural-to-Urban Transition: A Cross-Sectional Study

PubMed Central

Kodaman, Nuri; Aldrich, Melinda C.; Sobota, Rafal; Asselbergs, Folkert W.; Poku, Kwabena A.; Brown, Nancy J.; Moore, Jason H.; Williams, Scott M.

2016-01-01

Populations in sub-Saharan Africa are shifting from rural to increasingly urban. Although the burden of cardiovascular disease is expected to increase with this changing landscape, few large studies have assessed a wide range of risk factors in urban and rural populations, particularly in West Africa. We conducted a cross-sectional, population-based survey of 3317 participants from Ghana (≥18 years old), of whom 2265 (57% female) were from a mid-sized city (Sunyani, population ~250,000) and 1052 (55% female) were from surrounding villages (populations <5000). We measured canonical cardiovascular disease risk factors (BMI, blood pressure, fasting glucose, lipids) and fibrinolytic markers (PAI-1 and t-PA), and assessed how their distributions and related clinical outcomes (including obesity, hypertension and diabetes) varied with urban residence and sex. Urban residence was strongly associated with obesity (OR: 7.8, 95% CI: 5.3–11.3), diabetes (OR 3.6, 95% CI: 2.3–5.7), and hypertension (OR 3.2, 95% CI: 2.6–4.0). Among the quantitative measures, most affected were total cholesterol (+0.81 standard deviations, 95% CI 0.73–0.88), LDL cholesterol (+0.89, 95% CI: 0.79–0.99), and t-PA (+0.56, 95% CI: 0.48–0.63). Triglycerides and HDL cholesterol profiles were similarly poor in both urban and rural environments, but significantly worse among rural participants after BMI-adjustment. For most of the risk factors, the strength of the association with urban residence did not vary with sex. Obesity was a major exception, with urban women at particularly high risk (26% age-standardized prevalence) compared to urban men (7%). Overall, urban residents had substantially worse cardiovascular risk profiles, with some risk factors at levels typically seen in the developed world. PMID:27732601

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

Pathways of economic inequalities in maternal and child health in urban India: a decomposition analysis.

PubMed

Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy

2013-01-01

Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. Using data from the third wave of the National Family Health Survey (NFHS, 2005-06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501), institutional delivery (CI = -0.3214), children without fully immunization (CI = -0.18340), underweight children (CI = -0.19420), and infant deaths (CI = -0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.

Pathways of Economic Inequalities in Maternal and Child Health in Urban India: A Decomposition Analysis

PubMed Central

Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy

2013-01-01

Background/Objective Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. Methods Using data from the third wave of the National Family Health Survey (NFHS, 2005–06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. Results The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI  = −0.3501), institutional delivery (CI  = −0.3214), children without fully immunization (CI  = −0.18340), underweight children (CI  = −0.19420), and infant deaths (CI  = −0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. Conclusion Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India. PMID:23555587

Making cities resilient: Increasing resilience to disasters at the local level.

PubMed

Albrito, Paola

2012-01-01

Half of humanity is now living in cities, according to the United Nations Population Division. The urban population exceeded the rural for the first time in 2008, and by 2050 urbanisation will rise to 70 per cent with increased urban risk. 'Today, 100 cities are in control of 30 per cent of the world's economy.' The need for maintenance and upkeep of these cities makes safety measures for their citizens crucial. In this context, urban risk, city planning and the role of local governments in dealing with risk reduction have been recognised as key factors to build communities resilient to disasters. While many local governments have taken action to reduce vulnerability, especially when it comes to government organising capacity to deal with disasters, much remains to be done. Disaster risk has become an acute and increasingly urban issue. Poorly-planned urban environments, weak urban governance, an old and fragile infrastructure, and rapid population growth have increased pressure on the urban environment and triggered exposure to disaster risk. More and more people are settling in potential danger zones such as flood plains, volcanic flanks or earthquake faults and coastal areas. They do so because planners and local governments fail to provide alternatives, or because they cannot afford safer land. Local government officials are confronted with the threat of disasters daily, and need improved access to policies and tools to cope with them effectively.

Selective disappearance of great tits with short telomeres in urban areas.

PubMed

Salmón, Pablo; Nilsson, Johan F; Watson, Hannah; Bensch, Staffan; Isaksson, Caroline

2017-09-13

Urban environments pose novel challenges, as well as opportunities, for urban-dwelling wildlife. Although differences have been reported in several phenotypic traits (e.g. morphology, physiology and behaviour) between urban and rural populations, it is poorly understood whether this affects individual fitness. Telomere dynamics are posited as one possible mechanism underlying senescence and mortality. It was recently shown that telomere shortening is accelerated when growing up in an urban, compared with a rural, environment. However, the implications of accelerated telomere attrition for fitness are still unclear. Here, we examine the relationship between telomere length (TL) and survival in a bird common to urban and rural environments, and during both early and later life. The results reveal that TL is a strong predictor of post-fledging survival and recruitment in both habitats but, crucially, selective disappearance of individuals with short telomeres early in life is more pronounced in the urban environment, resulting in a longer average TL among the adult population. However, following recruitment, we found no difference in the relationship between TL and survival between the urban and rural environments. This indicates that the urban environment has negative effects in early life, while during later life the benefits could potentially outweigh the costs. © 2017 The Author(s).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henry, Rotich K.; Zhao Yongsheng; Dong Jun

This paper provides an overview of the state of municipal solid waste management (MSWM) by local authorities in Kenya as a case study of a low-income developing country. Approaches of possible solutions that can be undertaken to improve municipal solid waste (MSW) services are discussed. Poor economic growth (1.1% in 1993) has resulted in an increase in the poverty level which presently stands at 56%. Migration from the rural areas to the urban areas has resulted in unplanned settlements in suburban areas accommodating about 60% of the urban population on only 5% urban land area. Political interference also hampers smoothmore » running of local authorities. Vulnerability of pollution of surface and groundwater is high because local authorities rarely considered environmental impact in siting MSW disposal sites. Illegal dumping of MSW on the river banks or on the roadside poses environmental and economic threats on nearby properties. Poor servicing of MSW collection vehicles, poor state of infrastructure and the lack of adequate funding militate against optimization of MSW disposal service. The rural economy needs to be improved if rural-urban migration is to be managed. Involvement of stakeholders is important to achieve any meaningful and sustainable MSWM. The role of the informal sector through community-based organizations (CBOs), Non-Governmental Organizations (NGOs) and the private sector in offering solutions towards improvement of MSWM also is explored.« less

Climate Change and Developing-Country Cities: Implications For Environmental Health and Equity

PubMed Central

Corvalán, Carlos

2007-01-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity. PMID:17393341

Urban growth and water access in sub-Saharan Africa: Progress, challenges, and emerging research directions.

PubMed

Dos Santos, S; Adams, E A; Neville, G; Wada, Y; de Sherbinin, A; Mullin Bernhardt, E; Adamo, S B

2017-12-31

For the next decade, the global water crisis remains the risk of highest concern, and ranks ahead of climate change, extreme weather events, food crises and social instability. Across the globe, nearly one in ten people is without access to an improved drinking water source. Least Developed Countries (LDCs) especially in sub-Saharan Africa (SSA) are the most affected, having disproportionately more of the global population without access to clean water than other major regions. Population growth, changing lifestyles, increasing pollution and accelerating urbanization will continue to widen the gap between the demand for water and available supply especially in urban areas, and disproportionately affect informal settlements, where the majority of SSA's urban population resides. Distribution and allocation of water will be affected by climate-induced water stresses, poor institutions, ineffective governance, and weak political will to address scarcity and mediate uncertainties in future supply. While attempts have been made by many scientists to examine different dimensions of water scarcity and urban population dynamics, there are few comprehensive reviews, especially focused on the particular situation in Sub-Saharan Africa. This paper contributes to interdisciplinary understanding of urban water supply by distilling and integrating relevant empirical knowledge on urban dynamics and water issues in SSA, focusing on progress made and associated challenges. It then points out future research directions including the need to understand how alternatives to centralized water policies may help deliver sustainable water supply to cities and informal settlements in the region. Copyright © 2017 Elsevier B.V. All rights reserved.

After Oil

ERIC Educational Resources Information Center

Slone, Debra J.

2008-01-01

Public libraries were indispensable resources for newcomers during the height of European immigration to the United States. They were havens for the poor and jobless during the Great Depression and bridges between rural and urban communities during times of major demographic change. An increase in the Spanish-speaking population has inspired…

A spatial analysis of social and economic determinants of tuberculosis in Brazil.

PubMed

Harling, Guy; Castro, Marcia C

2014-01-01

We investigated the spatial distribution, and social and economic correlates, of tuberculosis in Brazil between 2002 and 2009 using municipality-level age/sex-standardized tuberculosis notification data. Rates were very strongly spatially autocorrelated, being notably high in urban areas on the eastern seaboard and in the west of the country. Non-spatial ecological regression analyses found higher rates associated with urbanicity, population density, poor economic conditions, household crowding, non-white population and worse health and healthcare indicators. These associations remained in spatial conditional autoregressive models, although the effect of poverty appeared partially confounded by urbanicity, race and spatial autocorrelation, and partially mediated by household crowding. Our analysis highlights both the multiple relationships between socioeconomic factors and tuberculosis in Brazil, and the importance of accounting for spatial factors in analysing socioeconomic determinants of tuberculosis. © 2013 Published by Elsevier Ltd.

Half the world in cities.

PubMed

Souza, J B

1980-06-01

City planners have exacerbated the problems connected with urbanization in Third World countries. Lower socioeconomic groups have moved from rural areas to the cities because they see greater employment, educational, and health opportunities there. These poor people must be provided for in the cities. But provision for these people cannot include allowing pollution and congestion to fester. Neither will urban renewal which merely displaces the poor (who, in fact, provide necessary services for the city) answer the problem. City managers do not pay enough attention to the poorer, more congested areas of their cities. Zoning policies actually seem to be outmoded and to do harm to city populations by increasing the time required for people to shop and commute to work. The walled city of Delhi, India, is cited as an example of a settlement where the population's convenience has been considered. Regulations must be changed to facilitate land ownership by the poorer groups. These practical policies are preferable to bulldozer or rural migration bans.

Negative impact of urban habitat on immunity in the great tit Parus major.

PubMed

Bailly, Juliette; Scheifler, Renaud; Belvalette, Marie; Garnier, Stéphane; Boissier, Elena; Clément-Demange, Valérie-Anne; Gète, Maud; Leblond, Matthieu; Pasteur, Baptiste; Piget, Quentin; Sage, Mickaël; Faivre, Bruno

2016-12-01

Urban habitats are described as having an overall negative influence on many fitness-related traits in several bird species, but a vital function such as immunity remains poorly studied. The immune response is strongly linked to individual condition, which partly depends on resource availability and the parasitic context that often differ between urban and natural habitats. A difference between the immunity of populations dwelling in urban areas and populations from more natural habitats can, therefore, be hypothesized. We conducted a 2-year experimental study on great tits (Parus major) in urban and forest areas. We stimulated the constitutive immunity of nestlings and assessed both the inflammatory response by measuring the plasma levels of haptoglobin, an inflammatory marker, and its activation cost through the loss of body mass. In addition, we checked the nestlings for ectoparasites and assessed haemosporidian prevalence in adults. Nestlings from urban sites produced relatively less haptoglobin and lost more body mass than those from forest sites, which suggests that the activation of constitutive immunity is more costly for birds living in urban sites than for those living in the forest. We detected no ectoparasite in birds in both habitats. However, urban adults showed lower haemosporidian prevalence than forest ones, suggesting a reduced exposure to these parasites and their vectors in towns. Overall, our study provides evidence for an immune difference between urban and forest populations. Because immunity is crucial for organism fitness, it is of prime interest to identify causes and processes at the origin of this difference.

Urban groundwater quality in sub-Saharan Africa: current status and implications for water security and public health

NASA Astrophysics Data System (ADS)

Lapworth, D. J.; Nkhuwa, D. C. W.; Okotto-Okotto, J.; Pedley, S.; Stuart, M. E.; Tijani, M. N.; Wright, J.

2017-06-01

Groundwater resources are important sources of drinking water in Africa, and they are hugely important in sustaining urban livelihoods and supporting a diverse range of commercial and agricultural activities. Groundwater has an important role in improving health in sub-Saharan Africa (SSA). An estimated 250 million people (40% of the total) live in urban centres across SSA. SSA has experienced a rapid expansion in urban populations since the 1950s, with increased population densities as well as expanding geographical coverage. Estimates suggest that the urban population in SSA will double between 2000 and 2030. The quality status of shallow urban groundwater resources is often very poor due to inadequate waste management and source protection, and poses a significant health risk to users, while deeper borehole sources often provide an important source of good quality drinking water. Given the growth in future demand from this finite resource, as well as potential changes in future climate in this region, a detailed understanding of both water quantity and quality is required to use this resource sustainably. This paper provides a comprehensive assessment of the water quality status, both microbial and chemical, of urban groundwater in SSA across a range of hydrogeological terrains and different groundwater point types. Lower storage basement terrains, which underlie a significant proportion of urban centres in SSA, are particularly vulnerable to contamination. The relationship between mean nitrate concentration and intrinsic aquifer pollution risk is assessed for urban centres across SSA. Current knowledge gaps are identified and future research needs highlighted.

Knowledge of cervical cancer and HPV vaccine in Bangladeshi women: a population based, cross-sectional study.

PubMed

Islam, Jessica Yasmine; Khatun, Fatema; Alam, Anadil; Sultana, Farhana; Bhuiyan, Afsana; Alam, Nazmul; Reichenbach, Laura; Marions, Lena; Rahman, Mustafizur; Nahar, Quamrun

2018-01-11

The objective of this study was to assess the level of knowledge of cervical cancer among Bangladeshi women and to assess their willingness to receive the human papillomavirus (HPV) vaccine. A population-based, cross-sectional survey was conducted from July to December 2011 in one urban and one rural area of Bangladesh. A total of 2037 ever-married women, aged 14 to 64 years, were interviewed using a structured questionnaire. Data on socio-demographic characteristics and knowledge of cervical cancer were collected. Willingness to receive the HPV vaccine was assessed. Univariate analyses were completed using quantitative data collected. Multivariable logistic regression models were developed to identify factors associated with having heard of cervical cancer and the HPV vaccine. The majority of study participants reported to have heard of cervical cancer (urban: 89.7%, rural 93.4%; P = 0.003). The odds of having heard of cervical cancer were significantly higher in urban women aged 35-44 years (aOR: 2.92 (1.34-6.33) and rural women aged 25-34 years (aOR: 2.90 (1.24-6.73) compared to those aged less than 24 years. Very few women reported to have detailed knowledge on risk factors (urban:9.1%, rural: 8.8%) and prevention (urban: 6.4%, rural: 4.4%) of cervical cancer. In our sample, one in five urban women and one in twenty rural women heard about a vaccine that can prevent cervical cancer. Among urban women, secondary education or higher (aOR: 3.48, 95% CI: 1.67-7.25), age of 20 years and above at marriage (aOR: 2.83, 95% CI: 1.61-5.00), and high socioeconomic status (aOR: 2.25, 95% CI: 1.28-3.95) were factors associated with having heard of the HPV vaccine. Willingness to receive the HPV vaccine among study participants either for themselves (urban: 93.9%, rural: 99.4%) or for their daughters (urban: 91.8%, rural: 99.2%) was high. Detailed knowledge of cervical cancer among Bangladeshi women was found to be poor. Education on cervical cancer must include information on symptoms, risk factors, and preventive methods. Despite poor knowledge, the study population was willing to receive the HPV vaccine.

Addressing the social and environmental determinants of urban health equity: evidence for action and a research agenda.

PubMed

Friel, Sharon; Akerman, Marco; Hancock, Trevor; Kumaresan, Jacob; Marmot, Michael; Melin, Thomas; Vlahov, David

2011-10-01

Urban living is the new reality for the majority of the world's population. Urban change is taking place in a context of other global challenges--economic globalization, climate change, financial crises, energy and food insecurity, old and emerging armed conflicts, as well as the changing patterns of communicable and noncommunicable diseases. These health and social problems, in countries with different levels of infrastructure and health system preparedness, pose significant development challenges in the 21st century. In all countries, rich and poor, the move to urban living has been both good and bad for population health, and has contributed to the unequal distribution of health both within countries (the urban-rural divide) and within cities (the rich-poor divide). In this series of papers, we demonstrate that urban planning and design and urban social conditions can be good or bad for human health and health equity depending on how they are set up. We argue that climate change mitigation and adaptation need to go hand-in-hand with efforts to achieve health equity through action in the social determinants. And we highlight how different forms of governance can shape agendas, policies, and programs in ways that are inclusive and health-promoting or perpetuate social exclusion, inequitable distribution of resources, and the inequities in health associated with that. While today we can describe many of the features of a healthy and sustainable city, and the governance and planning processes needed to achieve these ends, there is still much to learn, especially with respect to tailoring these concepts and applying them in the cities of lower- and middle-income countries. By outlining an integrated research agenda, we aim to assist researchers, policy makers, service providers, and funding bodies/donors to better support, coordinate, and undertake research that is organized around a conceptual framework that positions health, equity, and sustainability as central policy goals for urban management.

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

PubMed

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area.

Decomposing the gap in childhood undernutrition between poor and non-poor in urban India, 2005-06.

PubMed

Kumar, Abhishek; Singh, Aditya

2013-01-01

Despite 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. We 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. Considerable 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. The 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.

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

PubMed Central

Kumar, Abhishek; Singh, Aditya

2013-01-01

Background Despite 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. Methods We 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. Result Considerable 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. Conclusions The 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. PMID:23734231

Impediments to the adoption of alternative sewerage in South African urban informal settlements.

PubMed

Ashipala, N; Armitage, N P

2011-01-01

In recent decades South Africa has witnessed a substantial growth in its urban population. This growth has been accompanied by the mushrooming of informal settlements (shantytowns) flanking more formal development. The lack of adequate urban drainage in many of these informal settlements has resulted in extremely polluted environments which add to the disease burden of the poor people who live there. In many instances, informal settlements in South Africa are established on marginal land that is inherently difficult to service using conventional gravity sewerage. International experience has shown that various alternative wastewater collection systems may present more appropriate ways of providing water-borne sewerage in areas that are difficult to service by conventional means. Alternative sewerage schemes have however had a poor record of success in South African informal settlements - primarily stemming from the implementing agencies' failure to adequately address various social and institutional factors. In this paper, a review of South African experiences with simplified sewerage, settled sewerage and vacuum sewerage in urban informal settlements is used to highlight the key constraints that currently impede the application of these technologies.

The Prevention and Control of HIV/AIDS, TB and Vector-borne Diseases in Informal Settlements: Challenges, Opportunities and Insights

PubMed Central

Mercado, Susan P.; Becker, Daniel; Edmundo, Katia; Mugisha, Frederick

2007-01-01

Today’s urban settings are redefining the field of public health. The complex dynamics of cities, with their concentration of the poorest and most vulnerable (even within the developed world) pose an urgent challenge to the health community. While retaining fidelity to the core principles of disease prevention and control, major adjustments are needed in the systems and approaches to effectively reach those with the greatest health risks (and the least resilience) within today’s urban environment. This is particularly relevant to infectious disease prevention and control. Controlling and preventing HIV/AIDS, tuberculosis and vector-borne diseases like malaria are among the key global health priorities, particularly in poor urban settings. The challenge in slums and informal settlements is not in identifying which interventions work, but rather in ensuring that informal settlers: (1) are captured in health statistics that define disease epidemiology and (2) are provided opportunities equal to the rest of the population to access proven interventions. Growing international attention to the plight of slum dwellers and informal settlers, embodied by Goal 7 Target 11 of the Millennium Development Goals, and the considerable resources being mobilized by the Global Fund to fight AIDS, TB and malaria, among others, provide an unprecedented potential opportunity for countries to seriously address the structural and intermediate determinants of poor health in these settings. Viewed within the framework of the “social determinants of disease” model, preventing and controlling HIV/AIDS, TB and vector-borne diseases requires broad and integrated interventions that address the underlying causes of inequity that result in poorer health and worse health outcomes for the urban poor. We examine insights into effective approaches to disease control and prevention within poor urban settings under a comprehensive social development agenda. PMID:17431796

Urban environment and health: food security.

PubMed

Galal, Osman; Corroon, Meghan; Tirado, Cristina

2010-07-01

The authors examine the impact of urbanization on food security and human health in the Middle East. Within-urban-population disparities in food security represent one of the most dramatic indicators of economic and health disparities. These disparities are reflected in a double burden of health outcomes: increasing levels of chronic disease as well as growing numbers of undernourished among the urban poor. These require further comprehensive solutions. Some of the factors leading to food insecurity are an overdependence on purchased food commodities, lack of sufficient livelihoods, rapid reductions in peripheral agricultural land, and adverse impacts of climate change. The Food and Agriculture Organization of the United Nations (FAO) Food Security Framework is used to examine and compare 2 cities in the Middle East: Amman, Jordan, and Manama, Bahrain.

The role of farming and rural development as central to our diets.

PubMed

Fanzo, Jessica

2018-05-21

Farming and rural development are central to the diversity of global food systems and diets, both significant factors in determining the nutrition and health outcomes of the world's population. Diets are not static and indeed are changing due to globalization, urbanization and demographic shifts. In addition, multiple burdens of malnutrition (both undernutrition and overweight and obesity) are not improving fast enough and in some cases, reversing for the worse. Unhealthy diets are major contributors to these burdens. Rural people and particularly smallholder farmers, are critical in delivering the key nutrients in the global food supply that make up our diets for human health. However, rural populations in some parts of the world are often poor, and suffer burdens of malnutrition on both ends of the spectrum - undernourished or overweight. They are also faced with significant challenges, often due to poor investment towards rural development. Challenges include natural resource declines, climate change risk, women disempowerment, conflict, and urbanization; which wreak havoc on these populations. If actions are not taken and their livelihoods are not prioritized, it will be a challenge to achieve sustainable development in these rural places that are so essential for future food systems. Copyright © 2018 Elsevier Inc. All rights reserved.

Populations potentially exposed to traffic-related air pollution in seven world cities.

PubMed

Su, Jason G; Apte, Joshua S; Lipsitt, Jonah; Garcia-Gonzales, Diane A; Beckerman, Bernardo S; de Nazelle, Audrey; Texcalac-Sangrador, José Luis; Jerrett, Michael

2015-05-01

Traffic-related air pollution (TRAP) likely exerts a large burden of disease globally, and in many places, traffic is increasing dramatically. The impact, however, of urban form on the portion of population potentially exposed to TRAP remains poorly understood. In this study, we estimate portions of population potentially exposed to TRAP across seven global cities of various urban forms. Data on population distributions and road networks were collected from the best available sources in each city and from remote sensing analysis. Using spatial mapping techniques, we first overlaid road buffers onto population data to estimate the portions of population potentially exposed for four plausible impact zones. Based on a most likely scenario with impacts from highways up to 300meters and major roadways up to 50meters, we identified that the portions of population potentially exposed for the seven cities ranged from 23 to 96%. High-income North American cities had the lowest potential exposure portions, while those in Europe had the highest. Second, we adjusted exposure zone concentration levels based on a literature suggested multiplier for each city using corresponding background concentrations. Though Beijing and Mexico City did not have the highest portion of population exposure, those in their exposure zones had the highest levels of exposure. For all seven cities, the portion of population potentially exposed was positively correlated with roadway density and, to a lesser extent, with population density. These analyses suggest that urban form may influence the portion of population exposed to TRAP and vehicle emissions and other factors may influence the exposure levels. Greater understanding of urban form and other factors influencing potential exposure to TRAP may help inform interventions that protect public health. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Elephant in the Classroom

ERIC Educational Resources Information Center

Stillman, Jennifer Burns

2013-01-01

The gentrification of many the country's big cities is providing a once-in-a-generation opportunity to create a large number of racially and socioeconomically integrated schools. But to capitalize on this opportunity, urban schools that currently serve a predominantly poor and minority population must find a way to attract and retain the…

New light on old problem: population.

PubMed

Padilla, T

1982-01-01

A central issue of the Third Asian and Pacific Population Conference, to be held in Sri Lanka in September 1982, is the need for full recognition on the part of developing countries that an integrated approach to population and development is essential. Such an approach requires the following: management of internal migration and urbanization; women's participation in development; and increased involvement in promoting family planning, family welfare, and family health programs. Of much concern is the fact that the ESCAP region's urban population is projected to grow from 660 million in 1980 to 1347 million by the year 2000. Much of this increase will occur in the largest cities. Unplanned urbanization and a growing population reservoir in rural areas will continue to spur movements to the cities, aggravating the urban malaise, yet migration is young people's only option if rural populations are to survive. These problems plague most governments. A recent conference held in Rome urged governments to formulate comprehensive population policies and programs, to specify goals on the rate of population growth and on the distribution of population between urban and rural areas, and to plan for the redistribution of population. The conference also recommended that cities pay attention to problems of the shantytown and slum dwellers who are principally rural migrants and the urban poor. In addition the region's corps of development planners and experts worry about the staggering increase in migration by 3rd world guest workers to the high income OPEC members in the Middle East and the industrialized market economy nations. The proper management of international migration should increase the reabsorptive capacity of sending countries to ensure the reintegration of returning off-loaded guest workers and should try to prevent the rural stagnation due to large scale migration by the young and the better educated from the countryside. Internal and international migration give women an opportunity to discover their great development potential. Yet, more generally, women breaking out of social structures that foster dependency and exploitation are in need of more than simple, single factor solutions. Emerging relationships between declining mortality levels and women's participation in development and economic activities will be explored at the Third Asian and Pacific Population Conference.

Estimating benefit equity of government health subsidy in healthcare Services in Shandong Province, China: a cross-sectional study.

PubMed

Qin, Wenzhe; Xu, Lingzhong; Li, Jiajia; Sun, Long; Ding, Gan; Shao, Hui; Xu, Ningze

2018-05-18

Government health subsidy (GHS) is an effective tool to improve population health in China. Ensuring an equitable allocation of GHS, particularly among the poorer socio-economic groups, is a major goal of China's healthcare reform. The paper aims to explore how GHS was allocated across different socioeconomic groups, and how well the overall health system was performing in terms of the allocation of subsidy for different types of health services. Data from China's National Health Services Survey (NHSS) in 2013 were used. Benefit incidence analysis (BIA) was applied to examine if GHS was equally distributed across income quintile. Benefit incidence was presented as each quintile's percentage share of total benefits, and the concentration index (CI) and Kakwani index (KI) were calculated. Health benefits from three types of healthcare services (primary health care, outpatient and inpatient services) were analyzed, separated into urban and rural populations. In addition, the distribution of benefits was compared to the distribution of healthcare need (measured by self-reported illness and chronic disease) across income quintiles. In urban populations, the CI value of GHS for primary care was negative. (- 0.14), implying an allocation tendency toward poor region; the CI values of outpatient and inpatient services were both positive (0.174 and 0.194), indicating allocation tendencies toward rich region. Similar allocation pattern was observed in rural population, with pro-poor tendency of primary care service (CI = - 0.082), and pro-rich tendencies of outpatient (CI = 0.153) and inpatient services (CI = 0.203). All the KI values of three health services in urban and rural populations were negative (- 0.4991,-0.1851 and - 0.1651; - 0.482, - 0.247and - 0.197), indicating that government health subsidy was progressive and contributed to the narrowing of economic gap between the poor and rich. The inequitable distribution of GHS in China exited in different healthcare services; however, the GHS benefit is generally progressive. Future healthcare reforms in China should not only focus on expanding the coverage, but also on improving the equity of distribution of healthcare benefits.

Using formative research to develop a nutrition education resource aimed at assisting low-income households in South Africa adopt a healthier diet.

PubMed

Everett-Murphy, K; De Villiers, A; Ketterer, E; Steyn, K

2015-12-01

As part of a comprehensive programme to prevent non-communicable disease in South Africa, there is a need to develop public education campaigns on healthy eating. Urban populations of lower socioeconomic status are a priority target population. This study involved formative research to guide the development of a nutrition resource appropriate to the budgetary constraints and information needs of poor households in the major urban centres of South Africa. Twenty-two focus groups were convened to explore the target audience's knowledge, beliefs, attitudes and practices as they related to healthy eating and their views about the proposed nutrition resource (N = 167). A brief questionnaire assessed eating and cooking practices among focus group participants. Key informant interviews with eight dieticians/nutritionists working with this population added to the focus group findings. The research identified important issues to take into account in the development of the resource. These included the need to: directly address prevalent misconceptions about healthy eating and unhealthy eating practices; increase self-efficacy regarding the purchasing and preparation of healthy food; represent diverse cultural traditions and consider the issues of affordability and availability of food ingredients. This study demonstrates the value of using formative research in the design of nutrition-related communication in a multicultural, poor, urban South African setting. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Conclusions Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings. PMID:24690310

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

PubMed

Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

Urban poverty and utilization of maternal and child health care services in India.

PubMed

Prakash, Ravi; Kumar, Abhishek

2013-07-01

Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.

The shape of things to come.

PubMed

Gallagher, C F

1979-01-01

Basic projections for the future made by various international and national planning organizations form the basis for a report on the demographic, economic, and social implications of population growth for the year 2000, both as to the statistics involved and what they mean. The most signficiant factor is that by the end of the century, global population will be greater than 6 billion. Statistics on population patterns are presented for Asia; India; China; Africa; Latin America; North America; Europe, Oceania, and the USSR, including population growth; birthrate; mortality; population projections; population distribution; age of populations; and urbanization. The realities that stand behind these abstract and impersonal statistics of population change will pose significant problems in several major respects: how these increasing populations will support themselves; where they will live; and how they will be fed. These question are closely related, but the need to create jobs might come 1st since decisions about the kind of employment opportunities to be offered and where will directly affect the rural-urban population equation. It is clear that an enormous number of jobs must be found in developing countries by the end of the century, estimated at 500 million more. The economic implications of increasing urbanization in the developing world are explored, and it is noted that Asia, Latin America, and Africa now face the prospect of having to feed as many as 800 million more urbanites by the year 2000. Also, rural population will also continue to grow, and whether agricultural resources can be increased to what extent and how is a critical question. It is concluded that no matter how agriculture is improved or jobs found in developing countries, many will be poorly nourished, badly housed, and inadequately educated. It is finally suggested that by 2000 the Third World as such will no longer exist; instead the world will consist of older developed countries; rapidly developing countries; middle-income countries; oil-surplus countries; and still poor countries, with a movement toward a constantly more diversified echelon of socioeconomic levels of development, both among and within countries.

Municipal solid waste management challenges in developing countries--Kenyan case study.

PubMed

Henry, Rotich K; Yongsheng, Zhao; Jun, Dong

2006-01-01

This paper provides an overview of the state of municipal solid waste management (MSWM) by local authorities in Kenya as a case study of a low-income developing country. Approaches of possible solutions that can be undertaken to improve municipal solid waste (MSW) services are discussed. Poor economic growth (1.1% in 1993) has resulted in an increase in the poverty level which presently stands at 56%. Migration from the rural areas to the urban areas has resulted in unplanned settlements in suburban areas accommodating about 60% of the urban population on only 5% urban land area. Political interference also hampers smooth running of local authorities. Vulnerability of pollution of surface and groundwater is high because local authorities rarely considered environmental impact in siting MSW disposal sites. Illegal dumping of MSW on the river banks or on the roadside poses environmental and economic threats on nearby properties. Poor servicing of MSW collection vehicles, poor state of infrastructure and the lack of adequate funding militate against optimization of MSW disposal service. The rural economy needs to be improved if rural-urban migration is to be managed. Involvement of stakeholders is important to achieve any meaningful and sustainable MSWM. The role of the informal sector through community-based organizations (CBOs), Non-Governmental Organizations (NGOs) and the private sector in offering solutions towards improvement of MSWM also is explored.

Understanding Social Isolation Among Urban Aging Adults: Informing Occupation-Based Approaches.

PubMed

Hand, Carri; Retrum, Jessica; Ware, George; Iwasaki, Patricia; Moaalii, Gabe; Main, Deborah S

2017-10-01

Socially isolated aging adults are at risk of poor health and well-being. Occupational therapy can help address this issue; however, information is needed to guide such work. National surveys characterize social isolation in populations of aging adults but fail to provide meaningful information at a community level. The objective of this study is to describe multiple dimensions of social isolation and related factors among aging adults in diverse urban neighborhoods. Community-based participatory research involving a door-to-door survey of adults 50 years and older was used. Participants ( N = 161) reported social isolation in terms of small social networks (24%) and wanting more social engagement (43%). Participants aged 50 to 64 years reported the highest levels of isolation in most dimensions. Low income, poor health, lack of transportation, and infrequent information access appeared linked to social isolation. Occupational therapists can address social isolation in similar urban communities through policy and practice that facilitate social engagement and network building.

Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

PubMed

Geronimus, Arline T; Colen, Cynthia G; Shochet, Tara; Ingber, Lori Barer; James, Sherman A

2006-08-01

Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

Urbanization as a determinant of health: a socioepidemiological perspective.

PubMed

Patil, Rajan R

2014-01-01

Urbanization is a process that leads to the growth of cities due to industrialization and economic development and that leads to urban-specific changes. Urbanization is associated with profound changes in diet and exercise that in turn increase the prevalence of obesity with attendant increases in risk of type II diabetes and cardiovascular disease. The growing burden of disease among vulnerable populations and pervasive socioeconomic inequities within urban systems exaggerates the adverse impacts of urbanization on health. More than one half of children younger than age 5 of urban poor are stunted and/or underweight. More than one half of the child births occur at home, in slums, putting the life of the mother and newborn in serious risk. Inadequate reach of services due to illegality, social exclusion of slums, hidden slum pockets, and weak social fabric have resulted in a rapid proliferation of the unqualified private health sector, leading to high health expenditures and continuing a vicious cycle of poverty and ill health in urban slums.

Midcontinental Native American population dynamics and late Holocene hydroclimate extremes

NASA Astrophysics Data System (ADS)

Bird, Broxton W.; Wilson, Jeremy J.; Gilhooly, William P., III; Steinman, Byron A.; Stamps, Lucas

2017-01-01

Climate’s influence on late Pre-Columbian (pre-1492 CE), maize-dependent Native American populations in the midcontinental United States (US) is poorly understood as regional paleoclimate records are sparse and/or provide conflicting perspectives. Here, we reconstruct regional changes in precipitation source and seasonality and local changes in warm-season duration and rainstorm events related to the Pacific North American pattern (PNA) using a 2100-year-long multi-proxy lake-sediment record from the midcontinental US. Wet midcontinental climate reflecting negative PNA-like conditions occurred during the Medieval Climate Anomaly (950-1250 CE) as Native American populations adopted intensive maize agriculture, facilitating population aggregation and the development of urban centers between 1000-1200 CE. Intensifying midcontinental socio-political instability and warfare between 1250-1350 CE corresponded with drier positive PNA-like conditions, culminating in the staggered abandonment of many major Native American river valley settlements and large urban centers between 1350-1450 CE during an especially severe warm-season drought. We hypothesize that this sustained drought interval rendered it difficult to support dense populations and large urban centers in the midcontinental US by destabilizing regional agricultural systems, thereby contributing to the host of socio-political factors that led to population reorganization and migration in the midcontinent and neighboring regions shortly before European contact.

Midcontinental Native American population dynamics and late Holocene hydroclimate extremes

PubMed Central

Bird, Broxton W.; Wilson, Jeremy J.; Gilhooly III, William P.; Steinman, Byron A.; Stamps, Lucas

2017-01-01

Climate’s influence on late Pre-Columbian (pre-1492 CE), maize-dependent Native American populations in the midcontinental United States (US) is poorly understood as regional paleoclimate records are sparse and/or provide conflicting perspectives. Here, we reconstruct regional changes in precipitation source and seasonality and local changes in warm-season duration and rainstorm events related to the Pacific North American pattern (PNA) using a 2100-year-long multi-proxy lake-sediment record from the midcontinental US. Wet midcontinental climate reflecting negative PNA-like conditions occurred during the Medieval Climate Anomaly (950–1250 CE) as Native American populations adopted intensive maize agriculture, facilitating population aggregation and the development of urban centers between 1000–1200 CE. Intensifying midcontinental socio-political instability and warfare between 1250–1350 CE corresponded with drier positive PNA-like conditions, culminating in the staggered abandonment of many major Native American river valley settlements and large urban centers between 1350–1450 CE during an especially severe warm-season drought. We hypothesize that this sustained drought interval rendered it difficult to support dense populations and large urban centers in the midcontinental US by destabilizing regional agricultural systems, thereby contributing to the host of socio-political factors that led to population reorganization and migration in the midcontinent and neighboring regions shortly before European contact. PMID:28139698

The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

PubMed Central

2013-01-01

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health. PMID:23496934

The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria.

PubMed

Ahmad, Balsam; Ryan, Vicky; Maziak, Wasim; Pless-Mulloli, Tanja; White, Martin

2013-03-16

There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18-65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women's health.

Overview of migration, poverty and health dynamics in Nairobi City's slum settlements.

PubMed

Zulu, Eliya M; Beguy, Donatien; Ezeh, Alex C; Bocquier, Philippe; Madise, Nyovani J; Cleland, John; Falkingham, Jane

2011-06-01

The Urbanization, Poverty, and Health Dynamics research program was designed to generate and provide the evidence base that would help governments, development partners, and other stakeholders understand how the urban slum context affects health outcomes in order to stimulate policy and action for uplifting the wellbeing of slum residents. The program was nested into the Nairobi Urban Health and Demographic Surveillance System, a uniquely rich longitudinal research platform, set up in Korogocho and Viwandani slum settlements in Nairobi city, Kenya. Findings provide rich insights on the context in which slum dwellers live and how poverty and migration status interacts with health issues over the life course. Contrary to popular opinions and beliefs that see slums as homogenous residential entities, the findings paint a picture of a highly dynamic and heterogeneous setting. While slum populations are highly mobile, about half of the population comprises relatively well doing long-term dwellers who have lived in slum settlements for over 10 years. The poor health outcomes that slum residents exhibit at all stages of the life course are rooted in three key characteristics of slum settlements: poor environmental conditions and infrastructure; limited access to services due to lack of income to pay for treatment and preventive services; and reliance on poor quality and mostly informal and unregulated health services that are not well suited to meeting the unique realities and health needs of slum dwellers. Consequently, policies and programs aimed at improving the wellbeing of slum dwellers should address comprehensively the underlying structural, economic, behavioral, and service-oriented barriers to good health and productive lives among slum residents.

Population growth and rural-urban migration, with special reference to Ghana.

PubMed

De Graft-johnson, K T

1974-01-01

While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors but that once people decide to migrate, they base their choice of destination primarily on economic opportunities available at that end. Distance bears little relationship to choice of destination. To stem this tide efforts need to be made to increase rural income, provide employment opportunities for those displaced as agriculture becomes more efficient, and to provide for greater amenities in rural areas. Urban unemployment is an ever-increasing problem, accentuated by population growth and migration. Intensive rural development is needed to reverse this trend.

Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.

PubMed

Penrose, Katherine; de Castro, Marcia Caldas; Werema, Japhet; Ryan, Edward T

2010-03-16

As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania. Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km(2) in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest. Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand.

Informal Urban Settlements and Cholera Risk in Dar es Salaam, Tanzania

PubMed Central

Penrose, Katherine; de Castro, Marcia Caldas; Werema, Japhet; Ryan, Edward T.

2010-01-01

Background As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania. Methodology/Principal Findings Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km2 in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest. Conclusions/Significance Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand. PMID:20300569

Increasing expenditure on health care incurred by diabetic subjects in a developing country: a study from India.

PubMed

Ramachandran, Ambady; Ramachandran, Shobhana; Snehalatha, Chamukuttan; Augustine, Christina; Murugesan, Narayanasamy; Viswanathan, Vijay; Kapur, Anil; Williams, Rhys

2007-02-01

This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005. A total of 556 diabetic subjects from various urban and rural regions of seven Indian states were enrolled. A brief uniform coded questionnaire (24 items) on direct cost was used. Annual family income was higher in urban subjects (rupees [Rs] 100,000 or $2,273) than in the rural subjects (Rs 36,000 or $818) (P < 0.001). Total median expenditure on health care was Rs 10,000 ($227) in urban and Rs 6,260 ($142) in rural (P < 0.001) subjects. Treatment costs increased with duration of diabetes, presence of complications, hospitalization, surgery, insulin therapy, and urban setting. Lower-income groups spent a higher proportion of their income on diabetes care (urban poor 34% and rural poor 27%). After accounting for inflation, a secular increase of 113% was observed in the total expenses between 1998 and 2005 in the urban population. The highest increase in percentage of household income devoted to diabetes care was in the lowest economic group (34% of income in 1998 vs. 24.5% in 2005) (P < 0.01). There was a significant improvement in urban subjects in medical reimbursement from 2% (1998) to 21.3% (2005). Urban and rural diabetic subjects spend a large percentage of income on diabetes management. The economic burden on urban families in developing countries is rising, and the total direct cost has doubled from 1998 to 2005.

Urban Household Characteristics and Dietary Diversity: An Analysis of Food Security in Accra, Ghana.

PubMed

Codjoe, Samuel Nii Ardey; Okutu, David; Abu, Mumuni

2016-06-01

The world's population is increasingly becoming urbanized. If the current urban growth rate is to continue, new and unprecedented challenges for food security will be inevitable. Dietary diversity has been used to ascertain food security status albeit at the multicountry and country levels. Thus, household-level studies in urban settings, particularly in sub-Sahara African, are few. Yet, it is imperative that assessments of food security are undertaken particularly in urban settings, due to the projected fast rate of urbanization and the challenges of attaining food security. To examine household characteristics and dietary diversity. The study uses data from 452 households from the second round of the Regional Institute for Population Studies (RIPS) EDULINK urban poverty and health study. Bivariate and multivariate analyses are undertaken. Mean dietary diversity for all households is 6.8. Vegetables have the highest diversity, followed by cereal-based and grain products. Household characteristics that have statistically significant associations with dietary diversity include sex and level of education of household head, household wealth quintile, and source of food. There is high dietary diversity in the study communities of Accra but low consumption of foods rich in micronutrient, such as fruits and milk/dairy products. The study brings to fore issues related to resource-disadvantaged entities of the urban system, namely, females, poor households, and the non-educated who have food insecurity problems. © The Author(s) 2016.

Access to potable water and sanitation in Cameroon within the context of Millennium Development Goals (MDGS).

PubMed

Ako, Andrew Ako; Shimada, Jun; Eyong, Gloria Eneke Takem; Fantong, Wilson Yetoh

2010-01-01

Cameroon has been fully engaged with the Millennium Development Goals (MDGs) since their inception in 2000. This paper examines the situation of access to potable water and sanitation in Cameroon within the context of the Millennium Development Goals (MDGs), establishes whether Cameroon is on the track of meeting the MDGs in these domains and proposes actions to be taken to bring it closer to these objectives. Based on analyzed data obtained from national surveys, government ministries, national statistical offices, bibliographic research, reports and interviews, it argues that Cameroon will not reach the water and sanitation MGDs. While Cameroon is not yet on track to meet the targets of the MDGs for water and sanitation, it has made notable progress since 1990, much more needs to be done to improve the situation, especially in rural areas. In 2006, 70% of the population had access to safe drinking water and the coverage in urban centres is 88%, significantly better than the 47% in rural areas. However, rapid urbanization has rendered existing infrastructure inadequate with periurban dwellers also lacking access to safe drinking water. Sanitation coverage is also poor. In urban areas only 58% of the population has access to improved sanitation facilities, and the rate in rural areas is 42%. Women and girls shoulder the largest burden in collecting water, 15% of urban and 18% rural populations use improved drinking water sources over 30 minutes away. Cameroon faces the following challenges in reaching the water and sanitation MDGs: poor management and development of the resources, coupled with inadequate political will and commitment for the long term; rapid urbanization; urban and rural poverty and regulation and legislative lapses. The authors propose that: bridging the gap between national water policies and water services; recognizing the role played by Civil Society Organizations (CSOs) in the attainment of MDGs; developing a Council Water Resource Management Policy and Strategy (CWARMPS); organizing an institutional framework for the water and sanitation sector as well as completion and implementation of an Integrated Water Resources Management (IWRM) plan, would bring Cameroon closer to the water and sanitation MDGs.

Examining the Effect of Household Wealth and Migration Status on Safe Delivery Care in Urban India, 1992–2006

PubMed Central

Singh, Prashant Kumar; Rai, Rajesh Kumar; Singh, Lucky

2012-01-01

Background Although the urban health issue has been of long-standing interest to public health researchers, majority of the studies have looked upon the urban poor and migrants as distinct subgroups. Another concern is, whether being poor and at the same time migrant leads to a double disadvantage in the utilization of maternal health services? This study aims to examine the trends and factors that affect safe delivery care utilization among the migrants and the poor in urban India. Methodology/Principal Findings Using data from the National Family Health Survey, 1992–93 and 2005–06, this study grouped the household wealth and migration status into four distinct categories poor-migrant, poor-non migrant, non poor-migrant, non poor-non migrant. Both chi-square test and binary logistic regression were performed to examine the influence of household wealth and migration status on safe delivery care utilization among women who had experienced a birth in the four years preceding the survey. Results suggest a decline in safe delivery care among poor-migrant women during 1992–2006. The present study identifies two distinct groups in terms of safe delivery care utilization in urban India – one for poor-migrant and one for non poor-non migrants. While poor-migrant women were most vulnerable, non poor-non migrant women were the highest users of safe delivery care. Conclusion This study reiterates the inequality that underlies the utilization of maternal healthcare services not only by the urban poor but also by poor-migrant women, who deserve special attention. The ongoing programmatic efforts under the National Urban Health Mission should start focusing on the poorest of the poor groups such as poor-migrant women. Importantly, there should be continuous evaluation to examine the progress among target groups within urban areas. PMID:22970324

Another day in paradise? Life on the margins in urban New Zealand.

PubMed

Kearns, R A; Smith, C J; Abbott, M W

1991-01-01

This paper examines the relationships between housing and health with respect to a sample of New Zealand public housing applicants. In the first part of the paper, the notion of incipient homelessness is reviewed, the production of this population in advanced capitalist societies is considered and the social geography of the inadequately housed in New Zealand is surveyed. The second part of the paper presents some of the data collected in a survey of the inadequately housed in Auckland and Christchurch (n = 213 households). The results suggest that housing is an important determinant of the health and well-being of this population, but that rehousing the poor should be seen as only one step in addressing inequalities in contemporary urban New Zealand.

Capacitacion de educadores para areas marginales--I: Caracteristicas y necesidades educativas de los ninos, jovenes y adultos en las poblaciones menos favorecidas, rurales y urbanas. Tercera edicion (Preparation of Educators for Marginal Areas--I: Educational Needs and Characteristics of Children, Youth and Adults in Disadvantaged Populations, Rural and Urban. Third Edition).

ERIC Educational Resources Information Center

Tedesco, Juan Carlos

Forty percent of the families in Latin America have an income which does not provide essential necessities. Two-thirds of poor families live in the countryside, while the remainder reside in urban slums. The key variable in explaining poverty is education. Without education these families have irregular, unstable, and low paying employment…

The Assault on Public Education: Confronting the Politics of Corporate School Reform

ERIC Educational Resources Information Center

Watkins, William H., Ed.

2011-01-01

In this timely interdisciplinary volume, William Watkins has brought together leading scholars and activists to address some of the most urgent issues facing public education. What is underneath and behind the language of choice, efficiency, and improvement in current neoliberal discourse? How will urban and poor populations be affected? Will…

Old Skills and New Practices Mean Radical Change for Library Education

ERIC Educational Resources Information Center

Turner, Deborah; Gorichanaz, Tim

2016-01-01

Technological advances and other societal change have resulted in public libraries' increased reliance on online resources when providing access to information. However, a portion of those served by public libraries includes members of urban poor populations who may prefer to interact with information by talking. How can library educators ensure…

PAHs and PCBs deposited in surficial sediments along a rural to urban transect in a mid-Atlantic coastal river basin (USA).

PubMed

Foster, Gregory D; Cui, Vickie

2008-10-01

PAHs and PCBs were measured in river sediments along a 226 km longitudinal transect that spanned rural to urban land use settings through Valley and Ridge, Piedmont Plateau and Coastal Plain physiographic provinces in the Potomac River basin (mid-Atlantic USA). A gradient in PAH concentrations was found in river bed sediments along the upstream transect in the Potomac and Shenandoah Rivers that correlated with population densities in the nearby sub-basins. Sediment PAH concentrations halved per each approximately 40 km of transect distance upstream (i.e., the half-concentration distance) from the urban center (Washington, DC) of the Potomac River basin in direct proportion to population density. The PAH molecular composition was consistent across all geologic provinces, revealing a dominant pyrogenic source. Fluoranthene to perylene ratios served as useful markers for urban inputs, with a ratio > 2.4 observed in sediments near urban structures such as roadways, bridges and sewer outfalls. PCBs in sediments were not well correlated with population densities along the river basin transect, but the highest concentrations were found in the urban Coastal Plain region near Washington, DC and in the Shenandoah River near a known industrial Superfund site. PAHs were moderately correlated with sediment total organic carbon (TOC) in the Shenandoah River and Coastal Plain Potomac River regions, but TOC was poorly correlated with PCB concentrations throughout the entire basin. Although both PAHs and PCBs are widely recognized as urban-derived contaminants, their concentration profiles and geochemistry in river sediments were uniquely different throughout the upper Potomac River basin.

Integrating High-Resolution Datasets to Target Mitigation Efforts for Improving Air Quality and Public Health in Urban Neighborhoods

PubMed Central

Shandas, Vivek; Voelkel, Jackson; Rao, Meenakshi; George, Linda

2016-01-01

Reducing exposure to degraded air quality is essential for building healthy cities. Although air quality and population vary at fine spatial scales, current regulatory and public health frameworks assess human exposures using county- or city-scales. We build on a spatial analysis technique, dasymetric mapping, for allocating urban populations that, together with emerging fine-scale measurements of air pollution, addresses three objectives: (1) evaluate the role of spatial scale in estimating exposure; (2) identify urban communities that are disproportionately burdened by poor air quality; and (3) estimate reduction in mobile sources of pollutants due to local tree-planting efforts using nitrogen dioxide. Our results show a maximum value of 197% difference between cadastrally-informed dasymetric system (CIDS) and standard estimations of population exposure to degraded air quality for small spatial extent analyses, and a lack of substantial difference for large spatial extent analyses. These results provide the foundation for improving policies for managing air quality, and targeting mitigation efforts to address challenges of environmental justice. PMID:27527205

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed

Jaafar, Nasruddin; Hakim, Hina; Mohd Nor, Nor Azlida; Mohamed, Asma; Saub, Roslan; Esa, Rashidah; Doss, Jennifer; Mohd Yusof, Zamros Yuzadi; Ab-Murat, Norintan; Abu Kassim, Noor Lide; Majid, Hazreen Abdul

2014-01-01

The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed Central

2014-01-01

Background The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. Methods A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). Results The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. Conclusions The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group. PMID:25438162

[Towards an urban world].

PubMed

1991-12-01

It has been estimated that by the year 2006, the proportion of the world's population residing in cities will for the 1st time exceed 50%. The entire urban population will be living on 1% of the earth's surface. Rapid growth of cities is largely limited to developing countries, where about 9/10 of urban growth is expected to occur in coming decades. Urban growth in developing countries is due to high fertility as well as inmigration of poor peasants seeking a better life. The current growth rate of Third World cities is 3.6% annually, which signifies doubling of the population in 20 years. Paris required over a century to grow from 547,000 to 3 million, but Lagos grew from 700,000 to 5.6 million in 20 years and Cairo grew by 6.5 million in 34 years. Immoderate population growth places a great strain on cities attempting to provide basic services. Only a few authoritarian governments have succeeded in limiting immigration to their metropolitan areas. Rapidly growing cities have become symbols not only of poverty and social deterioration, but of ecological destruction, contamination, and lack of health. Air pollution, waste management, and the water supply are 3 of the most serious problems of hygiene and sanitation in the world's cities. Air pollution is caused by various factors including car exhausts and coal burning. According to World Health Organization data, less than 60% of Third World housing has access to an adequate sanitary system. 90% of sewage is not treated before elimination. And millions of persons with no potable water supply are obliged to consume contaminated water or to use their scarce resources to buy water. Many cities lose up to 60% of their scarce water supplies through leaking pipes. If these pipes were repaired, and the loss amounted to the 12% typical of the US and Great Britain, this single measure would double the volume of potable water available. The lack of social balance is at the root of urban problems in the Third World. 600 million inhabitants of the Third World live in unhealthy housing. Most housing inhabited by the poor shares 2 characteristics: presence of pathogenic microorganisms because of lack of access to sanitary means of waste disposal, and crowding. The wealthy inhabitants of Third world cities must act to mitigate the problems of urban growth, but external aid will also be needed to raise the quality of the urban environment. The increasing crowdedness of cities should prompt authorities to make family planning services universally available.

Urban informality as a signifier: Performing urban reordering in suburban Rio de Janeiro

PubMed Central

Müller, Frank I

2017-01-01

Urban informality is typically ascribed to the urban poor in cities of the Global South. Drawing on Judith Butler’s concept of performativity and taking the case of Rio de Janeiro in the context of the 2016 Olympic Games, this article conceptualizes informality as a signifier and a procedural, relational category. Specifically, it shows how different class actors have employed the signifier informality (1) to legitimize the confinement of marginalized populations; (2) to justify the organized efforts of the upper middle class to protect their ‘self-enclosed’ gated communities; and (3) to warrant the formation of opposition and alliances between inhabitants, activists, and researchers on the edges of the urban order. This article offers new perspectives to better understand the relationship between informality and confinement by examining the active role that inhabitants of marginalized settlements assume in the Olympic City. PMID:28781405

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas

PubMed Central

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area. PMID:27997577

Intensified summer monsoon and the urbanization of Indus Civilization in northwest India.

PubMed

Dixit, Yama; Hodell, David A; Giesche, Alena; Tandon, Sampat K; Gázquez, Fernando; Saini, Hari S; Skinner, Luke C; Mujtaba, Syed A I; Pawar, Vikas; Singh, Ravindra N; Petrie, Cameron A

2018-03-09

Today the desert margins of northwest India are dry and unable to support large populations, but were densely occupied by the populations of the Indus Civilization during the middle to late Holocene. The hydroclimatic conditions under which Indus urbanization took place, which was marked by a period of expanded settlement into the Thar Desert margins, remains poorly understood. We measured the isotopic values (δ 18 O and δD) of gypsum hydration water in paleolake Karsandi sediments in northern Rajasthan to infer past changes in lake hydrology, which is sensitive to changing amounts of precipitation and evaporation. Our record reveals that relatively wet conditions prevailed at the northern edge of Rajasthan from ~5.1 ± 0.2 ka BP, during the beginning of the agricultural-based Early Harappan phase of the Indus Civilization. Monsoon rainfall intensified further between 5.0 and 4.4 ka BP, during the period when Indus urban centres developed in the western Thar Desert margin and on the plains of Haryana to its north. Drier conditions set in sometime after 4.4 ka BP, and by ~3.9 ka BP an eastward shift of populations had occurred. Our findings provide evidence that climate change was associated with both the expansion and contraction of Indus urbanism along the desert margin in northwest India.

Family planning use among urban poor women from six cities of Uttar Pradesh, India.

PubMed

Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K

2012-08-01

Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

Oral health status of rural-urban migrant children in South China.

PubMed

Gao, Xiao-Li; McGrath, Colman; Lin, Huan-Cai

2011-01-01

In China, there is a massive rural-urban migration and the children of migrants are often unregistered residents (a 'floating population'). This pilot study aimed to profile the oral health of migrant children in South China's principal city of migration and identify its socio-demographic/behavioural determinants. An epidemiological survey was conducted in an area of Guangzhou among 5-year-old migrant children (n = 138) who received oral examinations according to the World Health Organization criteria. Parents' oral health knowledge/attitude, child practices, and impact of children's oral health on their quality-of-life (QoL) were assessed. The caries rate and mean (SD) dmft were 86% and 5.17 (4.16), respectively, higher than those national statistics for both rural and urban areas (P < 0.05). Oral hygiene was satisfactory (DI-S < 1.0) in 3% of children. Oral health impacts on QoL were considerable; 60% reported one or more impacts. 58% variance in 'dmft' was explained by 'non-local-born', 'low-educated parents', 'bedtime feeding', 'parental unawareness of fluoride's effect and importance of teeth', and 'poor oral hygiene' (all P < 0.05). 'Non-local-born' and 'dmft' indicated poor oral health-related QoL (both P < 0.05), accounting for 32% of variance. Oral health is poor among rural-urban migrant children and requires effective interventions in targeted sub-groups. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

PubMed

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum-rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

PubMed Central

Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum–rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Conclusion Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities. PMID:27924741

An Empirical Analysis of Rural-Urban Differences in Out-Of-Pocket Health Expenditures in a Low-Income Society of China.

PubMed

Wang, Lidan; Wang, Anjue; Zhou, Detong; FitzGerald, Gerry; Ye, Dongqing; Jiang, Qicheng

2016-01-01

The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China.

An Empirical Analysis of Rural-Urban Differences in Out-Of-Pocket Health Expenditures in a Low-Income Society of China

PubMed Central

Wang, Lidan; Wang, Anjue; Zhou, Detong; FitzGerald, Gerry; Ye, Dongqing; Jiang, Qicheng

2016-01-01

Objective The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Method Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Result Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. Conclusion A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China. PMID:27223811

Australian Study Cites Low English Standards

ERIC Educational Resources Information Center

Cohen, David

2007-01-01

This article reports the findings of a study showing that one-third of all foreign students who studied at Australian universities speak English so poorly that they should never have been granted visas to study in the country in the first place. The study, by Robert Birrell, director of the Centre for Population and Urban Research at Australia's…

Educating the Urban Poor: A Case Study of Running Preschools in Non-Notified Slums of India

ERIC Educational Resources Information Center

Vaijayanti, K.; Subramanian, Mathangi

2015-01-01

United Nations Children's Fund (UNICEF) recently reported that the world's population is shifting to its cities. India is no exception. Throughout the country, an increasing number of migrants are leaving agricultural lifestyles in search of economic and educational opportunities, often relocating to non-notified slums. Despite the fact that many…

Popular Education for Peasant Communities in Chile. Chapter 21.

ERIC Educational Resources Information Center

Infante R., Isabel; Letelier G., Eugenia

The rural population of Chile has been served poorly by the formal educational system, rural educational attainment lags behind that of urban areas, and outmigration and alienation of rural youth are high. In the past decade, popular education has attempted to educate rural people and put them in control of their destinies by drawing on popular…

Urban/rural interface: Governing the chaos

NASA Astrophysics Data System (ADS)

Ferreira, António

2016-04-01

Cities have become recently the home for more than half of the world's population. Cities are often seen as ecological systems just a short step away from collapse [Newman 2006]. Being a human construction, cities disrupt the natural cycles and the patterns of temporal and spatial distribution of environmental and ecological processes. Urbanization produces ruptures in biota, water, energy and nutrients connectivity that can lead to an enhanced exposure to disruptive events that hamper the wellbeing and the resilience of urban communities in a global change context. An important issue in what concerns urban sprawl is the interface between the urban and the rural territories. Being an extremely dynamic landscape, and assuring some quality of life and buffering some of the pervasive negative impacts of urban areas in terms of disrupting the function of the natural ecosystems, in limit situations this interface can act as a conveyor belt of catastrophic events originated in the rural world, into the urban space. The Coimbra 2005 wildfire is a fine example of how a poorly managed urban/rural interface can put populations in danger, by allowing the fire to spread towards the urban green infrastructure, burning houses in the process. Major river flows that flood urban areas are also good examples of the lack of management and planning can result in the loss of assets and even put in danger human lives. This presentation reviews the impact of extreme events and the transmission from the urban to the rural worlds, but also from the rural to the urban territories, and establishes the need to govern risk at various levels and using the full range of governance tools.

Urban compaction or dispersion? An air quality modelling study

NASA Astrophysics Data System (ADS)

Martins, Helena

2012-07-01

Urban sprawl is altering the landscape, with current trends pointing to further changes in land use that will, in turn, lead to changes in population, energy consumption, atmospheric emissions and air quality. Urban planners have debated on the most sustainable urban structure, with arguments in favour and against urban compaction and dispersion. However, it is clear that other areas of expertise have to be involved. Urban air quality and human exposure to atmospheric pollutants as indicators of urban sustainability can contribute to the discussion, namely through the study of the relation between urban structure and air quality. This paper addresses the issue by analysing the impacts of alternative urban growth patterns on the air quality of Porto urban region in Portugal, through a 1-year simulation with the MM5-CAMx modelling system. This region has been experiencing one of the highest European rates of urban sprawl, and at the same time presents a poor air quality. As part of the modelling system setup, a sensitivity study was conducted regarding different land use datasets and spatial distribution of emissions. Two urban development scenarios were defined, SPRAWL and COMPACT, together with their new land use and emission datasets; then meteorological and air quality simulations were performed. Results reveal that SPRAWL land use changes resulted in an average temperature increase of 0.4 °C, with local increases reaching as high as 1.5 °C. SPRAWL results also show an aggravation of PM10 annual average values and an increase in the exceedances to the daily limit value. For ozone, differences between scenarios were smaller, with SPRAWL presenting larger concentration differences than COMPACT. Finally, despite the higher concentrations found in SPRAWL, population exposure to the pollutants is higher for COMPACT because more inhabitants are found in areas of highest concentration levels.

Consideration of Environmental Factors in Planning and Development of Urban Areas

NASA Astrophysics Data System (ADS)

Kustysheva, I.

2017-11-01

Environmental factors, in varying degrees, always have a direct influence on the urban environment formation and the provision of favorable and safe conditions for the life of the population. Their role in the planning and development of urban areas remains an integral part of the management of such areas. Management should be aimed at improving the efficiency of use of the territories and ecological environment improvement. Planning must be done with the consideration of identified ecological processes in cities on the basis of the information about their occurrence in the past and present. Currently, cities face a multitude of problems that require urgent and immediate solutions. One of the most important issues is the poor state of the urban environment, so the environmental factors remain one of the most critical problems that should be considered by the authorities while implementing the urban areas’ development plans. The article discusses the role of environmental factors in the management and planning of urban territories by the example of the city of Tobolsk.

Determinants of immunization inequality among urban poor children: evidence from Nairobi's informal settlements.

PubMed

Egondi, Thaddaeus; Oyolola, Maharouf; Mutua, Martin Kavao; Elung'ata, Patricia

2015-02-27

Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008-9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. The study aims to determine the degree and determinants of immunization inequality among the urban poor of Nairobi. We used data from the Nairobi Cross-Sectional Slum Survey of 2012 and the health outcome was full immunization status among children aged 12-23 months. The wealth index was used as a measure of social economic position for inequality analysis. The potential determinants considered included sex of the child and mother's education, their occupation, age at birth of the child, and marital status. The concentration index (CI) was used to quantify the degree of inequality and decomposition approach to assess determinants of inequality in immunization. The CI for not fully immunized was -0.08 indicating that immunization inequality is mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother's level of education. There exists immunization inequality among urban poor children in Nairobi and efforts to reduce this inequality should aim at targeting mothers with low level of education during immunization campaigns.

Reducing violence in poor urban areas of Honduras by building community resilience through community-based interventions.

PubMed

Hansen-Nord, Nete Sloth; Kjaerulf, Finn; Almendarez, Juan; Rodas, Victor Morales; Castro, Julio

2016-11-01

To examine the impact of a 3 year community-based violence prevention intervention on risk of violence and social capital in two poor urban communities in Honduras in 2011-2014. A quasi-experimental design pre and post implementation of the intervention was conducted based on data from two randomly selected samples using the same structured questionnaire in 2011 and in 2014. Community members had a 42 % lower risk of violence in 2014 compared to 2011. There was a positive relation between participation in the intervention and structural social capital, and participants had more than twice the likelihood of engaging in citizenship activities compared to the general population. The intervention contributed to decreasing violence and increasing community resilience in two urban areas in Honduras. Citizenship activities and active community participation in the violence prevention agenda rather than social trust and cohesion characteristics was affected by the intervention. This research introduces important lessons learned to future researchers aiming to retrieve very sensitive data in a similarly violent setting, and provides strong research opportunities within areas, which to this date remain undiscovered.

Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey.

PubMed

Montagu, Dominic; Sudhinaraset, May; Lwin, Thandar; Onozaki, Ikushi; Win, Zaw; Aung, Tin

2013-01-10

Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. The study uses data from two sources: 1) Myanmar's first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p < 0.05). In rural areas, there was no statistically significant difference between the wealth distribution of SQH clinic patients and general TB positive individuals (p > 0.05). Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas.

Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

PubMed Central

2013-01-01

Introduction Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. Methods The study uses data from two sources: 1) Myanmar’s first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. Results TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p < 0.05). In rural areas, there was no statistically significant difference between the wealth distribution of SQH clinic patients and general TB positive individuals (p > 0.05). Conclusion Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas. PMID:23305063

Modeling the effects of land cover and use on landscape capability for urban ungulate populations: Chapter 11

USGS Publications Warehouse

Underwood, Harold; Kilheffer, Chellby R.; Francis, Robert A.; Millington, James D. A.; Chadwick, Michael A.

2016-01-01

Expanding ungulate populations are causing concerns for wildlife professionals and residents in many urban areas worldwide. Nowhere is the phenomenon more apparent than in the eastern US, where urban white-tailed deer (Odocoileus virginianus) populations are increasing. Most habitat suitability models for deer have been developed in rural areas and across large (>1000 km2) spatial extents. Only recently have we begun to understand the factors that contribute to space use by deer over much smaller spatial extents. In this study, we explore the concepts, terminology, methodology and state-of-the-science in wildlife abundance modeling as applied to overabundant deer populations across heterogeneous urban landscapes. We used classified, high-resolution digital orthoimagery to extract landscape characteristics in several urban areas of upstate New York. In addition, we assessed deer abundance and distribution in 1-km2 blocks across each study area from either aerial surveys or ground-based distance sampling. We recorded the number of detections in each block and used binomial mixture models to explore important relationships between abundance and key landscape features. Finally, we cross-validated statistical models of abundance and compared covariate relationships across study sites. Study areas were characterized along a gradient of urbanization based on the proportions of impervious surfaces and natural vegetation which, based on the best-supported models, also distinguished blocks potentially occupied by deer. Models performed better at identifying occurrence of deer and worse at predicting abundance in cross-validation comparisons. We attribute poor predictive performance to differences in deer population trajectories over time. The proportion of impervious surfaces often yielded better predictions of abundance and occurrence than did the proportion of natural vegetation, which we attribute to a lack of certain land cover classes during cold and snowy winters. Merits and limitations of our approach to habitat suitability modeling are discussed in detail.

Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan.

PubMed

Abe, Y; Fujise, N; Fukunaga, R; Nakagawa, Y; Ikeda, M

2012-08-01

The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression. A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used. Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area. Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.

Microbial diversity in the floral nectar of Linaria vulgaris along an urbanization gradient.

PubMed

Bartlewicz, Jacek; Lievens, Bart; Honnay, Olivier; Jacquemyn, Hans

2016-03-30

Microbes are common inhabitants of floral nectar and are capable of influencing plant-pollinator interactions. All studies so far investigated microbial communities in floral nectar in plant populations that were located in natural environments, but nothing is known about these communities in nectar of plants inhabiting urban environments. However, at least some microbes are vectored into floral nectar by pollinators, and because urbanization can have a profound impact on pollinator communities and plant-pollinator interactions, it can be expected that it affects nectar microbes as well. To test this hypothesis, we related microbial diversity in floral nectar to the degree of urbanization in the late-flowering plant Linaria vulgaris. Floral nectar was collected from twenty populations along an urbanization gradient and culturable bacteria and yeasts were isolated and identified by partially sequencing the genes coding for small and large ribosome subunits, respectively. A total of seven yeast and 13 bacterial operational taxonomic units (OTUs) were found at 3 and 1% sequence dissimilarity cut-offs, respectively. In agreement with previous studies, Metschnikowia reukaufii and M. gruessi were the main yeast constituents of nectar yeast communities, whereas Acinetobacter nectaris and Rosenbergiella epipactidis were the most frequently found bacterial species. Microbial incidence was high and did not change along the investigated urbanization gradient. However, microbial communities showed a nested subset structure, indicating that species-poor communities were a subset of species-rich communities. The level of urbanization was putatively identified as an important driver of nestedness, suggesting that environmental changes related to urbanization may impact microbial communities in floral nectar of plants growing in urban environments.

Quantifying urbanization as a risk factor for noncommunicable disease.

PubMed

Allender, Steven; Wickramasinghe, Kremlin; Goldacre, Michael; Matthews, David; Katulanda, Prasad

2011-10-01

The aim of this study was to investigate the poorly understood relationship between the process of urbanization and noncommunicable diseases (NCDs) in Sri Lanka using a multicomponent, quantitative measure of urbanicity. NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study, comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n = 4,485/5,000; response rate = 89.7%). We constructed a measure of the urban environment for seven areas using a 7-item scale based on data from study clusters to develop an "urbanicity" scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors. Among men, urbanicity was positively associated with physical inactivity (odds ratio [OR] = 3.22; 2.27-4.57), high body mass index (OR = 2.45; 95% CI, 1.88-3.20) and diabetes mellitus (OR = 2.44; 95% CI, 1.66-3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR = 2.29; 95% CI, 1.64-3.21), high body mass index (OR = 2.92; 95% CI, 2.41-3.55), and diabetes mellitus (OR = 2.10; 95% CI, 1.58 - 2.80). There is a clear relationship between urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults.

Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.

PubMed

de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita

2011-12-01

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.

Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.

PubMed

Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

2016-01-01

The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51), unemployment (1.36; 1.18-1.56), single status (1.34; 1.23-1.45), and Wealth Index middle class (1.20; 1.08-1.32) or poor (1.33; 1.21-1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89). Single (1.50; 1.26-1.78), unemployed (1.39; 1.07-1.80) and inactive respondents (1.42; 1.10-1.83) had a higher odds of chronic anxiety or depression than married individuals, or those with partner, and employed persons. Those with perceived good health status had lower odds for poor MHI-5, chronic anxiety or depression than those whose general health was average and poor. Almost half of the population assessed their mental health as poor and 5% had diagnosed chronic anxiety or depression. Multi-sectoral socioeconomic and female-sensitive policies should be wisely tailored to reduce mental health inequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.

Environmental management problems in India

NASA Astrophysics Data System (ADS)

Bowonder, B.

1986-09-01

Environmental problems are becoming serious in India because of the interacting effects of increasing population density, industrialization and urbanization, and poor environmental management practices. Unless stringent regulatory measures are taken, environmental systems will be irreversibly degraded. Lack of political commitment, lack of a comprehensive environmental policy, poor environmental awareness, functional fragmentation of the public administration system, poor mass media concern, and prevalence of poverty are some of the major factors responsible for increasing the severity of the problems. Environmental problems in India are highly complex, and management procedures have to be developed to achieve coordination between various functional departments, and for this, political leaders have to be convinced of the need to initiate environmental protection measures.

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

PubMed

Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

2014-01-01

To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

Residential Exposure to Nighttime Retained Heat in the El Paso, Texas, USA Desert Metroplex

NASA Astrophysics Data System (ADS)

Amaya, M. A.; Mohammed, M.; Pingitore, N. E.; Aldouri, R. K.; Benedict, B. A.

2013-12-01

The urban heat island is a well recognized and extensively studied phenomenon that has accelerating importance resulting from two trends associated with world-wide population growth: increasing urbanization and global warming. Urbanization, particularly when unplanned and haphazard, changes such thermal parameters as albedo, surface roughness, and heat capacities of surface materials. Rapid urbanization in the contiguous El Paso, Texas, USA - Ciudad Juarez, Chihuahua, Mexico bi-national metroplex has produced an urban heat island that is warmer than the surrounding Chihuahuan desert (temperature: 35-40 C summer; high elevation: 600-1675 m; rainfall: less than 250 mm annual). Despite the extensive literature on the urban heat island, little is known about urban nighttime land surface temperatures. We employed infrared satellite imaging to establish the variation of nighttime neighborhood surface temperatures across the city of El Paso, as well as all of El Paso County. The underlying purpose of our continuing investigation is to evaluate the geography of morbidity risk: are different neighborhoods at different risk of high nighttime temperatures. Those risks can include heat stress, and irritability and sleep deprivation, with possible resultant violence. Heat exposure at night is significant because residents are at home and 90% of El Pasoans do not have 'refrigerated' air conditioning, but instead have evaporative coolers, which are less expensive to own and operate, but are less effective since they raise the humidity of the partially cooled air. Our geographically weighted regression model showed that both day and nighttime land surface temperatures correlated with the normalized difference vegetation index, population density, and albedo. The association with the index and albedo was stronger during the daytime and with population density during the nighttime. Vegetation (negative) and population density (positive) were the dominant temperature drivers, with albedo and elevation as secondary drivers. Using archived satellite imagery we determined that over the last two decades there has been an increase in both day and nighttime temperatures. With no expected change in urban growth and global warming, local residents will be at increasing risk in the future, as will residents in other urban centers in the desert southwest of the US. We currently are evaluating exposure risk in different population sectors. Do the aged or the poor reside in higher risk neighborhoods? Are there simple measures that can be taken to ameliorate nighttime temperatures?

Using a Birth Center Model of Care to Improve Reproductive Outcomes in Informal Settlements-a Case Study.

PubMed

Wallace, Jacqueline

2018-06-04

The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. Informal settlements are frequently located in environmentally hazardous areas and typically lack adequate sanitation and clean water, leading to poor health outcomes for residents. In these difficult circumstances women and children fair the worst, and reproductive outcomes for women living in informal settlements are grim. Insufficient uptake of antenatal care, lack of skilled birth attendants and poor-quality care contribute to maternal mortality rates in informal settlements that far outpace wealthier urban neighborhoods (Chant and McIlwaine (2016)). In response, a birth center model of maternity care is proposed for informal settlements. Birth centers have been shown to provide high quality, respectful, culturally appropriate care in high resource settings (Stapleton et al. J Midwifery Women's Health 58(1):3-14, 2013; Hodnett et al. Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.

Hypertension in the Hispanic and Black Population in New York City

PubMed Central

Barrios, Eugene; Iler, Elizabeth; Mulloy, Katherine; Goldstein, Jonathan; Chalfin, Donald; Muñoz, Eric

1987-01-01

Little data have been accumulated on the health care problems of underserved, urban Hispanic-Americans. The purpose of this study was to determine the prevalence of hypertension and the adequacy of treatment for Hispanic-Americans (predominately Puerto Ricans) and blacks living in the South Bronx section of New York City. Almost three fourths (74.5 percent) of the study subjects (n = 145) knew what hypertension was, and 40.7 percent said they had hypertension. However, 52.3 percent of subjects (Hispanic, 49.2 percent and black, 61.5 percent) who responded that they were not hypertensive had hypertension. Of those who said they had hypertension, only 55.9 percent were taking medication (Hispanic, 57.5 percent and black, 57.1 percent). For those taking medication, the majority did not have their hypertension controlled (Hispanic, 78.2 percent and black, 100 percent). These data suggest that for urban Hispanics and blacks, both hypertensive awareness and control is poor. This population thus appears likely to suffer excess morbidity and mortality from hypertension. Public policy programs for surveillance and control of hypertension in urban Hispanic and black populations may decrease the rate of morbidity and mortality from this treatable disease. PMID:3498048

Spread and character of Tomostethus nigritus F. outbreaks in Croatia during the last decade

Treesearch

Dinka Matosevic; Boris Hrasovec; Milan Pernek

2003-01-01

The larvae of Tomostethus nigritus F. (Hym.: Tenthredinidae) began causing severe defoliation on ash along avenues and tree lines in Zagreb, Croatia since 1997. The phenomenon of population outbreaks in periurban and urban environments is known but poorly documented in the literature; the fact that it has not yet been recorded in Croatian forests has...

Community-level demographic consequences of urbanization: an ecological network approach.

PubMed

Rodewald, Amanda D; Rohr, Rudolf P; Fortuna, Miguel A; Bascompte, Jordi

2014-11-01

Ecological networks are known to influence ecosystem attributes, but we poorly understand how interspecific network structure affect population demography of multiple species, particularly for vertebrates. Establishing the link between network structure and demography is at the crux of being able to use networks to understand population dynamics and to inform conservation. We addressed the critical but unanswered question, does network structure explain demographic consequences of urbanization? We studied 141 ecological networks representing interactions between plants and nesting birds in forests across an urbanization gradient in Ohio, USA, from 2001 to 2011. Nest predators were identified by video-recording nests and surveyed from 2004 to 2011. As landscapes urbanized, bird-plant networks were more nested, less compartmentalized and dominated by strong interactions between a few species (i.e. low evenness). Evenness of interaction strengths promoted avian nest survival, and evenness explained demography better than urbanization, level of invasion, numbers of predators or other qualitative network metrics. Highly uneven networks had approximately half the nesting success as the most even networks. Thus, nest survival reflected how urbanization altered species interactions, particularly with respect to how nest placement affected search efficiency of predators. The demographic effects of urbanization were not direct, but were filtered through bird-plant networks. This study illustrates how network structure can influence demography at the community level and further, that knowledge of species interactions and a network approach may be requisite to understanding demographic responses to environmental change. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.

Channelling urban modernity to sustainable pro-poor tourism development in Indonesia

NASA Astrophysics Data System (ADS)

Prasetyanti, R.

2017-06-01

Sustainable urban planning and development requires not only a fast-growing economic growth and modernity, but also social equity and environmental sustainability. Meanwhile, the global goals of sustainable development have fascinatingly set a promising urban development future by enhancing ecology based pro-poor policy program. Apparently, pro-poor development agenda has led to the notion of pro-poor tourism as part of urban development strategies on poverty alleviation. This research presents Jakarta Hidden Tour and Kampung Warna-warni as certain cases of pro-poor tourism in Indonesia. By the emergence of criticism on “pro-growth” paradigm, the critical analysis of this research focuses on the scenario of sustainable pro-poor tourism through eco-cultural based Kampung-Tour development. In accordance, debates and dilemma have been continuously arising as pros and cons regarding the ethical issues of poverty alleviation based Kampung-Tour development. Nevertheless, this paper tries to redefine Slum Kampung as potential; the writer wildly offers a concept of poverty alleviation by reinventing pro-poor tourism strategy; revitalizing slum site to eco-cultural based pro-poor tourism development as an embodiment of a sustainable urban development. By holding system thinking analysis as research method, sustainable pro-poor tourism highlights the urgency community based tourism and eco-tourism so that poverty alleviation based tourism can be tangibly perceived by the poor. In this sense, good local governance and public private partnership must be enhanced, it is due to, like any other development projects; sustainable pro-poor tourism needs a strong political commitment to alleviate urban poverty, as well as to pursue a better future of sustainable nation.

Poor Schools, Poor Students, Successful Teachers

ERIC Educational Resources Information Center

Gehrke, Rebecca Swanson

2005-01-01

Today, one out of four American children attends school in an urban district; one out of every six American children lives in poverty; and, in urban schools where most of the students are poor, two-thirds or more of the children fail to reach even the "basic" level of achievement on national tests. Urban schools are where most states face the…

The dual function of and counter-measures for rural population migration.

PubMed

Gu, S; Jian, X

1996-01-01

The authors posit that migration of the Chinese population from poverty stricken and backward rural areas to economically developed and advanced cities and coastal areas can have a positive effect on economic development and social stability. Policies must eliminate the negative disorderly and ineffective aspects and reinforce the positive, well-organized, orderly, and effective aspects. Population mobility enhances the formation of a national, unified labor market and resource distribution that is responsive to supply and demand. Population mobility allows for the transfer of rural surplus labor, relief of employment pressure in rural areas, and reduced population pressure on land availability. Rural surplus labor that moves into rural township enterprises is a major new source of financial capital for the economic development of rural areas. Population mobility aids in the development of an urban economy and increases farmers' income and living standard. Population mobility increases China's shift to a dual economic mode that includes a modern economy. Adverse effects include a decline in the quality of the rural labor force and diminished capital input into agriculture, a strain on urban resources and social services, and disruption of the socioeconomic order. Population mobility enhances social stability by advancing economic development and standards of living. Population mobility allows for the smooth transfer of surplus labor during periods of economic change to a modern economy. A poor economy and deteriorated living conditions lead to violent social disturbances, social conflicts, and resentment among the public. Adverse effects on social stability include increased crime, housing scarcity and temporary shelters, and social conflicts between urban residents and migrants. Government strategies should include the direction of surplus migrants into multiple channels. Six channels are identified. Rural labor should be encouraged to work in enterprises and to move to urban areas. Nonagricultural industrialization should be concentrated in certain geographic regions. Measures must be in place to regulate the flow of surplus migrants into a gradual stream.

Comparison of asthma prevalence among African American teenage youth attending public high schools in rural Georgia and urban Detroit.

PubMed

Ownby, Dennis R; Tingen, Martha S; Havstad, Suzanne; Waller, Jennifer L; Johnson, Christine C; Joseph, Christine L M

2015-09-01

The high prevalence of asthma among urban African American (AA) populations has attracted research attention, whereas the prevalence among rural AA populations is poorly documented. We sought to compare the prevalence of asthma among AA youth in rural Georgia and urban Detroit, Michigan. The prevalence of asthma was compared in population-based samples of 7297 youth attending Detroit public high schools and in 2523 youth attending public high schools in rural Georgia. Current asthma was defined as a physician diagnosis and symptoms in the previous 12 months. Undiagnosed asthma was defined as multiple respiratory symptoms in the previous 12 months without a physician diagnosis. In Detroit, 6994 (95.8%) youth were AA compared with 1514 (60.0%) in Georgia. Average population density in high school postal codes was 5628 people/mile(2) in Detroit and 45.1 people/mile(2) in Georgia. The percentages of poverty and of students qualifying for free or reduced lunches were similar in both areas. The prevalence of current diagnosed asthma among AA youth in Detroit and Georgia was similar: 15.0% (95% CI, 14.1-15.8) and 13.7% (95% CI, 12.0-17.1) (P = .22), respectively. The prevalence of undiagnosed asthma in AA youth was 8.0% in Detroit and 7.5% in Georgia (P = .56). Asthma symptoms were reported more frequently among those with diagnosed asthma in Detroit, whereas those with undiagnosed asthma in Georgia reported more symptoms. Among AA youth living in similar socioeconomic circumstances, asthma prevalence is as high in rural Georgia as it is in urban Detroit, suggesting that urban residence is not an asthma risk factor. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Population migration and the spread of types 1 and 2 human immunodeficiency viruses.

PubMed Central

Quinn, T C

1994-01-01

Over 14 million people are estimated to be infected with the human immunodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migration of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business purposes, and the drug trade. In sub-Saharan Africa, between 1960 and 1980, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The result was a massive migration of rural inhabitants to urban centers concomitant with the spread of HIV-1 to large population centers. With the associated demographic, economic, and social changes, an epidemic of sexually transmitted diseases and HIV-1 was ignited. Migratory patterns were also responsible for the spread of endemic HIV-2 to neighboring West African countries and eventually to Europe, the Americans, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to population density and inherent risk behaviors. Thus, the migration of poor, rural, and young sexually active individuals to urban centers coupled with large international movements of HIV-infected individuals played a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasing the population at risk through increased urban migration, disruption of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled. Images PMID:8146131

Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana.

PubMed

Sengupta, Paramita; Benjamin, Anoop I

2015-01-01

Depression, the most common psychiatric disorder among the elderly, is not yet perceived as an important health problem in India, where few population-based studies have addressed this problem. To estimate the prevalence of depression and identify the associated risk factors in the elderly population. 3038 consenting elderly (>60 years old) rural and urban residents of both sexes from the field practice areas were interviewed and examined in a cross-sectional study. Physical impairment in the subjects was assessed with the Everyday Abilities Scale for India (EASI), depression by the 15-item Geriatric Depression Scale (GDS-15), and cognitive impairment by the Mini-Mental State Examination (MMSE). Data were analyzed using Epi Info version-6 software. Statistical analysis included proportions, χ[2] -test, odds ratio, and its 95% confidence interval. Multiple logistic regression was done using SPSS version 21. The prevalence of depression in the study population was 8.9%. It was significantly higher in urban residents, females, older elderly, nuclear families, in those living alone, those not working, illiterates, poor, functionally impaired, and cognitively impaired. In the multivariate analysis, unmarried/widowed status, unemployment, and illiteracy did not emerge as risk factors. Urban residence, female gender, higher age, nuclear family, poverty, and functional and cognitive impairment were found to be associated with depression even after controlling for other factors.

Social justice, climate change, and dengue.

PubMed

Chang, Aileen Y; Fuller, Douglas O; Carrasquillo, Olveen; Beier, John C

2014-06-14

Climate change should be viewed fundamentally as an issue of global justice. Understanding the complex interplay of climatic and socioeconomic trends is imperative to protect human health and lessen the burden of diseases such as dengue fever. Dengue fever is rapidly expanding globally. Temperature, rainfall, and frequency of natural disasters, as well as non-climatic trends involving population growth and migration, urbanization, and international trade and travel, are expected to increase the prevalence of mosquito breeding sites, mosquito survival, the speed of mosquito reproduction, the speed of viral incubation, the distribution of dengue virus and its vectors, human migration patterns towards urban areas, and displacement after natural disasters. The burden of dengue disproportionately affects the poor due to increased environmental risk and decreased health care. Mobilization of social institutions is needed to improve the structural inequalities of poverty that predispose the poor to increased dengue fever infection and worse outcomes. This paper reviews the link between dengue and climatic factors as a starting point to developing a comprehensive understanding of how climate change affects dengue risk and how institutions can address the issues of social justice and dengue outbreaks that increasingly affect vulnerable urban populations. Copyright © 2014 Chang, Fuller, Carrasquillo, Beier. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies.

PubMed

Aryeetey, Genevieve Cecilia; Jehu-Appiah, Caroline; Spaan, Ernst; Agyepong, Irene; Baltussen, Rob

2012-01-01

To analyse the costs and evaluate the equity, efficiency and feasibility of four strategies to identify poor households for premium exemptions in Ghana's National Health Insurance Scheme (NHIS): means testing (MT), proxy means testing (PMT), participatory wealth ranking (PWR) and geographic targeting (GT) in urban, rural and semi-urban settings in Ghana. We conducted the study in 145-147 households per setting with MT as our gold standard strategy. We estimated total costs that included costs of household surveys and cost of premiums paid to the poor, efficiency (cost per poor person identified), equity (number of true poor excluded) and the administrative feasibility of implementation. The cost of exempting one poor individual ranged from US$15.87 to US$95.44; exclusion of the poor ranged between 0% and 73%. MT was most efficient and equitable in rural and urban settings with low-poverty incidence; GT was efficient and equitable in the semi-urban setting with high-poverty incidence. PMT and PWR were less equitable and inefficient although feasible in some settings. We recommend MT as optimal strategy in low-poverty urban and rural settings and GT as optimal strategy in high-poverty semi-urban setting. The study is relevant to other social and developmental programmes that require identification and exemptions of the poor in low-income countries. © 2011 Blackwell Publishing Ltd.

Relationship of tooth wear to chronological age among indigenous Amazon populations.

PubMed

Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

2015-01-01

In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups.

Relationship of Tooth Wear to Chronological Age among Indigenous Amazon Populations

PubMed Central

Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

2015-01-01

In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups. PMID:25602501

Urbanization and the dynamics of RNA viruses in Mallards (Anas platyrhynchos).

PubMed

Wille, Michelle; Lindqvist, Kristine; Muradrasoli, Shaman; Olsen, Björn; Järhult, Josef D

2017-07-01

Urbanization is intensifying worldwide, and affects the epidemiology of infectious diseases. However, the effect of urbanization on natural host-pathogen systems remains poorly understood. Urban ducks occupy an interesting niche in that they directly interact with both humans and wild migratory birds, and either directly or indirectly with food production birds. Here we have collected samples from Mallards (Anas platyrhynchos) residing in a pond in central Uppsala, Sweden, from January 2013 to January 2014. This artificial pond is kept ice-free during the winter months, and is a popular location where the ducks are fed, resulting in a resident population of ducks year-round. Nine hundred and seventy seven (977) fecal samples were screened for RNA viruses including: influenza A virus (IAV), avian paramyxovirus 1, avian coronavirus (CoV), and avian astrovirus (AstroV). This intra-annual dataset illustrates that these RNA viruses exhibit similar annual patterns to IAV, suggesting similar ecological factors are at play. Furthermore, in comparison to wild ducks, autumnal prevalence of IAV and CoV are lower in this urban population. We also demonstrate that AstroV might be a larger burden to urban ducks than IAV, and should be better assessed to demonstrate the degree to which wild birds contribute to the epidemiology of these viruses. The presence of economically relevant viruses in urban Mallards highlights the importance of elucidating the ecology of wildlife pathogens in urban environments, which will become increasingly important for managing disease risks to wildlife, food production animals, and humans. Copyright © 2017 Elsevier B.V. All rights reserved.

Does intrinsic light heterogeneity in Ricinus communis L. monospecific thickets drive species' population dynamics?

PubMed

Goyal, Neha; Shah, Kanhaiya; Sharma, Gyan Prakash

2018-06-19

Ricinus communis L. colonizes heterogeneous urban landscapes as monospecific thickets. The ecological understanding on colonization success of R. communis population due to variable light availability is lacking. Therefore, to understand the effect of intrinsic light heterogeneity on species' population dynamics, R. communis populations exposed to variable light availability (low, intermediate, and high) were examined for performance strategies through estimation of key vegetative, eco-physiological, biochemical, and reproductive traits. Considerable variability existed in studied plant traits in response to available light. Individuals inhabiting high-light conditions exhibited high eco-physiological efficiency and reproductive performance that potentially confers population boom. Individuals exposed to low light showed poor performance in terms of eco-physiology and reproduction, which attribute to bust. However, individuals in intermediate light were observed to be indeterminate to light availability, potentially undergoing trait modulations with uncertainty of available light. Heterogeneous light availability potentially drives the boom and bust cycles in R. communis monospecific thickets. Such boom and bust cycles subsequently affect species' dominance, persistence, collapse, and/or resurgence as an aggressive colonizer in contrasting urban environments. The study fosters extensive monitoring of R. communis thickets to probe underlying mechanism(s) affecting expansions and/or collapses of colonizing populations.

Maternal Health Literacy Is Associated with Early Childhood Nutritional Status in India.

PubMed

Johri, Mira; Subramanian, S V; Koné, Georges K; Dudeja, Sakshi; Chandra, Dinesh; Minoyan, Nanor; Sylvestre, Marie-Pierre; Pahwa, Smriti

2016-07-01

The global burden of child undernutrition is concentrated in South Asia, where gender inequality and female educational disadvantage are important factors. Maternal health literacy is linked to women's education and empowerment, can influence multiple malnutrition determinants, and is rapidly modifiable. This study investigated whether maternal health literacy is associated with child undernutrition in 2 resource-poor Indian populations. We conducted cross-sectional surveys in an urban and a rural site, interviewing 1 woman with a child aged 12-23 mo/household. Multivariate logistic regression analyses were conducted independently for each site. The main exposure was maternal health literacy. We assessed respondents' ability to understand, appraise, and apply health-related information with the use of Indian health promotion materials. The main outcomes were severe stunting, severe underweight, and severe wasting. We classified children as having a severe nutritional deficiency if their z score was <-3 SDs from the WHO reference population for children of the same age and sex. Analyses controlled for potential confounding factors including parental education and household wealth. Rural and urban analyses included 1116 and 657 mother-child pairs, respectively. In each site, fully adjusted models showed that children of mothers with high health literacy had approximately half the likelihood of being severely stunted (rural adjusted OR: 0.50; 95% CI: 0.33, 0.74; P = 0.001; urban adjusted OR: 0.58; 95% CI: 0.35, 0.94; P = 0.028) or severely underweight (rural adjusted OR: 0.57; 95% CI: 0.38, 0.87; P = 0.009; urban adjusted OR: 0.48; 95% CI: 0.25, 0.91; P = 0.025) than children of mothers with low health literacy. Health literacy was not associated with severe wasting. In resource-poor rural and urban settings in India, maternal health literacy is associated with child nutritional status. Programs targeting health literacy may offer effective entry points for intervention. © 2016 American Society for Nutrition.

Potential roles of high salt intake and maternal malnutrition in the development of hypertension in disadvantaged populations.

PubMed

Thrift, Amanda G; Srikanth, Velandai; Fitzgerald, Sharyn M; Kalyanram, Kartik; Kartik, Kamakshi; Hoppe, Chantal C; Walker, Karen Z; Evans, Roger G

2010-02-01

1. It has been argued that all major risk factors for cardiovascular disease have been identified. Yet, epidemiological studies undertaken to identify risk factors have largely focused on populations in developed nations or on the urban or relatively affluent rural populations of developing countries. Poor rural populations are seldom studied. 2. Somewhat different risk factors may operate in poor rural populations. Evidence for this is provided by the finding that, in disadvantaged rural India, the prevalence of hypertension is greater than would be expected based on established risk factors in these populations. One risk factor to be considered is a poor intrauterine environment. 3. In animals, maternal macro- and micronutrient malnutrition can lead to reduced nephron endowment. Nephron deficiency, in turn, can render blood pressure salt sensitive. The combination of nephron deficiency and excessive salt intake will predispose to hypertension. 4. Human malnutrition may have similar effects, particularly in regions of the world where malnutrition is endemic and where women are disadvantaged by existing social practices. 5. Moreover, high salt intake is endemic in many parts of Asia, including India. Therefore, we propose that maternal malnutrition (leading to reduced nephron endowment), when combined with excessive salt intake postnatally, will account, at least in part, for the unexpectedly high prevalence of hypertension in disadvantaged rural communities in India and elsewhere.

Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru.

PubMed

Gross, Rainer; Lechtig, Aarón; López de Romaña, Daniel

2006-01-01

Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.

The Urban Environmental Monitoring/100 Cities Project: Legacy of the First Phase and Next Steps

NASA Technical Reports Server (NTRS)

Stefanov, William L.; Wentz, Elizabeth A.; Brazel, Anthony; Netzband, Maik; Moeller, Matthias

2009-01-01

The Urban Environmental Monitoring (UEM) project, now known as the 100 Cities Project, at Arizona State University (ASU) is a baseline effort to collect and analyze remotely sensed data for 100 urban centers worldwide. Our overarching goal is to use remote sensing technology to better understand the consequences of rapid urbanization through advanced biophysical measurements, classification methods, and modeling, which can then be used to inform public policy and planning. Urbanization represents one of the most significant alterations that humankind has made to the surface of the earth. In the early 20th century, there were less than 20 cities in the world with populations exceeding 1 million; today, there are more than 400. The consequences of urbanization include the transformation of land surfaces from undisturbed natural environments to land that supports different forms of human activity, including agriculture, residential, commercial, industrial, and infrastructure such as roads and other types of transportation. Each of these land transformations has impacted, to varying degrees, the local climatology, hydrology, geology, and biota that predate human settlement. It is essential that we document, to the best of our ability, the nature of land transformations and the consequences to the existing environment. The focus in the UEM project since its inception has been on rapid urbanization. Rapid urbanization is occurring in hundreds of cities worldwide as population increases and people migrate from rural communities to urban centers in search of employment and a better quality of life. The unintended consequences of rapid urbanization have the potential to cause serious harm to the environment, to human life, and to the resulting built environment because rapid development constrains and rushes decision making. Such rapid decision making can result in poor planning, ineffective policies, and decisions that harm the environment and the quality of human life. Slower, more thought-out, decision making could result in more favorable outcomes. The harm to the environment includes poor air quality, soil erosion, polluted rivers and aquifers, and loss of wildlife habitat. Human life is then threatened because of increased potential for disease spreading, human conflict, environmental hazards, and diminished quality of life. The built environment is potentially threatened when cities are built in areas that can be impacted by events such as hurricanes, tsunamis, earthquakes, fires, and landslides. Our goals include assessing the threat of such events on cities and the people living there.

School Choice in Rural Nigeria? The Limits of Low-Fee Private Schooling in Kwara State

ERIC Educational Resources Information Center

Härmä, Joanna

2016-01-01

The rise in low-fee private (LFP) primary schooling serving relatively poor clients is becoming well-documented. However much of this literature focuses on urban areas whose dense populations are favourable to market growth and competition. This paper goes some way to filling a gap in the literature on whether LFP schools are serving the needs of…

[Population pressure: a factor of political destabilization].

PubMed

Tallon, F

1993-04-01

Political stability throughout the world appears to be greater in countries with slowly growing populations than in those with rapid growth. Population is not the only influence on political stability, however. The relationship between political stability and development is strong. The rich countries with the slowest growth are the most stable, while poor developing countries with rapid growth suffer from chronic instability. Demographic pressure and density are not the same thing and must be distinguished. A fragile environment like that of the Sahel will experience demographic pressure despite low density. Japan has a greater population density than Rwanda and little cultivable land, but the population has a high standard of living. demographic pressure is not comparable in Japan and Rwanda because Japan has slow population growth and stable democratic political institutions. The rate of growth seems to be a more important element in destabilization than density. Rapid growth creates enormous political tensions especially when profound ethnic divisions exist, and it complicates problems of government by encouraging rapid urbanization. The unbalanced age structures resulting from rapid growth hinder the satisfaction of employment, educational, and health care needs for the ever-increasing masses of young people. 49% of Rwanda's population is under 15 and 66% is under 25. Rwanda is already densely populated, with around 300 inhabitants/sq km, and its population is projected to double in 20 years. 95% of the population is dependent on agriculture, but by 1988 the average landholding per family was only 1.25 hectares and 58% of families did not grown sufficient food for household needs. Further reduction in the size of holdings or a growing landless population will have multiple consequences. Urban migration will inevitably increase, bringing with it all the problems so evident in other poor countries where the process is more advanced than in Rwanda. Chaotic urbanization is in itself a destabilizing force. The phenomenon of potential political destabilization due to demographic pressure had been analyzed according to different criteria. Unconstitutional sudden changes of government, incomplete civil and political liberties, violent conflicts between ethnic and other subgroups, and the frustrated aspirations of large numbers of young persons are among possible indicators of political instability. A report by the Population Crisis committee which evaluated these indicators in different countries placed Rwanda 39th among 120 countries for potential destabilization. But the period of observation avoided the 1973 disturbances and the 1990 war in Rwanda. The results would undoubtedly be considerably less favorable if the period of observation extended to the present.

Comparing progress toward the millennium development goal for under-five mortality in León and Cuatro Santos, Nicaragua, 1990–2008

PubMed Central

2014-01-01

Background Social inequality in child survival hampers the achievement of Millennium Development Goal 4 (MDG4). Monitoring under-five mortality in different social strata may contribute to public health policies that strive to reduce social inequalities. This population-based study examines the trends, causes, and social inequality of mortality before the age of five years in rural and urban areas in Nicaragua. Methods The study was conducted in one rural (Cuatro Santos) and one urban/rural area (León) based on data from Health and Demographic Surveillance Systems. We analyzed live births from 1990 to 2005 in the urban/rural area and from 1990 to 2008 in the rural area. The annual average rate reduction (AARR) and social under-five mortality inequality were calculated using the education level of the mother as a proxy for socio-economic position. Causes of child death were based on systematic interviews (verbal autopsy). Results Under-five mortality in all areas is declining at a rate sufficient to achieve MDG4 by 2015. Urban León showed greater reduction (AARR = 8.5%) in mortality and inequality than rural León (AARR = 4.5%) or Cuatro Santos (AARR = 5.4%). Social inequality in mortality had increased in rural León and no improvement in survival was observed among mothers who had not completed primary school. However, the poor and remote rural area Cuatro Santos was on track to reach MDG4 with equitable child survival. Most of the deaths in both areas were due to neonatal conditions and infectious diseases. Conclusions All rural and urban areas in Nicaragua included in this study were on track to reach MDG4, but social stratification in child survival showed different patterns; unfavorable patterns with increasing inequity in the peri-urban rural zone and a more equitable development in the urban as well as the poor and remote rural area. An equitable progress in child survival may also be accelerated in very poor settings. PMID:24428933

People on the move.

PubMed

Hancock, G

1979-09-01

Internal migration of the rural poor to urban areas in all Third World countries is the so-called "largest migratory movement in human history." This trend is true for many reasons. Conditions make village life, based on small-scale or subsistence agriculture, less and less bearable. Governmental programs for development seem to concentrate and overinvest in urban areas, to the disadvantage of the countryside. Urban areas have always held a romantic attraction. Modern-day urban areas also offer employment and educational opportunities unequalled in rural areas. The rural poor in many parts of the Third World seem to be getting poorer while the urban poor can at least keep pace with the cost of living.

Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates.

PubMed

Sathasivam, Jeyanthini; Kamaruzzaman, Shahrul Bahyah; Hairi, Farizah; Ng, Chiu Wan; Chinna, Karuthan

2015-11-01

In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state. © 2015 APJPH.

Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

PubMed

Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

2013-10-24

Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities. This study's findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.

Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya

PubMed Central

Kimani-Murage, Elizabeth W.; Muthuri, Stella K.; Oti, Samuel O.; Mutua, Martin K.; van de Vijver, Steven; Kyobutungi, Catherine

2015-01-01

Background Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya. Methods Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults. Results Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese. Conclusion The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further research is needed to understand the pathways to this coexistence, and to test feasibility and effectiveness of context-specific interventions to curb associated health risks. PMID:26098561

Determinants of poor self-rated health among adults in urban Mozambique.

PubMed

Cau, Boaventura M; Falcão, Joana; Arnaldo, Carlos

2016-08-24

Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique. Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health. About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40-49 years (OR = 0.45, p < 0.01), or 50-59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors. Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals' health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub-Saharan Africa, the rising importance of non-communicable diseases and the scarcity of studies on determinants of poor self-rated health among adults in the region, our findings may have implications for a better understanding of the drivers of poor health among adults in urban sub-Saharan Africa.

The lot of female child in an economically weaker society.

PubMed

Grover, V L; Roy, S N

1990-01-01

The study aim was to determine the demographic profile of female children 0-14 years old living in urban slums in Delhi, India. The sample included 1680 slum dwellers in 386 households, of whom 733 were children 0-14 years old. The sex ratio of the sample population was 900 females per 1000 males, compared to the national ratio of 933 females per 1000 males. The sample population included 796 females and 884 males. The sex ratio among children 0-14 years old in the sample was 960 females per 1000 males. School enrollment of children 5-14 years old numbered 232 (50.4%): 46% males and 27.5% females. The lower enrollment of females in slum areas compared to the national average was attributed to the greater participation of young girls in domestic work. 22% of children 0-14 years old were married. The infant mortality rate was 143.2/1000 live births. The crude death rate was 19.64/1000 population, which was 150% higher than the national rate. Female mortality among those 0-6 years old was higher than male mortality; after 6 years of age, male mortality was higher. The study revealed the needs of female children in urban slum areas of India. Government and voluntary agencies must work together in the areas of social work, nutrition, education, health among the poor urban female population in India.

Urban transmission of schistosomiasis: new epidemiological situation in the forest area of Pernambuco.

PubMed

Gomes, Elainne Christine de Souza; Mesquita, Millena Carla da Silva; Rehn, Vitorina Nerivânia Covello; Nascimento, Wheverton Ricardo Correia do; Loyo, Rodrigo; Barbosa, Constança Simões

2016-01-01

Schistosomiasis is considered an endemic disease in Vitória de Santo Antão, Pernambuco, a district which has presented both high incidence and prevalence of it for decades. Poor environmental conditions lead to contamination of water sources in rural areas, which are used by the population during daily activities, resulting in typical transmission. Recently, there has been evidence of vector snails in urban areas, which could set a new model for schistosomiasis transmission in this district. To identify the new epidemiological situation for the urban transmission of schistosomiasis in Vitória de Santo Antão, Pernambuco. A malacological survey was conducted in all water sources in the city limits to investigate schistosomiasis vector snails (Biomphalaria spp.). The collected snails were examined for taxonomic identification and Schistosoma mansoni infection. All breeding sites were georeferenced to build risk maps through the TrackMaker PRO program and ArcGIS software. We identified 22 Biomphalaria straminea breeding sites and collected 1,704 snails. One of these breeding sites was identified as a source of transmission and seven as potential sources of transmission. The designed maps identified two risk areas of urban transmission of schistosomiasis and expansion areas for breeding sites, establishing an increased risk of transmission to the population. This study verified the existence of a new epidemiological situation in which the possibility of the urban transmission of the disease was confirmed.

Response of bacterial community structure and function to experimental rainwater additions in a coastal eutrophic embayment

NASA Astrophysics Data System (ADS)

Teira, Eva; Hernando-Morales, Víctor; Martínez-García, Sandra; Figueiras, Francisco G.; Arbones, Belén; Álvarez-Salgado, Xosé Antón

2013-03-01

Although recognized as a potentially important source of both inorganic and organic nutrients, the impact of rainwater on microbial populations from marine planktonic systems has been poorly assessed. The effect of rainwater additions on bacterioplankton metabolism and community composition was evaluated in microcosm experiments enclosing natural marine plankton populations from the Ría de Vigo (NW Spain). The experiments were conducted during three different seasons (spring, autumn and winter) using rainwater collected at three different locations: marine, urban and rural sites. Bacterial abundance and production significantly increased up to 1.3 and 1.8-fold, respectively, after urban rainwater additions in spring, when ambient nutrient concentration was very low. Overall, the increments in bacterial production were higher than those in bacterial respiration, which implies that a higher proportion of carbon consumed by bacteria would be available to higher trophic levels. The response of the different bacterial groups to distinct rainwater types differed between seasons. The most responsive bacterial groups were Betaproteobacteria which significantly increased their abundance after urban (in spring and winter) and marine (in spring) rainwater additions, and Bacteroidetes which positively responded to all rainwater treatments in spring and to urban rainwater in autumn. Gammaproteobacteria and Roseobacter responded only to urban (in spring) and marine (in winter) rainwater treatment, respectively. The responses to rainwater additions were moderate and transient, and the resulting bacterial community structure was not importantly altered.

Associations between Poor Health and School-Related Behavior Problems at the Child and Family Levels: A Cross-Sectional Study of Migrant Children and Adolescents in Southwest Urban China

ERIC Educational Resources Information Center

Zhang, Jing-Jing; Li, Ning-Xiu; Liu, Chao-Jie

2010-01-01

Background: Due to urbanization in China, the numbers of migrant children and adolescents in urban environments have increased. Previous studies have indicated that children and adolescents are more likely to suffer from health problems and poor school achievement. The present study identified associations between poor health and school-related…

Nutritional status and its health-related factors among older adults in rural and urban areas.

PubMed

Chen, Su-Hui; Cheng, Hsin-Yi; Chuang, Yeu-Hui; Shao, Jung-Hua

2015-01-01

To compare health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban counties of Taiwan. The older adult population of Taiwan is increasing. Furthermore, older people living in rural areas have shorter life expectancy and more chronic diseases than their urban counterparts. However, little is known about the health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban areas of Taiwan, limiting nurses' ability to identify and care for older adults at risk of poor nutritional health. Cross-sectional, comparative. Older adults were randomly selected from names of residents of an adjacent rural and urban area of northern Taiwan and having completing the 2009 health evaluation. From March-July 2010, older adult participants (N = 366) provided data on demographic and health-related information, nutritional self-efficacy, health locus of control and nutritional status. Data were analysed by descriptive statistics and compared using chi-square and t-test. Older rural participants had significantly lower educational level, less adequate income, higher medication use, lower scores on self-rated health status and researcher-rated health status and lower self-rated healthy eating status than their urban counterparts. Moreover, rural participants had significantly lower nutritional self-efficacy, higher chance health locus of control and poorer nutritional status than their urban counterparts. Our results suggest that nurses should assess older adults living in rural areas for nutritional health and nutrition knowledge. Based on this assessment, nurses should develop easy, practical and accessible nutritional programmes for this population. © 2014 John Wiley & Sons Ltd.

Urban Intensification and Expansion in Sub-Saharan Africa: Impacts on Urban Agriculture and Food Security

NASA Astrophysics Data System (ADS)

Uzokwe, V. N. E. N.; Muchelo, R. O.; Odeh, I. A.

2015-12-01

In Sub-Saharan Africa (SSA), urban intensification and expansion are increasing at alarming rates due to rapid population growth and rural-to-urban migration. This has led to the premise that the proportion of SSA urban residents most vulnerable to food insecurity is the highest in the world. Using a focused survey and multi-temporal (decadal) land use/cover classification of Landsat images, we explored the effect of urban intensification and expansion on urban agriculture and food security, focusing on a megacity and a regional center in Uganda: Kampala and Mbarara, respectively. We found that food insecurity arose due to a number of reasons, among which are: i) expansion and intensification of of urban settlements into previously productive agricultural lands in urban and peri-urban areas; ii) loss of predominantly young (rural agricultural) adult labor force to urban centers, leading to decline in rural food production; iii) lack of proper urban planning incorporating green and agricultural development leading to low productive market garden systems. We discussed these outcomes in light of existing studies which estimated that urban agriculture alone supports over 800 million people globally and accounts for 15-20% of world food supply. In spite of this relatively low contribution by urban/peri-urban agriculture, it probably accounts for higher proportion of food supply to urban poor in SSA and thus are most vulnerable to the loss of urban and peri-urban agricultural land. Further recommendations require policy makers and urban planners to team up to design a suitable framework for sustainable urban planning and development.

Self-rated health and perceived violence in the neighborhood is heterogeneous between young women and men.

PubMed

Almeida Bentes, Aline; Comini César, Cibele; Coelho Xavier, César; Teixeira Caiaffa, Waleska; Proietti, Fernando Augusto

2017-12-19

Self-rated health (SRH) is the general perception of an individual's own health and a key indicator to measure health in population-based studies. Few studies have examined the association between perceived urban violence and SRH among young adults. There were an estimated 475,000 deaths in 2012 as a result of homicide on the world. Sixty percent of these deaths occurred among males aged 15-44 years, making homicide the third leading cause of death for this population group. This study aimed to determine and quantify the association between sex-specific perception of violence in the neighborhood and SRH among young adults. Participants included 955 young adults (18-29 years) residing in Belo Horizonte, Minas Gerais, Brazil between 2008 and 2009. Logistic regression analysis was used to estimate the strength of the associations. The perceived urban violence score was constructed from variables that assessed the respondents' insecurity and perception of fear and danger of suffering some form of violence in the neighborhood using exploratory factor analysis. 18,3% of respondents rated their health as fair/ poor/very poor. Among women, fair/ poor/very poor SRH was associated with age between 25 and 29 years, low socioeconomic status score, being dissatisfied with weight, not exercising regularly, not having a healthy diet, and having some chronic disease. Men who rated their health as fair/poor/very poor more frequently smoked, were dissatisfied with their weight, did not exercise regularly, consumed fewer fruits and vegetables, and had some chronic disease compared to men who rated their health as very good/good. In the final model, after adjusting for confounding variables, perceived violence in the neighborhood was associated with poor SRH in young women only (OR = 1.52; 95% CI: 1.04-2.21). The results indicate that public and health policies should implement interventions on the neighborhood physical and social environment to improve the perception of safety and have a positive impact on people's health, especially women.

The dynamics of heatwave over a coastal megacity

NASA Astrophysics Data System (ADS)

Ramamurthy, P.

2017-12-01

A majority of the current population in the U.S. resides in urban areas and nearly 40% live in urban coastal communities. These cities are disproportionately affected by extreme events such as heatwaves, hurricanes and extreme precipitation. The microclimate of the coastal cities is profoundly influenced by the interaction between the highly convective urban core and the moist sea breeze advection. However, such interactions are poorly characterized due to lack of observations over these complex terrains. Herein we use a comprehensive observational platform and numerical simulations to characterize the impact of heatwaves over New York City. As part of the campaign the urban boundary layer over New York City was continuously monitored during July 2016, a period that witnessed three heatwave events. Surface weather stations and indoor sensors were also used to characterize the urban heat island intensity. Our results reveal that during the month, the urban heat island intensity was nearly twice as compared to the decadal average. During the heatwave episodes urban heat island intensities as high as 10 ˚C were observed. The thermal profiles indicate elevated temperatures in much of the boundary layer between 800-2500 m during the heatwave episodes. The profiles indicate a complex thermal structure and high intra-city variability. Thermal internal boundary layer was observed in neighborhoods populated by tall buildings. The results show that heat released from buildings heating and air conditioning system during extreme heat events can be as high as 18 percent of the overall available energy. Overall the high-pressure system during the heatwave episodes acted as a thermal block and much of the heat generated in the urban surface layer remained within the boundary layer, thereby amplifying the near surface air temperature.

"It's Kind of a Dichotomy": Thoughts Related to Calling and Purpose from Pastors Working and Counseling in Urban Resource-Poor Communities.

PubMed

Payne, Jennifer Shepard

2017-08-01

Pastors serving low-income urban areas are first-responders to emotional issues by default, since fewer mental health resources are available. Thus, it is important to understand how pastors serving urban resource-poor areas reflect on their counseling role. Forty-eight Black, Hispanic, and White pastors with urban congregations in Los Angeles or Chicago reflect on their pastoral calling and its relation to their counseling role. Through phenomenology, the pastors' lived experiences as they counseled in an urban context were explored. Analysis revealed complex feelings about their counseling role in light of their resource-poor environments. Recommendations are provided based on the findings.

Dental Fear and Avoidance in Treatment Seekers at a Large, Urban Dental Clinic.

PubMed

Heyman, Richard E; Slep, Amy M Smith; White-Ajmani, Mandi; Bulling, Lisanne; Zickgraf, Hana F; Franklin, Martin E; Wolff, Mark S

2016-01-01

The prevalence and correlates of dental fear have been studied in representative population studies, but not in patients presenting for dental treatment. We hypothesized that dental fear among patients presenting at a large, urban college of dentistry would be similar to that of the population (e.g. 11% high dental fear, 17% to 35% moderate or higher fear) and that fear would be associated with avoidance of routine dental care, increased use of urgent dental care and poor oral health. Participants were 1070 consecutive patients at a large, urban dental care center. All patients completed a clinical interview, including demographics, medical history, dental history and presenting concerns, and behavioral health history. Patients were also asked to rate their dental anxiety/fear on a 1 (none) to 10 (high) scale. Over 20% of patients reported elevated anxiety/fear, of which 12.30% reported moderate and 8.75% high fear. Severity of dental anxiety/fear was strongly related to the likelihood of avoiding dental services in the past and related to myriad presenting problems. As hypothesized, the prevalence of moderate or higher fear in dental patients was considerable and closely matched that found in general population surveys. Thus, the 'dental home' is an ideal location to treat clinically significant dental anxiety/fear.

Urbanization and Access Inequality to Collective Consumption Goods & Services related to Sanitation & Solid Waste in the cities of Sao Paulo State, Brazil

NASA Astrophysics Data System (ADS)

Roig, C. D. A.; Feitosa, F. D. F.; Monteiro, A. M. V.

2016-12-01

Cities are mainly a product of collective consumption and there is a pressing need to expand and deepen the discussion about the quality of access to collective goods and services in the urban world: the availability of electricity and potable water and its interrelation with the lack of solid waste management and wastewater treatment leading to pollution of water sources.This study attempts to measure urban stratification through access conditions to collective goods in the metropolitan regions of Sao Paulo State (SPS) by contributing with a research method that incorporates collective consumption as a core component of the population-environment relationship. The use of spatial analysis allows the examination of the structure and distribution of accessibility to sanitation services and basic urban infrastructure.The water stress situation in SPS is dramatic. The average water loss within these distribution systems is 34,3% and a 39% average sewage treatment rate of all wastewater generated. The SPS also imports 60,6% of electricity from other states that use mostly hydroelectric power which imposes greater pressure on the country's water resources. The energy and water crisis has harmed a number of essential rights related mostly to resource access and service continuity as suburban residents of poor municipalities are the ones most affected by disruptions.SPS is the most populous state of Brazil and this region of study is responsible for 75% of total State population with 83% of State GDP. There has been a major increase in water use conflicts such as power generation, urban water supply (including the Rio de Janeiro water demand) and the dilution of urban sewage and solid waste disposal. These collective consumption access problems demonstrate the urgent need for better integrated metropolitan management of natural resources and the urban commons.

Smoking Behaviors Among Urban and Rural Pregnant Women Enrolled in the Kansas WIC Program.

PubMed

Jacobson, Lisette T; Dong, Frank; Scheuermann, Taneisha S; Redmond, Michelle L; Collins, Tracie C

2015-10-01

Smoking during pregnancy is associated with poor birth outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a public nutritional assistance program for low-income pregnant women and their children up to age five. This study examined differences in smoking behavior among women enrolled in the Kansas WIC program. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of enrolled women between 2005 and 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Chi square tests of association were used to assess differences. Multi-variable binary logistic regression was used to assess maternal characteristics and smoking 3 months prior to pregnancy. Total sample size averaged 21,650 women for years 2005 through 2011. Low-income, rural pregnant women smoked at significantly higher rates before, during, and after pregnancy. High smoking rates have remained unchanged since 2008. The following characteristics were associated with reduced odds of smoking 3 months prior to pregnancy: being 17 years old or younger, Hispanic, a high school graduate, urban location, normal body mass index, no live births prior to current pregnancy, and using multi-vitamins. Results from this study indicate that the WIC population in rural areas may have different needs regarding smoking cessation programming than the urban WIC population. Findings help inform WIC program administrators and assist in enhancing current smoking cessation services to the Kansas WIC population.

[Sanitation and racial inequality conditions in urban Brazil: an analysis focused on the indigenous population based on the 2010 Population Census].

PubMed

Raupp, Ludimila; Fávaro, Thatiana Regina; Cunha, Geraldo Marcelo; Santos, Ricardo Ventura

2017-01-01

The aims of this study were to analyze and describe the presence and infrastructure of basic sanitation in the urban areas of Brazil, contrasting indigenous with non-indigenous households. Methods: A cross-sectional study based on microdata from the 2010 Census was conducted. The analyses were based on descriptive statistics (prevalence) and the construction of multiple logistic regression models (adjusted by socioeconomic and demographic covariates). The odds ratios were estimated for the association between the explanatory variables (covariates) and the outcome variables (water supply, sewage, garbage collection, and adequate sanitation). The statistical significance level established was 5%. Among the analyzed services, sewage proved to be the most precarious. Regarding race or color, indigenous households presented the lowest rate of sanitary infrastructure in Urban Brazil. The adjusted regression showed that, in general, indigenous households were at a disadvantage when compared to other categories of race or color, especially in terms of the presence of garbage collection services. These inequalities were much more pronounced in the South and Southeastern regions. The analyses of this study not only confirm the profile of poor conditions and infrastructure of the basic sanitation of indigenous households in urban areas, but also demonstrate the persistence of inequalities associated with race or color in the country.

Urban food insecurity in the context of high food prices: a community based cross sectional study in Addis Ababa, Ethiopia

PubMed Central

2014-01-01

Background High food prices have emerged as a major global challenge, especially for poor and urban households in low-income countries such as Ethiopia. However, there is little empirical evidence on urban food security and how people living in urban areas are coping with sustained high food prices. This study aims to address this gap by investigating the food insecurity situation in urban Ethiopia -a country experiencing sustained high food prices, high rates of urban poverty, and a growing urban population. Methods A community based cross-sectional study was conducted from January 18 to February 14, 2012. A total of 550 households were selected from three sub-cities of Addis Ababa using three-stage sampling technique. Data were collected using questionnaire based interview with household heads. Items in the questionnaire include, among others, basic socioeconomic variables, dietary diversity and coping strategies. Food security status of households was assessed by a Household Food Insecurity Access Score. Data analysis was done using SPSS software and both univariate and bivariate analysis were done. Results The study found that 75% of households were food insecure and 23% were in a state of hunger. Households with higher food insecurity scores tend to have lower dietary diversity and are less likely to consume high quality diets. Reduction in meal size and shifting to poor quality/less expensive/food types were among the common coping strategies to high food price used by households. Household incomes, occupational and educational status of household heads were significant determinants of food security. Conclusion Food insecurity in Ethiopia is not only a rural problem. Urban food insecurity is a growing concern due to the toxic combination of high rates of urban poverty, high dependency of urban households on food supplied by the market, and fluctuating food prices. Household food insecurity was particularly high among low income households and those headed by uneducated, daily wagers and government employed household heads. Therefore, policy makers should work on stabilization of the food market and creating opportunities that could improve the livelihood and purchasing power of urban households. PMID:24993286

Urban food insecurity in the context of high food prices: a community based cross sectional study in Addis Ababa, Ethiopia.

PubMed

Birhane, Tesfay; Shiferaw, Solomon; Hagos, Seifu; Mohindra, Katia Sarla

2014-07-04

High food prices have emerged as a major global challenge, especially for poor and urban households in low-income countries such as Ethiopia. However, there is little empirical evidence on urban food security and how people living in urban areas are coping with sustained high food prices. This study aims to address this gap by investigating the food insecurity situation in urban Ethiopia -a country experiencing sustained high food prices, high rates of urban poverty, and a growing urban population. A community based cross-sectional study was conducted from January 18 to February 14, 2012. A total of 550 households were selected from three sub-cities of Addis Ababa using three-stage sampling technique. Data were collected using questionnaire based interview with household heads. Items in the questionnaire include, among others, basic socioeconomic variables, dietary diversity and coping strategies. Food security status of households was assessed by a Household Food Insecurity Access Score. Data analysis was done using SPSS software and both univariate and bivariate analysis were done. The study found that 75% of households were food insecure and 23% were in a state of hunger. Households with higher food insecurity scores tend to have lower dietary diversity and are less likely to consume high quality diets. Reduction in meal size and shifting to poor quality/less expensive/food types were among the common coping strategies to high food price used by households. Household incomes, occupational and educational status of household heads were significant determinants of food security. Food insecurity in Ethiopia is not only a rural problem. Urban food insecurity is a growing concern due to the toxic combination of high rates of urban poverty, high dependency of urban households on food supplied by the market, and fluctuating food prices. Household food insecurity was particularly high among low income households and those headed by uneducated, daily wagers and government employed household heads. Therefore, policy makers should work on stabilization of the food market and creating opportunities that could improve the livelihood and purchasing power of urban households.

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

PubMed

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Anthropogenic biogeochemical impacts on coral reefs in the Pacific Islands—An overview

NASA Astrophysics Data System (ADS)

Morrison, R. J.; Denton, G. R. W.; Bale Tamata, U.; Grignon, J.

2013-11-01

Coral reefs dominate the coastal environment in many Pacific Islands, being present as atolls, coral platforms, barrier and fringing reefs. With ever increasing populations and migration of people to the coast, the anthropogenic impacts on these reefs have increased dramatically in the last 30 years. While research on these impacts has been limited, some important progress has been made. This paper reviews some of the completed studies, with outcomes from American Samoa, Fiji, French Polynesia, Guam, Saipan, New Caledonia and Tonga presented. These studies indicate that the most significant impacts have been found in locations close to major urban centres or industrial and mining activities. The extent of impact varies from place to place with minimal impacts in the more isolated and less industrialised communities. Common anthropogenic impacts are contamination caused by inadequate sewage treatment, erosion from adjacent agricultural and urban expansion activities, poor waste management, eutrophication, inefficient and/or inappropriate pesticide use and hydrocarbons use, storage and management. The outcomes include contaminated sediments (trace metals, pesticides, PCBs, hydrocarbons) with some impacts on resident biota. In some instances, the edible quality of local fisheries resources has been significantly compromised.Even in locations with small populations, increasing populations and poor economic conditions have resulted in noticeable effects on the adjacent fringing reefs, including dramatic algal proliferation and declines in fish numbers resulting from increasing nutrient discharges and increased herbivore fish catches. Recovery measures including fishing bans and alternative fishing practices have been implemented to address these issues in some areas.

The urban environment and health in a world of increasing globalization: issues for developing countries.

PubMed Central

McMichael, A. J.

2000-01-01

Urban living is the keystone of modern human ecology. Cities have multiplied and expanded rapidly worldwide over the past two centuries. Cities are sources of creativity and technology, and they are the engines for economic growth. However, they are also sources of poverty, inequality, and health hazards from the environment. Urban populations have long been incubators and gateways for infectious diseases. The early industrializing period of unplanned growth and laissez-faire economic activity in cities in industrialized countries has been superseded by the rise of collective management of the urban environment. This occurred in response to environmental blight, increasing literacy, the development of democratic government, and the collective accrual of wealth. In many low-income countries, this process is being slowed by the pressures and priorities of economic globalization. Beyond the traditional risks of diarrhoeal disease and respiratory infections in the urban poor and the adaptation of various vector-borne infections to urbanization, the urban environment poses various physicochemical hazards. These include exposure to lead, air pollution, traffic hazards, and the "urban heat island" amplification of heatwaves. As the number of urban consumers and their material expectations rise and as the use of fossil fuels increases, cities contribute to the large-scale pressures on the biosphere including climate change. We must develop policies that ameliorate the existing, and usually unequally distributed, urban environmental health hazards and larger-scale environmental problems. PMID:11019460

The urban environment and health in a world of increasing globalization: issues for developing countries.

PubMed

McMichael, A J

2000-01-01

Urban living is the keystone of modern human ecology. Cities have multiplied and expanded rapidly worldwide over the past two centuries. Cities are sources of creativity and technology, and they are the engines for economic growth. However, they are also sources of poverty, inequality, and health hazards from the environment. Urban populations have long been incubators and gateways for infectious diseases. The early industrializing period of unplanned growth and laissez-faire economic activity in cities in industrialized countries has been superseded by the rise of collective management of the urban environment. This occurred in response to environmental blight, increasing literacy, the development of democratic government, and the collective accrual of wealth. In many low-income countries, this process is being slowed by the pressures and priorities of economic globalization. Beyond the traditional risks of diarrhoeal disease and respiratory infections in the urban poor and the adaptation of various vector-borne infections to urbanization, the urban environment poses various physicochemical hazards. These include exposure to lead, air pollution, traffic hazards, and the "urban heat island" amplification of heatwaves. As the number of urban consumers and their material expectations rise and as the use of fossil fuels increases, cities contribute to the large-scale pressures on the biosphere including climate change. We must develop policies that ameliorate the existing, and usually unequally distributed, urban environmental health hazards and larger-scale environmental problems.

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

PubMed

Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

2015-07-01

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

Cities in the developing world: agenda for action following Habitat II.

PubMed

Annez, P; Friendly, A

1996-12-01

This article discusses the issue of priorities in development in urban centers of developing countries. Urbanization is advancing rapidly in the developing world. There are needs for adequate infrastructure, environmental protection, and fiscal reform. Development can result in a reduction in poverty, if properly conducted. By the turn of the century, 8 of the world's 10 megacities will be located in developing countries. There are already the megacities of Mexico City, Sao Paulo, Bombay, Calcutta, and Shanghai. By 2015 there will be 27 megacities, and urban population in developing countries will amount to over 4 billion. By 2020, 50% of total population in developing countries and 80% of total population in Latin America will be urban, of which 25% will live in poverty. Economic progress is at risk if cities cannot develop effective roads and transportation systems, public transportation, communications, sanitation services, and adequate shelters. The City Summit was held in June 1996 in Istanbul. The World Bank announced priorities for funding of urban health initiatives for reducing lead and particulate emissions, for providing sanitation and clean water to slum areas, and for securing sustainable, business-like city finances. The World Bank, the City Summit's Global Plan of Action, and Parliamentarians for Global Action support the reduction of lead emissions from gasoline and air. Cost-effective approaches include refitting public transportation vehicles with cleaner-burning engines or engines relying on natural gas, reducing emissions from industrial and power plants, and shifting domestic fuel sources from coal to natural gas. The World Bank in Slovenia and Beijing is financially supporting this household conversion. Reductions in soot and dust levels reduce public health costs, lost work time due to illness, and mortality. The cost to the poor for basic services is too high. Decentralization, community involvement, and cost sharing are viable options.

Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael Baffour; Asante, Paapa Yaw; Sakyi, Lionel; Biney, Adriana A E; Kushitor, Mawuli Komla; Agyei, Francis; de-Graft Aikins, Ama

2018-04-16

In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Urbanization and human health in urban India: institutional analysis of water-borne diseases in Ahmedabad.

PubMed

Saravanan, V S; Ayessa Idenal, Marissa; Saiyed, Shahin; Saxena, Deepak; Gerke, Solvay

2016-10-01

Diseases are rapidly urbanizing. Ageing infrastructures, high levels of inequality, poor urban governance, rapidly growing economies and highly dense and mobile populations all create environments rife for water-borne diseases. This article analyzes the role of institutions as crosscutting entities among a myriad of factors that breed water-borne diseases in the city of Ahmedabad, India. It applies 'path dependency' and a 'rational choice' perspective to understand the factors facilitating the breeding of diseases. This study is based on household surveys of approximately 327 households in two case study wards and intermittent interviews with key informants over a period of 2 years. Principle component analysis is applied to reduce the data and convert a set of observations, which potentially correlate with each other, into components. Institutional analyses behind these components reveal the role of social actors in exploiting the deeply rooted inefficiencies affecting urban health. This has led to a vicious cycle; breaking this cycle requires understanding the political dynamics that underlie the exposure and prevalence of diseases to improve urban health. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Moderators of noise-induced cognitive change in healthy adults.

PubMed

Wright, Bernice Al; Peters, Emmanuelle R; Ettinger, Ulrich; Kuipers, Elizabeth; Kumari, Veena

2016-01-01

Environmental noise causes cognitive impairment, particularly in executive function and episodic memory domains, in healthy populations. However, the possible moderating influences on this relationship are less clear. This study assessed 54 healthy participants (24 men) on a cognitive battery (measuring psychomotor speed, attention, executive function, working memory, and verbal learning and memory) under three (quiet, urban, and social) noise conditions. IQ, subjective noise sensitivity, sleep, personality, paranoia, depression, anxiety, stress, and schizotypy were assessed on a single occasion. We found significantly slower psychomotor speed (urban), reduced working memory and episodic memory (urban and social), and more cautious decision-making (executive function, urban) under noise conditions. There was no effect of sex. Variance in urban noise-induced changes in psychomotor speed, attention, Trail Making B-A (executive function), and immediate recall and social noise-induced changes in verbal fluency (executive function) and immediate recall were explained by a combination of baseline cognition and paranoia, noise sensitivity, sleep, or cognitive disorganization. Higher baseline cognition (but not IQ) predicted greater impairment under urban and social noise for most cognitive variables. Paranoia predicted psychomotor speed, attention, and executive function impairment. Subjective noise sensitivity predicted executive function and memory impairment. Poor sleep quality predicted less memory impairment. Finally, lower levels of cognitive disorganization predicted slower psychomotor speed and greater memory impairment. The identified moderators should be considered in studies aiming to reduce the detrimental effects of occupational and residential noise. These results highlight the importance of studying noise effects in clinical populations characterized by high levels of the paranoia, sleep disturbances, noise sensitivity, and cognitive disorganization.

Moderators of noise-induced cognitive change in healthy adults

PubMed Central

Wright, Bernice AL; Peters, Emmanuelle R; Ettinger, Ulrich; Kuipers, Elizabeth; Kumari, Veena

2016-01-01

Environmental noise causes cognitive impairment, particularly in executive function and episodic memory domains, in healthy populations. However, the possible moderating influences on this relationship are less clear. This study assessed 54 healthy participants (24 men) on a cognitive battery (measuring psychomotor speed, attention, executive function, working memory, and verbal learning and memory) under three (quiet, urban, and social) noise conditions. IQ, subjective noise sensitivity, sleep, personality, paranoia, depression, anxiety, stress, and schizotypy were assessed on a single occasion. We found significantly slower psychomotor speed (urban), reduced working memory and episodic memory (urban and social), and more cautious decision-making (executive function, urban) under noise conditions. There was no effect of sex. Variance in urban noise-induced changes in psychomotor speed, attention, Trail Making B-A (executive function), and immediate recall and social noise-induced changes in verbal fluency (executive function) and immediate recall were explained by a combination of baseline cognition and paranoia, noise sensitivity, sleep, or cognitive disorganization. Higher baseline cognition (but not IQ) predicted greater impairment under urban and social noise for most cognitive variables. Paranoia predicted psychomotor speed, attention, and executive function impairment. Subjective noise sensitivity predicted executive function and memory impairment. Poor sleep quality predicted less memory impairment. Finally, lower levels of cognitive disorganization predicted slower psychomotor speed and greater memory impairment. The identified moderators should be considered in studies aiming to reduce the detrimental effects of occupational and residential noise. These results highlight the importance of studying noise effects in clinical populations characterized by high levels of the paranoia, sleep disturbances, noise sensitivity, and cognitive disorganization. PMID:27157685

The Calcutta metropolitan district.

PubMed

1987-01-01

11 million residents in 1450 square kilometers make the Calcutta Metropolitan District the world's most densely packed metropolis and the world's 6th largest urban agglomeration. But even though Calcutta is India's largest city, it is growing at a much slower pace than other Indian cities. Its annual growth rate between 1971 and 1981 was 2.65%, well below the 3.8% growth rate for India's urban population as a whole. Even at this relatively slow growth rate, however, Calcutta's population will still grow to 11.7 million residents in 1990 and 15.9 million in 2000. Calcutta's failure to create urban jobs quickly enough to accommodate its vast population increase has led to widespread evidence of unemployment and extreme poverty. Many in Calcutta complain that the central goverment has thwarted development and international aid to Calcutta. Industrial stagnation has slowed the area's urbanization and rural-urban migration. As greater numbers of new job seekers enter the labor force and the dropout rate diminishes due to dramatic inprovement in health, relentless pressure is put on Calcutta's already strained economy. Calcutta's job seekers will be partly absorbed by the informal sector; one study estimates that 40-50% of Calcutta's labor force is employed in the informal sector. In 1971, 6% of Calcutta's work force was employed in agriculture, 40% in manufacturing, and 54% in services. 2/3 of the population make less than $35 a month, and about 10% are officially unemployed. Despite great improvements in public works, Calcutta's slums are still India's worst. Living standards have gone down compared to India as a whole. Most of the middle class has moved to the suburbs; what is left in the central core is the rich and the poor. However, despite widening income disparities, Calcutta is still a peaceful city--especially so at a time when India is marked with so much violence.

Work disability prevention in rural healthcare workers.

PubMed

Franche, Renée L; Murray, Eleanor J; Ostry, Aleck; Ratner, Pamela A; Wagner, Shannon L; Harder, Henry G

2010-01-01

Approximately 20% of healthcare workers in high-income countries such as Australia, Canada and the USA work in rural areas. Healthcare workers are known to be vulnerable to occupational injury and poor work disability outcomes; given their rural-urban distribution, it is possible to compare work disability prevention in rural and urban areas. However, little attention has been paid to work disability prevention issues specific to rural workers, including rural healthcare workers. A comprehensive review of the literature was conducted to identify rural-urban differences in work disability outcomes (defined as the incidence of occupational injury and the duration of associated work absence), as well as risk factors for poor work disability outcomes in rural healthcare workers. The databases MEDLINE, CINAHL, and EMBASE were searched, as were relevant research centers and government agencies, to identify all quantitative and qualitative English-language studies published between 1 January 2000 and 6 October 2009 that discussed occupational injury, work absence duration, work disability management, or risk factors for poor work disability outcomes, for rural workers specifically, or in comparison with urban workers. To ensure inclusion of studies of healthcare workers as a distinct group among other sector-specific groups, a broad search for literature related to all industrial sectors was conducted. Of 860 references identified, 5 discussed work disability outcomes and 25 discussed known risk factors. Known risk factors were defined as factors firmly established to be associated with poor work disability outcomes in the general worker population based on systematic reviews, well-established conceptual models of work disability prevention, and public health literature. Although somewhat conflicting, the evidence suggests that rural healthcare workers experience higher rates of occupational injury compared with urban healthcare workers, within occupational categories. Rural workers also appear to be more vulnerable to prolonged work absence although the data are limited. No studies directly compared risk factors for work disability prevention outcomes between rural and urban healthcare workers. However, potential risk factors were identified at the level of the environment, worker, job, organization, worker compensation system and healthcare access. Important methodological limitations were noted, including unclear definitions of rurality, inadequate methods of urban-rural comparisons such as comparing samples from different countries, and a paucity of studies applying longitudinal or multivariate designs. There is a notable lack of evidence about work disability prevention issues for healthcare workers in rural areas. Available evidence supports the hypothesis that rural healthcare workers are vulnerable to occupational injury, and suggests they are vulnerable to prolonged work absence. They may be particularly vulnerable to poor work disability prevention outcomes due to complex patient needs in the context of risk factors such as heavy workloads, long hours, heavy on-call demands, high stress levels, limited support and workplace violence. Additional vulnerability may occur because their work conditions are managed in distant urban administrative centers, and due to barriers in their own healthcare access. Although rural healthcare workers seem generally at greater risk of injury, one study suggests that urban emergency medical service workers experience a high vulnerability to injury that may outweigh the effects of rurality. Additional research is needed to document rural-urban disparities in work disability outcomes and to identify associated sources and risk factors. Other issues to address are access to and quality of healthcare for rural healthcare workers, streamlining the compensation system, the unique needs of Aboriginal healthcare workers, and the management of prolonged work absence. Finally, occupational injury and work absence duration programs should be tailored to meet the needs of rural workers.

Prevalence of obesity, hypertension, and diabetes, and cascade of care in sub-Saharan Africa: a cross-sectional, population-based study in rural and urban Malawi.

PubMed

Price, Alison J; Crampin, Amelia C; Amberbir, Alemayehu; Kayuni-Chihana, Ndoliwe; Musicha, Crispin; Tafatatha, Terence; Branson, Keith; Lawlor, Debbie A; Mwaiyeghele, Elenaus; Nkhwazi, Lawrence; Smeeth, Liam; Pearce, Neil; Munthali, Elizabeth; Mwagomba, Beatrice M; Mwansambo, Charles; Glynn, Judith R; Jaffar, Shabbar; Nyirenda, Moffat

2018-03-01

Sub-Saharan Africa is in rapid demographic transition, and non-communicable diseases are increasingly important causes of morbidity and mortality. We investigated the burden of diabetes, overweight and obesity, hypertension, and multimorbidity, their treatment, and their associations with lifestyle and other factors in Malawi, a very poor country with a predominantly rural-but rapidly growing urban-population, to identify high-risk populations and inform appropriate interventions. In this cross-sectional, population-based study, we enrolled all adults (≥18 years) residing in two defined geographical areas within Karonga District and Lilongwe city. All adults self-defining as usually resident in the study areas were eligible, and recruited at household level. Participants were interviewed, had anthropometry and blood pressure measured, and had fasting blood samples collected. The study outcomes were prevalence estimates and risk ratios for diabetes (defined as fasting blood glucose of at least 7·0 mmol/L or self-report of a previous diagnosis of diabetes), hypertension (systolic blood pressure of at least 140 mm Hg, diastolic blood pressure of at least 90 mm Hg, or self-report of current antihypertensive medication), overweight (BMI of 25·0-29·9 kg/m 2 ) and obesity (BMI of 30·0 kg/m 2 or more), and multimorbidity (two or more of the above conditions) by location-specific (urban vs rural), age-specific, and sex-specific groups, calculated using negative binomial regression. We used χ 2 likelihood ratio tests to assess heterogeneity by age, location, and sex. Between May 16, 2013, and Feb 8, 2016, we enrolled 15 013 (62%) of 24 367 eligible urban adults in Lilongwe and 13 878 (88%) of 15 806 eligible rural adults in Karonga District. Overweight and obesity, hypertension, and diabetes were highly prevalent, more so in urban residents, the less poor, and better educated than in rural, the poorest, and least educated participants. 18% of urban men (961 of 5211 participants) and 44% (4115 of 9282) of urban women, and 9% (521 of 5834) of rural men and 27% (2038 of 7497) of rural women were overweight or obese; 16% (859 of 5212), 14% (1349 of 9793), 13% (787 of 5847), and 14% (1101 of 8025) had hypertension; and 3% (133 of 3928), 3% (225 of 7867), 2% (84 of 5004), and 2% (124 of 7116) had diabetes, respectively. Of 566 participants with diabetes, 233 (41%) were undiagnosed, and of 4096 participants with hypertension, 2388 (58%) were undiagnosed. Fewer than half the participants on medication for diabetes or hypertension had well controlled diabetes (84 [41%] of 207 participants) or blood pressure (440 [37%] of 1183 participants). Multimorbidity was highest in urban women (n=519, 7%). Overweight and obesity, hypertension, and diabetes are highly prevalent in urban and rural Malawi, yet many patients are undiagnosed and management is limited. Local-evidence-informed multisectoral, innovative, and targeted interventions are needed urgently to manage the already high burden. Wellcome Trust. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Role of Federal Food Assistance Programs in Strategies To Reduce Infant Mortality. Hearing before the Domestic Task Force of the Select Committee on Hunger. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Hunger.

This document presents oral and written testimony concerning the effectiveness of federal assistance programs in reducing infant mortality. In opening statements, members of the House Select Committee on Hunger voiced their concern over the persistence of high infant death rates among minorities, the rural poor, and urban populations, despite…

Subsidence Induced Faulting Hazard risk maps in Mexico City and Morelia, central Mexico

NASA Astrophysics Data System (ADS)

Cabral-Cano, E.; Solano-Rojas, D.; Hernández-Espriu, J.; Cigna, F.; Wdowinski, S.; Osmanoglu, B.; Falorni, G.; Bohane, A.; Colombo, D.

2012-12-01

Subsidence and surface faulting have affected urban areas in Central Mexico for decades and the process has intensified as a consequence of urban sprawl and economic growth. This process causes substantial damages to the urban infrastructure and housing structures and in several cities it is becoming a major factor to be considered when planning urban development, land use zoning and hazard mitigation strategies in the next decades. Subsidence is usually associated with aggressive groundwater extraction rates and a general decrease of aquifer static level that promotes soil consolidation, deformation and ultimately, surface faulting. However, local stratigraphic and structural conditions also play an important role in the development and extension of faults. Despite its potential for damaging housing, and other urban infrastructure, the economic impact of this phenomena is poorly known, in part because detailed, city-wide subsidence induced faulting risk maps have not been published before. Nevertheless, modern remote sensing techniques are most suitable for this task. We present the results of a risk analysis for subsidence induced surface faulting in two cities in central Mexico: Morelia and Mexico City. Our analysis in Mexico City and Morelia is based on a risk matrix using the horizontal subsidence gradient from a Persistent Scatterer InSAR (Morelia) and SqueeSAR (Mexico City) analysis and 2010 census population distribution data from Mexico's National Institute of Statistics and Geography. Defining subsidence induced surface faulting vulnerability within these urbanized areas is best determined using both magnitude and horizontal subsidence gradient. Our Morelia analysis (597,000 inhabitants with localized subsidence rates up to 80 mm/yr) shows that 7% of the urbanized area is under a high to very high risk level, and 14% of its population (11.7% and 2.3% respectively) lives within these areas. In the case of the Mexico City (15'490,000 inhabitants for the Mexico city Metropolitan area included within our map, and up to 370 mm/yr subsidence rate) our risk map shows that 13.5% of the urbanized area is under a high to very high risk level, and 26.2% of its population (22.1% and 4.4% respectively) lives within these areas.

Rich and Poor Cities in Europe. An Urban Scaling Approach to Mapping the European Economic Transition

PubMed Central

2016-01-01

Recent advances in the urban science make broad use of the notion of scaling. We focus here on the important scaling relationship between the gross metropolitan product (GMP) of a city and its population (pop). It has been demonstrated that GMP ∝ Y Ypopβ with β always greater than 1 and close to 1.2. This fundamental finding highlights a universal rule that holds across countries and cultures and might explain the very nature of cities. However, in an increasingly connected world, the hypothesis that the economy of a city solely depends on its population might be questionable. Using data for 248 cities in the European Union between 2005 and 2010, we found a double GMP/pop scaling regime. For West EU cities, β = 1 over the whole the period, while for post-communist cities β > 1 and increases from ∼1.2 to ∼1.4. The evolution of the scaling exponent describes the convergence of post-communist European cities to open and liberal economies. We propose a simple model of economic convergence in which, under stable political conditions, a linear GMP/pop scaling is expected for all cities. The results suggest that the GMP/pop super-linear scaling represents a phase of economic growth rather than a steady, universal urban feature. The results also suggest that relationships between cities are embedded in their political and economic context and cannot be neglected in explanations of cities, urbanization and urban economics. PMID:27551719

Urban Cholera and Water Sustainability Challenges under Climatic and Anthropogenic Change

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Jutla, A.; Huq, A.; Faruque, A. G.; Colwell, R. R.

2013-12-01

The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city of the world - Dhaka, Bangladesh. Emerging megacities in the developing world, especially those located in coastal regions of the tropics remain vulnerable to similar. However, there has not been any systematic study on linking the long-term disease trends with changes in related climatic, environmental, or societal variables. Here, we analyze the 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or societal factors: regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, as well as shifting climate patterns. An interesting change is observed in the seasonal trends of cholera incidence; while an endemic upward trend is seen in the dry season, the post-monsoon trend seem to be more epidemic in nature. Evidence points to growing urbanization and rising population in unplanned settlements that have negligible to poor water and sanitation systems compounded by increasing frequency of record flood events. Growing water scarcity in the dry season and lack of sustainable water and sanitation infrastructure for urban settlements have increased endemicity of spring outbreaks, while record flood events and prolonged post-monsoon inundation have contributed to increased epidemic outbreaks in fall. We analyze our findings with the World Health Organization recommended guidelines and investigate water sustainability challenges in the context of climatic and anthropogenic changes in the region.

Rich and Poor Cities in Europe. An Urban Scaling Approach to Mapping the European Economic Transition.

PubMed

Strano, Emanuele; Sood, Vishal

2016-01-01

Recent advances in the urban science make broad use of the notion of scaling. We focus here on the important scaling relationship between the gross metropolitan product (GMP) of a city and its population (pop). It has been demonstrated that GMP ∝ Y Ypopβ with β always greater than 1 and close to 1.2. This fundamental finding highlights a universal rule that holds across countries and cultures and might explain the very nature of cities. However, in an increasingly connected world, the hypothesis that the economy of a city solely depends on its population might be questionable. Using data for 248 cities in the European Union between 2005 and 2010, we found a double GMP/pop scaling regime. For West EU cities, β = 1 over the whole the period, while for post-communist cities β > 1 and increases from ∼1.2 to ∼1.4. The evolution of the scaling exponent describes the convergence of post-communist European cities to open and liberal economies. We propose a simple model of economic convergence in which, under stable political conditions, a linear GMP/pop scaling is expected for all cities. The results suggest that the GMP/pop super-linear scaling represents a phase of economic growth rather than a steady, universal urban feature. The results also suggest that relationships between cities are embedded in their political and economic context and cannot be neglected in explanations of cities, urbanization and urban economics.

Understanding Critical Socio-political and Hydro-climatic drivers behind Water Management and Increasing Dengue Disease Burden in Arid Regions of Mexico

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Johnson, K.; Frost, M.; Serman, E. A.

2016-12-01

Dengue is a significant public health problem in Mexico, with distribution of dengue throughout the country. Mexico is characterized by a number of attributes likely to contribute to the spread of dengue, including population growth, poor water management, urbanization, significant seasonal migration, and concentrated poverty. Understanding the socio-political and hydro-climatic drivers behind the increasing dengue disease burden in the central arid regions of Mexico is a vital component for modeling the distribution and spread of Aedes aegypti vector borne infections such as Dengue and Zika as more parts of the Americas is affected. Here, we focus on the critical socio-economic and environmental drivers behind water management, urbanization, and population migration in the arid Oaxaca region, situated in the rain shadow of the Sierra Madre Mountains at an altitude of 5000 feet. In contrast to the Pacific Coastal region which hosts climactic conditions conducive to the survival of Aedes aegypti mosquitoes with a moist tropical environment, Oaxaca is arid and exists in a constant state of water insecurity. Within Oaxaca City, water is trucked in and stored in large roof tanks; many of which are failing, allowing for leaks or mosquito infestation. Alternate sources range from existing cisterns, sophisticated collection systems, to open-air rock pits. Few resources exist to improve water security, particularly in poor neighborhoods creating a disincentive to invite surveillance for disease or to move to safer and improved water systems. Meanwhile, the region has experienced significant socio-political and demographic shift including migration, economic reorganization and urbanization over the last decade. The rise in dengue incidence during the dry season suggests human intervention (through migration, water management, sanitation, cultural practices) as a potentially important predictive factor. In this study, we analyze associations of regional hydroclimatic patterns and resulting water scarcity, and urban water sources and management practices with various socio-political and economic factors that influence urbanization, water prices and vendors, to develop a comprehensive understanding of the dominant drivers of dengue burden and the recent upward trends.

Growing the Seeds of Strength in High Risk Urban Neighborhoods.

ERIC Educational Resources Information Center

Saegert, Susan

The lives of poor minority city residents demonstrate the diversity, multiple potentials, and vulnerability to external structures. In spite of the stereotypes of failure and the very real problems of the urban poor, there are many strengths among the so-called urban underclass and there are aspects of life that are successful and productive. In…

Managing rapid urbanization in the third world: some aspects of policy.

PubMed

Hope, K R

1989-01-01

A priority task for developing countries is the formulation of national urbanization policies that: 1) foster the full development of national resources; 2) promote cohesion among regions, especially where there are striking inequities in per capita output; 3) prevent or correct the overconcentration of economic activity in a few urban centers; and 4) create a more efficient, equitable management of growth within cities. Although urban households tend to be served better by the health and educational sectors than their rural counterparts, the urban poor are denied these benefits in the absence of special programs to ensure universal access. The urban poor are further denied access to the benefits of urban centers through a transportation policy that is oriented more toward roads and cars than public transit systems. Of major concern are the overcrowded squatter settlements that have developed in response to massive rural-urban migration. Since the landlessness, joblessness, and demoralization in rural areas and the consequent urban influx are at the root of the urban crisis in the Third World, integrated rural development is essential to retain substantial new additions to the urban labor force in rural areas. Land reform is the single strategy with the greatest potential to improve the quality of life of the landless poor and small holders. Other needs include programs of labor-intensive rural public works to provide supplementary income-earning opportunities and improve the rural infrastructure and more widespread participation of the rural poor in the development process. Increasingly sophisticated administrative and financing systems will be required to carry out a national urbanization policy, and current politicized bureaucracies must be replaced by a reliance on technically skilled professional administrators.

Urban regeneration as population health intervention: a health impact assessment in the Bay of Pasaia (Spain).

PubMed

Serrano, Elena; Larrañaga, Isabel; Morteruel, Maite; Baixas de Ros, María Dolores; Basterrechea, Mikel; Martinez, Dolores; Aldasoro, Elena; Bacigalupe, Amaia

2016-09-15

An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia (Spain). Potential differential impacts on local residents and socially vulnerable groups were evaluated to determine health inequalities. An in-depth, prospective and concurrent Health-Impact-Assessment (HIA) focused on equity was conducted by the regional Public Health Department, following the Merseyside guidelines. Data from different sources was triangulated and impacts were identified using qualitative and quantitative methods. The intervention area is characterised by poor social, environmental, and health indicators. The distinctness of the two projects generates contrasting health and inequality impacts: generally positive for the new fish market and negative for the port area. The former creates recreational spaces and improves urban quality and social cohesion. By contrast, inaction and stagnation of the project in the port area perpetuates deterioration, a lack of safety, and poor health, as well as increased social frustration. In addition to assessing the health impacts of both projects this HIA promoted intersectoral partnerships, boosted a holistic and positive view of health and incorporated health and equity into the political discourse. Community-level participatory action enabled public health institutions to respond to new urban planning challenges and responsibilities in a more democratic manner.

Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh.

PubMed

Ahsan, Karar Zunaid; Arifeen, Shams El; Al-Mamun, Md Abdullah; Khan, Shusmita H; Chakraborty, Nitai

2017-01-01

Bangladesh urban population is expected to overtake rural population by 2040, and a significant part of the increase will be in slums. Wide disparities between urban slums and the rest of the country can potentially push country indicators off track unless the specific health and nutrition needs of the expanding slum communities are addressed. The study aims at describing the individual, household and community determinants of undernutrition status among children living in major urban strata, viz. City Corporation slums and non-slums, in order to understand the major drivers of childhood undernutrition in urban slum settings. Data are derived from Bangladesh Urban Health Survey conducted in 2013. This survey is a large-scale, nationally representative of urban areas, household survey designed specifically to provide health and nutrition status of women and children in urban Bangladesh. Data showed that 50% of under-5 children in slums are stunted and 43% are underweight, whereas for non-slums these rates are 33 and 26% respectively. In terms of severity, proportion of under-5 children living in slums severely underweight or stunted are nearly double than the children living in non-slums. Logistic analyses indicate that mother's education, child's age, and household's socio-economic status significantly affects stunting and underweight levels among children living in the urban slums. Logistic models also indicate that all individual-level characteristics, except exposure to mass media and mother's working outside home, significantly affect undernutrition levels among children living on non-slums. Among the household- and community-level characteristics, only household's socioeconomic status remains significant for the non-slums. Poor nutritional status is a major concern in slum areas, particularly as this group is expected to grow rapidly in the next few years. The situation calls for specially designed and well targeted interventions that take into account that many of the mothers are poorer and less educated, which affects their ability to provide care to their children.

Prevalence of metabolic syndrome among an urban population in Kenya.

PubMed

Kaduka, Lydia U; Kombe, Yeri; Kenya, Eucharia; Kuria, Elizabeth; Bore, John K; Bukania, Zipporah N; Mwangi, Moses

2012-04-01

Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya. This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure. The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education. Metabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

Prevalence of Metabolic Syndrome Among an Urban Population in Kenya

PubMed Central

Kaduka, Lydia U.; Kombe, Yeri; Kenya, Eucharia; Kuria, Elizabeth; Bore, John K.; Bukania, Zipporah N.; Mwangi, Moses

2012-01-01

OBJECTIVE Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya. RESEARCH DESIGN AND METHODS This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure. RESULTS The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education. CONCLUSIONS Metabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs. PMID:22374643

Influence of socioeconomic status on the prevalence of stunted growth and obesity in prepubertal Indonesian children.

PubMed

Julia, M; van Weissenbruch, M M; de Waal, H A Delemarre-van; Surjono, A

2004-12-01

This cross-sectional study assesses the prevalence of stunting, overweight, and obesity in prepubertal children from different socioeconomic groups in Indonesia. Children from rural, poor urban, and nonpoor urban communities were studied (n = 3,010). The prevalences of stunting, wasting, overweight, and obesity were 19.3%, 5.0%, 2.7%, and 0.8%, respectively. The odds ratios (OR) for stunting, as compared with nonpoor urban children, were higher among rural children (2.92; 95% confidence interval [CI], 2.37-3.59) than among poor urban children (1.58; 95% CI, 1.18-2.13). The prevalence of wasting was not influenced by socioeconomic status. Both rural and poor urban children were significantly less likely to be overweight than were nonpoor urban children: in comparison with nonpoor urban children, the OR values were 0.19 (95% CI, 0.10-0.36) for rural and 0.13 (95% CI, 0.04-0.43) for poor urban children. Boys were more likely to be stunted or obese than girls: OR for stunting, 1.75 (95% CI, 1.44-2.12); OR for obesity, 4.07 (95% CI, 1.40-11.8). Stunted children were less likely than non-stunted children to be overweight: OR, 0.10 (95% CI, 0.03-0.43). In Indonesia, undernutrition is still related to poverty, whereas obesity is more related to prosperity.

Conflict, displacement and health in the Middle East.

PubMed

Mowafi, Hani

2011-01-01

Displacement is a hallmark of modern humanitarian emergencies. Displacement itself is a traumatic event that can result in illness or death. Survivors face challenges including lack of adequate shelter, decreased access to health services, food insecurity, loss of livelihoods, social marginalisation as well as economic and sexual exploitation. Displacement takes many forms in the Middle East and the Arab World. Historical conflicts have resulted in long-term displacement of Palestinians. Internal conflicts have driven millions of Somalis and Sudanese from their homes. Iraqis have been displaced throughout the region by invasion and civil strife. In addition, large numbers of migrants transit Middle Eastern countries or live there illegally and suffer similar conditions as forcibly displaced people. Displacement in the Middle East is an urban phenomenon. Many displaced people live hidden among host country populations in poor urban neighbourhoods - often without legal status. This represents a challenge for groups attempting to access displaced populations. Furthermore, health information systems in host countries often do not collect data on displaced people, making it difficult to gather data needed to target interventions towards these vulnerable populations. The following is a discussion of the health impacts of conflict and displacement in the Middle East. A review was conducted of published literature on migration and displacement in the region. Different cases are discussed with an emphasis on the recent, large-scale and urban displacement of Iraqis to illustrate aspects of displacement in this region.

Dentist Supply and Children’s Oral Health in the United States

PubMed Central

Guarnizo-Herreño, Carol C.

2014-01-01

Objectives. We evaluated the relationship between dentist supply and children’s oral health and explored heterogeneity by children’s age and urbanicity. Methods. We obtained data from the 2007 National Survey of Children’s Health (> 27 000 children aged 1–10 years; > 23 000 children aged 11–17 years). We estimated the association between state-level dentist supply and multiple measures of children’s oral health using regression analysis adjusting for several child, family, and population-level characteristics. Results. Dentist supply was significantly related to better oral health outcomes among children aged 1 to 10 years. The odds of decay and bleeding gums were lower by more than 50% (odds ratio [OR] = 0.46; 95% CI = 0.23, 0.95) and 80% (OR = 0.18; 95% CI = 0.05, 0.76), respectively, with an additional dentist per 1000 population. The odds of a worse maternal rating of child’s dental health on a 5-category scale from poor to excellent were lower by about 50% in this age group with an additional dentist per 1000 population (OR = 0.51; 95% CI = 0.29, 0.91). We observed associations only for children in urban settings. Conclusions. Dentist supply is associated with improved oral health for younger children in urban settings. PMID:25122013

Sustainable urban water systems in rich and poor cities--steps towards a new approach.

PubMed

Newman, P

2001-01-01

The 'big pipes in, big pipes out' approach to urban water management was developed in the 19th century for a particular linear urban form. Large, sprawling car-dependent cities are pushing this approach to new limits in rich cities and it has never worked in poor cities. An alternative which uses new small-scale technology and is more community-based, is suggested for both rich and poor countries. The Sydney Olympics and a demonstration project in Java show that the approach can work.

Socioeconomic Inequalities Persist Despite Declining Stunting Prevalence in Low- and Middle-Income Countries.

PubMed

da Silva, Inácio Crochemore M; França, Giovanny V; Barros, Aluisio J D; Amouzou, Agbessi; Krasevec, Julia; Victora, Cesar G

2018-02-01

Global stunting prevalence has been nearly halved between 1990 and 2016, but it remains unclear whether this decline has benefited poor and rural populations within low- and middle-income countries (LMICs). We assessed time trends in stunting among children <5 y of age (under-5) according to household wealth and place of residence in 67 LMICs. Stunting prevalence was analyzed in 217 nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 67 countries with ≥2 surveys between 1993 and 2014. National estimates were stratified by wealth and area of residence, comparing the poorest 40% with the wealthiest 60%, and those residing in urban and rural areas. Time trends were calculated for LMICs by using multilevel regression models weighted by under-5 population, with stratification by wealth and by residence. Trends in absolute (slope index of inequality; SII) and relative (concentration index; CIX) inequalities were calculated. Mean prevalences in 1993 were 53.7% in low-income and 48.2% in middle-income countries, with annual average linear declines of 0.76 and 0.72 percentage points (pp), respectively. Although similar slopes of declines were observed for the poorest 40% and wealthiest 60% groups in all countries (0.78 and 0.74 pp, respectively), absolute and relative inequalities increased over time in low-income countries (SII increased from -19.3% in 1993 to -23.7% in 2014 and CIX increased from -6.2% to -10.8% in the same period). In middle-income countries, socioeconomic inequalities remained stable. Overall, stunting prevalence decreased more rapidly among rural than for urban children (0.78 and 0.55 pp, respectively). The prevalence of stunting is decreasing. Poor-rich gaps are stable in middle-income countries and slightly increasing in low-income countries. Rural-urban inequalities are decreasing over time.

Life and death in a civitas capital: metabolic disease and trauma in the children from late Roman Dorchester, Dorset.

PubMed

Lewis, Mary E

2010-07-01

The impact that "Romanization" and the development of urban centers had on the health of the Romano-British population is little understood. A re-examination of the skeletal remains of 364 nonadults from the civitas capital at Roman Dorchester (Durnovaria) in Dorset was carried out to measure the health of the children living in this small urban area. The cemetery population was divided into two groups; the first buried their dead organized within an east-west alignment with possible Christian-style graves, and the second with more varied "pagan" graves, aligned north-south. A higher prevalence of malnutrition and trauma was evident in the children from Dorchester than in any other published Romano-British group, with levels similar to those seen in postmedieval industrial communities. Cribra orbitalia was present in 38.5% of the children, with rickets and/or scurvy at 11.2%. Twelve children displayed fractures of the ribs, with 50% of cases associated with rickets and/or scurvy, suggesting that rib fractures should be considered during the diagnosis of these conditions. The high prevalence of anemia, rickets, and scurvy in the Poundbury children, and especially the infants, indicates that this community may have adopted child-rearing practices that involved fasting the newborn, a poor quality weaning diet, and swaddling, leading to general malnutrition and inadequate exposure to sunlight. The Pagan group showed no evidence of scurvy or rib fractures, indicating difference in religious and child-rearing practices but that both burial groups were equally susceptible to rickets and anemia suggests a shared poor standard of living in this urban environment. (c) 2009 Wiley-Liss, Inc.

Reaching Urban Poor Hypertensive Patients: A Novel Model of Chronic Disease Care Versus a Traditional Fee-for-Service Approach.

PubMed

Sanders, Jim; Guse, Clare E

2016-08-09

There is a significant disparity in hypertensive treatment rates between those with and without health insurance. If left untreated, hypertension leads to significant morbidity and mortality. The uninsured face numerous barriers to access chronic disease care. We developed the Community-based Chronic Disease Management (CCDM) clinics specifically for the uninsured with hypertension utilizing nurse-led teams, community-based locations, and evidence-based clinical protocols. All services, including laboratory and medications, are provided on-site and free of charge. In order to ascertain if the CCDM model of care was as effective as traditional models of care in achieving blood pressure goals, we compared CCDM clinics' hypertensive care outcomes with 2 traditional fee-for-service physician-led clinics. All the clinics are located near one another in poor urban neighborhoods of Milwaukee, Wisconsin. Patients seen at the CCDM clinics and at 1 of the 2 traditional clinics showed a statistically significant improvement in reaching blood pressure goal at 6 months (P < .001 and P < .05, respectively). Logistic regression analysis found no difference in attaining blood pressure goal at 6 months for either of the 2 fee-for-service clinics when compared with the CCDM clinics. The CCDM model of care is at least as effective in controlling hypertension as more traditional fee-for-service models caring for the same population. The CCDM model of care to treat hypertension may offer another approach for engaging the urban poor in chronic disease care. © The Author(s) 2016.

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya.

PubMed

Calhoun, Lisa M; Speizer, Ilene S; Guilkey, David; Bukusi, Elizabeth

2018-03-01

Objectives In 2013, Kenya removed delivery fees at public health facilities in an effort to promote equity in access to health services and address high maternal mortality. This study determines the effect of the policy to remove user fees on institutional delivery in a population-based sample of women from urban Kenya. Methods Longitudinal data were collected from a representative sample of 8500 women from five cities in Kenya in 2010 with a follow-up interview in 2014 (response rate 58.9%). Respondents were asked about their most recent birth since 2008 at baseline and 2012 at endline, including the delivery location. Multinomial logistic regression is used, controlling for the temporal time trend and background characteristics, to determine if births which occurred after the national policy change were more likely to occur at a public facility than at home or a private facility. Results Multivariate findings show that women were significantly more likely to deliver at a public facility as compared to a private facility after the policy. Among the poor, the results show that poor women were significantly more likely to deliver in a public facility compared to home or a private facility after policy change. Conclusions for Practice These findings show Kenya's progress towards achieving universal access to delivery services and meeting its national development targets. The removal of delivery fees in the public sector is leading to increased use of facilities for delivery among the urban poor; this is an important first step in reducing maternal death.

More than a Library?: Urban Poverty and an Exploratory Look at the Role of a Neighborhood Institution

ERIC Educational Resources Information Center

Ly, Carolyn

2010-01-01

Libraries have traditionally tended to be one of the few institutionally provided public resources for local residents in poor, urban, neighborhoods. This paper presents findings from the exploratory phase of an ongoing research project which examines, through participant observation, the "value" of a public library in a poor urban neighborhood.…

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor

PubMed Central

2016-01-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030. PMID:27467691

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor.

PubMed

Amegah, Adeladza Kofi; Jaakkola, Jouni J K

2016-07-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030.

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women.

PubMed

Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R

2011-07-22

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey.

PubMed

Gopalan, Anjali; Makelarski, Jennifer A; Garibay, Lori B; Escamilla, Veronica; Merchant, Raina M; Wolfe, Marcus B; Holbrook, Rebecca; Lindau, Stacy Tessler

2016-06-28

More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may substitute for or complement community-based resources for weight management. However, little is currently known about health-specific ICT use among urban-dwelling people with obesity. We describe health-specific ICT use and its relationship to measured obesity among adults in high-poverty urban communities. Using data collected between November 2012 and July 2013 from a population-based probability sample of urban-dwelling African American and Hispanic adults residing on the South Side of Chicago, we described patterns of ICT use in relation to measured obesity defined by a body mass index (BMI) of ≥30 kg/m(2). Among those with BMI≥30 kg/m(2), we also assessed the association between health-specific ICT use and diagnosed versus undiagnosed obesity as well as differences in health-specific ICT use by self-reported comorbidities, including diabetes and hypertension. The survey response rate was 44.6% (267 completed surveys/598.4 eligible or likely eligible individuals); 53.2% were African American and 34.6% were Hispanic. More than 35% of the population reported an annual income of less than US $25,000. The population prevalence of measured obesity was 50.2%. People with measured obesity (BMI≥30 kg/m(2)) were more likely to report both general (81.5% vs 67.0%, P=.04) and health-specific (61.1% vs 41.2%, P=.01) ICT use. In contrast, among those with measured obesity, being told of this diagnosis by a physician was not associated with increased health-specific ICT use. People with measured obesity alone had higher rates of health-specific use than those with comorbid hypertension and/or diabetes diagnoses (77.1% vs 60.7% vs 47.4%, P=.04). In conclusion, ICT-based health resources may be particularly useful for people in high-poverty urban communities with isolated measured obesity, a population that is at high risk for poor health outcomes.

Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey

PubMed Central

Makelarski, Jennifer A; Garibay, Lori B; Escamilla, Veronica; Merchant, Raina M; Wolfe Sr, Marcus B; Holbrook, Rebecca; Lindau, Stacy Tessler

2016-01-01

Background More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may substitute for or complement community-based resources for weight management. However, little is currently known about health-specific ICT use among urban-dwelling people with obesity. Objective We describe health-specific ICT use and its relationship to measured obesity among adults in high-poverty urban communities. Methods Using data collected between November 2012 and July 2013 from a population-based probability sample of urban-dwelling African American and Hispanic adults residing on the South Side of Chicago, we described patterns of ICT use in relation to measured obesity defined by a body mass index (BMI) of ≥30 kg/m2. Among those with BMI≥30 kg/m2, we also assessed the association between health-specific ICT use and diagnosed versus undiagnosed obesity as well as differences in health-specific ICT use by self-reported comorbidities, including diabetes and hypertension. Results The survey response rate was 44.6% (267 completed surveys/598.4 eligible or likely eligible individuals); 53.2% were African American and 34.6% were Hispanic. More than 35% of the population reported an annual income of less than US $25,000. The population prevalence of measured obesity was 50.2%. People with measured obesity (BMI≥30 kg/m2) were more likely to report both general (81.5% vs 67.0%, P=.04) and health-specific (61.1% vs 41.2%, P=.01) ICT use. In contrast, among those with measured obesity, being told of this diagnosis by a physician was not associated with increased health-specific ICT use. People with measured obesity alone had higher rates of health-specific use than those with comorbid hypertension and/or diabetes diagnoses (77.1% vs 60.7% vs 47.4%, P=.04). Conclusions In conclusion, ICT-based health resources may be particularly useful for people in high-poverty urban communities with isolated measured obesity, a population that is at high risk for poor health outcomes. PMID:27352770

[Overweight and obesity: prevalence and determining social factors of overweight in the Peruvian population (2009-2010)].

PubMed

Álvarez-Dongo, Doris; Sánchez-Abanto, Jose; Gómez-Guizado, Guillermo; Tarqui-Mamani, Carolina

2012-01-01

Estimate the prevalence of overweight, obesity and the determining social factors of overweight in the Peruvian population. A cross-cut study was conducted which included family members from homes in the sample of the National Household Survey, 2009-2010. Stratified random and multistage sampling was used. The sample included 69 526 members; the anthropometric measurements were done based on the international methodology. To evaluate overweight and obesity, weight-for-height (children <5 years), BMI for age (children and teenagers from 5 to 19 years old), and BMI for adults were used. An analysis of complex samples was made in SPSS and the weighting factor was adjusted. Descriptive statistics and logistic regression were calculated with a 95% confidence interval. Overweight and obesity were higher in young adults (62.3%) and lower in children <5 years old (8.2%). The determining social factors for overweight according to age group were: not being poor (child <5 years old, children 5-9 years old, teenagers and the elderly), living in urban areas (child <5 years old, teenagers, young adults, adults and the elderly) and being a woman (children 5-9 years old, adults and the elderly). Overweight and obesity are indeed a public health issue in Peru. Not being poor and living in urban areas are determining social factors of overweight among Peruvian people.

[Association between waist circumference and the prevalence/control of hypertension by gender and different body mass index classification in an urban elderly population].

PubMed

Wu, Lei; He, Yao; Jiang, Bin; Liu, Miao; Yang, Shanshan; Zeng, Jing; Wang, Yiyan; Wang, Jianhua; Zhang, Di

2015-12-01

The aim of the present study was to evaluate the association between waist circumference and the prevalence/control of hypertension in an urban elderly population. From September 2009 to June 2010, a population-based cross-sectional study was conducted in Wanshoulu area of Beijing, China. A total of 2 035 elderly (828 male, 1 207 females) participants aged ≥60 years from a community were included in this study for data analysis. We found that the increased waist circumference could significantly increase the risk of prevalence and poor control of hypertension, with the adjusted odds ratios (95% CI) as 1.04 (1.01-1.08) and 0.96 (0.92-1.00) , respectively. Among those identified pure central obesity females (64.7%) , the prevalence of hypertension was significantly higher than those females with normal body mass index (BMI) or with normal waist circumference (52.2%). The adjusted odds ratio (95%CI) between the above said groups appeared as 1.58 (1.07-2.32). The control rate of hypertension among females (32.9%) with pure central obesity, was lower than that of the females with normal BMI and waist circumference (43.5%) , with an adjusted odds ratio (95%CI) as 0.62 (0.37-1.04, P=0.071). There appeared significant association between people with pure central obesity and the increased risk of prevalence or with poor control of hypertension. More attention should be paid to both the prevalence and control of hypertension programs among females with pure central obesity.

Involvement of urban living environments in atopy and enhanced eosinophil activity: potential risk factors of airway allergic symptoms.

PubMed

Kuwahara, Y; Kondoh, J; Tatara, K; Azuma, E; Nakajima, T; Hashimoto, M; Komachi, Y

2001-03-01

Airway allergic diseases, such as bronchial asthma and allergic rhinitis, have increased, especially in urban areas. These diseases are characterized by airway inflammation with enhanced eosinophil activity, and the risk of disease development has been shown to increase with the prevalence of atopy. Questionnaires were administered to 426 healthy adult women aged 30-74 years, living in an urban area of Osaka, Japan, to survey individual living environments and airway allergic symptoms such as cough, sputum, and wheezing. Moreover, serum house-dust-mite (Dermatophagoides pteronyssinus, [Der p])-specific immunoglobulin E (IgE) and serum eosinophil cationic protein (ECP) were examined by radioimmunoassay, and the atopic status (atopic sensitization) and enhanced eosinophil activity were assessed as Der p-specific IgE RAST scores of 2-6 and ECP levels of more than 10 ng/ml, respectively. Intensive use of electric air conditioners in hot weather (odds ratio: 2.07 [95% CI: 1.11-3.87]) and mold proliferation in the kitchen (2.77 [1.34-5.73]) significantly increased the risk of atopic sensitization. Poor home ventilation and family smoking appeared to be positively but not significantly associated with atopic sensitization. Personal smoking and intensive use of the air conditioner appeared to be positively related to enhanced eosinophil activity. Atopic status showed significant involvement in the development of wheezing, and the development of cough was significantly associated with enhanced eosinophil activity. The results suggest that some urban styles of living are involved in atopic sensitization and enhanced eosinophil activity in the Japanese urban population, probably due to living conditions, such as indoor dampness and poor home ventilation, caused by tight insulation, which increase exposure to indoor air pollutants, such as respirable mite allergens and tobacco smoke.

Characterising Wildlife Trade Market Supply-Demand Dynamics

PubMed Central

Rowcliffe, M.; Cowlishaw, G.; Alexander, J. S.; Ntiamoa-Baidu, Y.; Brenya, A.; Milner-Gulland, E. J.

2016-01-01

The trade in wildlife products can represent an important source of income for poor people, but also threaten wildlife locally, regionally and internationally. Bushmeat provides livelihoods for hunters, traders and sellers, protein to rural and urban consumers, and has depleted the populations of many tropical forest species. Management interventions can be targeted towards the consumers or suppliers of wildlife products. There has been a general assumption in the bushmeat literature that the urban trade is driven by consumer demand with hunters simply fulfilling this demand. Using the urban bushmeat trade in the city of Kumasi, Ghana, as a case study, we use a range of datasets to explore the processes driving the urban bushmeat trade. We characterise the nature of supply and demand by explicitly considering three market attributes: resource condition, hunter behaviour, and consumer behaviour. Our results suggest that bushmeat resources around Kumasi are becoming increasingly depleted and are unable to meet demand, that hunters move in and out of the trade independently of price signals generated by the market, and that, for the Kumasi bushmeat system, consumption levels are driven not by consumer choice but by shortfalls in supply and consequent price responses. Together, these results indicate that supply-side processes dominate the urban bushmeat trade in Kumasi. This suggests that future management interventions should focus on changing hunter behaviour, although complementary interventions targeting consumer demand are also likely to be necessary in the long term. Our approach represents a structured and repeatable method to assessing market dynamics in information-poor systems. The findings serve as a caution against assuming that wildlife markets are demand driven, and highlight the value of characterising market dynamics to inform appropriate management. PMID:27632169

Characterising Wildlife Trade Market Supply-Demand Dynamics.

PubMed

McNamara, J; Rowcliffe, M; Cowlishaw, G; Alexander, J S; Ntiamoa-Baidu, Y; Brenya, A; Milner-Gulland, E J

2016-01-01

The trade in wildlife products can represent an important source of income for poor people, but also threaten wildlife locally, regionally and internationally. Bushmeat provides livelihoods for hunters, traders and sellers, protein to rural and urban consumers, and has depleted the populations of many tropical forest species. Management interventions can be targeted towards the consumers or suppliers of wildlife products. There has been a general assumption in the bushmeat literature that the urban trade is driven by consumer demand with hunters simply fulfilling this demand. Using the urban bushmeat trade in the city of Kumasi, Ghana, as a case study, we use a range of datasets to explore the processes driving the urban bushmeat trade. We characterise the nature of supply and demand by explicitly considering three market attributes: resource condition, hunter behaviour, and consumer behaviour. Our results suggest that bushmeat resources around Kumasi are becoming increasingly depleted and are unable to meet demand, that hunters move in and out of the trade independently of price signals generated by the market, and that, for the Kumasi bushmeat system, consumption levels are driven not by consumer choice but by shortfalls in supply and consequent price responses. Together, these results indicate that supply-side processes dominate the urban bushmeat trade in Kumasi. This suggests that future management interventions should focus on changing hunter behaviour, although complementary interventions targeting consumer demand are also likely to be necessary in the long term. Our approach represents a structured and repeatable method to assessing market dynamics in information-poor systems. The findings serve as a caution against assuming that wildlife markets are demand driven, and highlight the value of characterising market dynamics to inform appropriate management.

Addressing Inequities in Urban Health: Do Decision-Makers Have the Data They Need? Report from the Urban Health Data Special Session at International Conference on Urban Health Dhaka 2015.

PubMed

Elsey, H; Thomson, D R; Lin, R Y; Maharjan, U; Agarwal, S; Newell, J

2016-06-01

Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that adequately represents the needs of the urban poorest as well as others across the socio-economic spectrum.We report on the findings of a special session held at the International Conference on Urban Health, Dhaka 2015. We present an overview of the need for data on urban health for planning and allocating resources to address urban inequities. Such data needs to provide information on differences between urban and rural areas nationally, between and within urban communities. We discuss the limitations of data most commonly available to national and municipality level government, donor and NGO staff. In particular we assess, with reference to the WHO's Urban HEART tool, the challenges in the design of household surveys in understanding urban health inequities.We then present two novel approaches aimed at improving the information on the health of the urban poorest. The first uses gridded population sampling techniques within the design and implementation of household surveys and the second adapts Urban HEART into a participatory approach which enables slum residents to assess indicators whilst simultaneously planning the response. We argue that if progress is to be made towards inclusive, safe, resilient and sustainable cities, as articulated in Sustainable Development Goal 11, then understanding urban health inequities is a vital pre-requisite to an effective response by governments, donors, NGOs and communities.

The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa.

PubMed

Kabaria, Caroline W; Gilbert, Marius; Noor, Abdisalan M; Snow, Robert W; Linard, Catherine

2017-01-26

Although malaria has been traditionally regarded as less of a problem in urban areas compared to neighbouring rural areas, the risk of malaria infection continues to exist in densely populated, urban areas of Africa. Despite the recognition that urbanization influences the epidemiology of malaria, there is little consensus on urbanization relevant for malaria parasite mapping. Previous studies examining the relationship between urbanization and malaria transmission have used products defining urbanization at global/continental scales developed in the early 2000s, that overestimate actual urban extents while the population estimates are over 15 years old and estimated at administrative unit level. This study sought to discriminate an urbanization definition that is most relevant for malaria parasite mapping using individual level malaria infection data obtained from nationally representative household-based surveys. Boosted regression tree (BRT) modelling was used to determine the effect of urbanization on malaria transmission and if this effect varied with urbanization definition. In addition, the most recent high resolution population distribution data was used to determine whether population density had significant effect on malaria parasite prevalence and if so, could population density replace urban classifications in modelling malaria transmission patterns. The risk of malaria infection was shown to decline from rural areas through peri-urban settlements to urban central areas. Population density was found to be an important predictor of malaria risk. The final boosted regression trees (BRT) model with urbanization and population density gave the best model fit (Tukey test p value <0.05) compared to the models with urbanization only. Given the challenges in uniformly classifying urban areas across different countries, population density provides a reliable metric to adjust for the patterns of malaria risk in densely populated urban areas. Future malaria risk models can, therefore, be improved by including both population density and urbanization which have both been shown to have significant impact on malaria risk in this study.

Increasing of Urban Radiation due to Climate Change and Reduction Strategy using Vegetation

NASA Astrophysics Data System (ADS)

Park, C.; Lee, D.; Heo, H. K.; Ahn, S.

2017-12-01

Urban Heat Island (UHI) which means urban air temperature is higher than suburban area is one of the most important environmental issues in Urban. High density of buildings and high ratio of impervious surfaces increases the radiation fluxes in urban canopy. Furthermore, climate change is expected to make UHI even more seriously in the future. Increased irradiation and air temperature cause high amount of short wave and long wave radiation, respectively. This increases net radiation negatively affects heat condition of pedestrian. UHI threatens citizen's health by increasing violence and heat related diseases. For this reason, understanding how much urban radiation will increase in the future, and exploring radiation reduction strategies is important for reducing UHI. In this research, we aim to reveal how the radiation flux in the urban canyon will change as the climate change and determine how much of urban vegetation will be needed to cover this degradation. The study area is a commercial district in Seoul where highly populated area. Due to the high density of buildings and lack of urban vegetation, this area has a poor thermal condition in summer. In this research, we simulate the radiation flux on the ground using multi-layer urban canopy model. Unlike conventionally used urban canopy model to simulate radiation transfer using vertically single layer, the multi-layer model we used here, enables to consider the vertical heterogeneous of buildings and urban vegetation. As a result, net radiation of urban ground will be increase 2.1 W/m² in the 2050s and 2.7 W/m² in the 2100s. And to prevent the increase of radiation, it is revealed that the urban vegetation should by increased by 10%. This research will be valuable in establishing greening planning as a strategy to reduce UHI effect.

Enhancement of urban heat load through social inequalities on an example of a fictional city King's Landing.

PubMed

Žuvela-Aloise, M

2017-03-01

The numerical model MUKLIMO_3 is used to simulate the urban climate of an imaginary city as an illustrative example to demonstrate that the residential areas with deprived socio-economic conditions can exhibit an enhanced heat load at night, and thus more disadvantageous environmental conditions, compared with the areas of higher socio-economic status. The urban climate modelling simulations differentiate between orographic, natural landscape, building and social effects, where social differences are introduced by selection of location, building type and amount of vegetation. The model results show that the increase of heat load can be found in the areas inhabited by the poor population as a combined effect of natural and anthropogenic factors. The unfavourable location in the city and the building type, consisting of high density, low housing with high fraction of pavement and small amount of vegetation contribute to the formation of excessive heat load. This abstract example shows that the enhancement of urban heat load can be linked to the concept of a socially stratified city and is independent of the historical development of any specific city.

Enhancement of urban heat load through social inequalities on an example of a fictional city King's Landing

NASA Astrophysics Data System (ADS)

Žuvela-Aloise, M.

2017-03-01

The numerical model MUKLIMO_3 is used to simulate the urban climate of an imaginary city as an illustrative example to demonstrate that the residential areas with deprived socio-economic conditions can exhibit an enhanced heat load at night, and thus more disadvantageous environmental conditions, compared with the areas of higher socio-economic status. The urban climate modelling simulations differentiate between orographic, natural landscape, building and social effects, where social differences are introduced by selection of location, building type and amount of vegetation. The model results show that the increase of heat load can be found in the areas inhabited by the poor population as a combined effect of natural and anthropogenic factors. The unfavourable location in the city and the building type, consisting of high density, low housing with high fraction of pavement and small amount of vegetation contribute to the formation of excessive heat load. This abstract example shows that the enhancement of urban heat load can be linked to the concept of a socially stratified city and is independent of the historical development of any specific city.

Using UAV's to Measure the Urban Boundary Layer

NASA Astrophysics Data System (ADS)

Jacob, R. L.; Sankaran, R.; Beckman, P. H.

2015-12-01

The urban boundary layer is one of the most poorly studied regions of the atmospheric boundary layer. Since a majority of the world's population now lives in urban areas, it is becoming a more important region to measure and model. The combination of relatively low-cost unmanned aerial vehicles and low-cost sensors can together provide a new instrument for measuring urban and other boundary layers. We have mounted a new sensor and compute platform called Waggle on an off-the-shelf XR8 octo-copter from 3DRobotics. Waggle consists of multiple sensors for measuring pressure, temperature and humidity as well as trace gases such as carbon monoxide, nitrogen dioxide, sulfur dioxide and ozone. A single board computer running Linux included in Waggle on the UAV allows in-situ processing and data storage. Communication of the data is through WiFi or 3G and the Waggle software can save the data in case communication is lost during flight. The flight pattern is a deliberately simple vertical ascent and descent over a fixed location to provide vertical profiles and so flights can be confined to urban parks, industrial areas or the footprint of a single rooftop. We will present results from test flights in urban and rural areas in and around Chicago.

Urban lymphatic filariasis.

PubMed

Simonsen, Paul E; Mwakitalu, Mbutolwe E

2013-01-01

Lymphatic filariasis (LF) is a disabling and disfiguring disease resulting from a mosquito-borne parasitic infection. It is a major public health problem in many countries with a warm climate. Research and control activities have mainly focused on LF in rural areas where it also has its major impact. However, with rapid and unplanned growth of cities in the developing world, there is a need also to consider LF transmission and control in urban settings. Here, we review currently available knowledge on urban LF and the environmental and socio-economic basis for its occurrence. Among the three parasite species causing LF in humans, only Wuchereria bancrofti has been documented to have a significant potential for urban transmission. This is primarily because one of its vectors, Culex quinquefasciatus, thrives and proliferates excessively in crowded city areas with poor sanitary, sewerage and drainage facilities. For this reason, urban LF also often shows a marked focality in distribution, with most cases clustered in areas inhabited by the less privileged city populations. More knowledge on urban LF is needed, in particular on its socio-economic and human behavioural context, on the potential for transmission in regions where other LF vector species predominate, and on rapid methods for identification and mapping of risk areas, to provide a strong evidence base for its control.

Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS).

PubMed

Beguy, Donatien; Elung'ata, Patricia; Mberu, Blessing; Oduor, Clement; Wamukoya, Marylene; Nganyi, Bonface; Ezeh, Alex

2015-04-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first urban-based longitudinal health and demographic surveillance platform in sub-Saharan Africa (SSA). The NUHDSS was established in 2002 to provide a platform to investigate the long-term social, economic and health consequences of urban residence, and to serve as a primary research tool for intervention and impact evaluation studies focusing on the needs of the urban poor in SSA. Since its inception, the NUHDSS has successfully followed every year a population of about 65,000 individuals in 24,000 households in two slum communities--Korogocho and Viwandani--in Nairobi, Kenya. Data collected include key demographic and health information (births, deaths including verbal autopsy, in- and out-migration, immunization) and other information that characterizes living conditions in the slums (livelihood opportunities, household amenities and possessions, type of housing etc.). In addition to the routine data, it has provided a robust platform for nesting several studies examining the challenges of rapid urbanization in SSA and associated health and poverty dynamics. NUHDSS data are shared through internal and external collaborations, in accordance with the Centre's guidelines for publications, data sharing. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Modeling Mosquito-Borne Disease Spread in U.S. Urbanized Areas: The Case of Dengue in Miami

PubMed Central

Robert, Michael A.; Christofferson, Rebecca C.; Silva, Noah J. B.; Vasquez, Chalmers; Mores, Christopher N.; Wearing, Helen J.

2016-01-01

Expansion of mosquito-borne pathogens into more temperate regions of the world necessitates tools such as mathematical models for understanding the factors that contribute to the introduction and emergence of a disease in populations naïve to the disease. Often, these models are not developed and analyzed until after a pathogen is detected in a population. In this study, we develop a spatially explicit stochastic model parameterized with publicly available U.S. Census data for studying the potential for disease spread in Urbanized Areas of the United States. To illustrate the utility of the model, we specifically study the potential for introductions of dengue to lead to autochthonous transmission and outbreaks in a population representative of the Miami Urbanized Area, where introductions of dengue have occurred frequently in recent years. We describe seasonal fluctuations in mosquito populations by fitting a population model to trap data provided by the Miami-Dade Mosquito Control Division. We show that the timing and location of introduced cases could play an important role in determining both the probability that local transmission occurs as well as the total number of cases throughout the entire region following introduction. We show that at low rates of clinical presentation, small outbreaks of dengue could go completely undetected during a season, which may confound mitigation efforts that rely upon detection. We discuss the sensitivity of the model to several critical parameter values that are currently poorly characterized and motivate the collection of additional data to strengthen the predictive power of this and similar models. Finally, we emphasize the utility of the general structure of this model in studying mosquito-borne diseases such as chikungunya and Zika virus in other regions. PMID:27532496

Exploring the contexts of urban science classrooms: Cogenerative dialogues, coteaching, and cosmopolitanism

NASA Astrophysics Data System (ADS)

Emdin, Christopher

The body of work presented in this dissertation is a response to the reported association between poor outcomes in science achievement and students of color in urban schools. By presenting counterexamples to the cultural motif that urban students of color perform poorly in science, I argue that poor achievement cannot be traced to a group of people but can be linked to institutions promoting subject delivery methods that instill distaste for science and compel students to display an illusion of disinterest in school. There are two major goals of this study. First, I plan to demonstrate how plans of action generated by coteachers and cogenerative dialogue groups can coalesce under the ethos of making science and schooling accessible to populations that are traditionally marginalized from science achievement. My second aim is to develop mechanisms for transforming science learning contexts into cosmopolitan learning communities that develop student success in science. Through a three-year ethnographic study of physics and chemistry classrooms in a high school in New York City, I present explorations of the culture and context of the urban classroom as a chief means to meet my goals. In my research, I find that obstacles to identity development around science can be tied to corporate understandings of teaching and learning that are amenable to local efforts toward change. This change is facilitated through the use of transformative tools like cogenerative dialogues, coteaching, and cosmopolitanism. Through the application of these research tools, I uncover and investigate how various misalignments that present themselves in physics and chemistry classrooms serve as signifiers of macro issues that permeate science classrooms from larger fields. By utilizing cogenerative dialogues as a tool for investigating both micro enactments within classrooms and the macro structures that generate these enactments, I show how students and teachers can work together as co-researchers and coteachers that engage in a dual process of questioning existent structures that do not support science success and transforming them.

High urban population density of birds reflects their timing of urbanization.

PubMed

Møller, Anders Pape; Diaz, Mario; Flensted-Jensen, Einar; Grim, Tomas; Ibáñez-Álamo, Juan Diego; Jokimäki, Jukka; Mänd, Raivo; Markó, Gábor; Tryjanowski, Piotr

2012-11-01

Living organisms generally occur at the highest population density in the most suitable habitat. Therefore, invasion of and adaptation to novel habitats imply a gradual increase in population density, from that at or below what was found in the ancestral habitat to a density that may reach higher levels in the novel habitat following adaptation to that habitat. We tested this prediction of invasion biology by analyzing data on population density of breeding birds in their ancestral rural habitats and in matched nearby urban habitats that have been colonized recently across a continental latitudinal gradient. We estimated population density in the two types of habitats using extensive point census bird counts, and we obtained information on the year of urbanization when population density in urban habitats reached levels higher than that of the ancestral rural habitat from published records and estimates by experienced ornithologists. Both the difference in population density between urban and rural habitats and the year of urbanization were significantly repeatable when analyzing multiple populations of the same species across Europe. Population density was on average 30 % higher in urban than in rural habitats, although density reached as much as 100-fold higher in urban habitats in some species. Invasive urban bird species that colonized urban environments over a long period achieved the largest increases in population density compared to their ancestral rural habitats. This was independent of whether species were anciently or recently urbanized, providing a unique cross-validation of timing of urban invasions. These results suggest that successful invasion of urban habitats was associated with gradual adaptation to these habitats as shown by a significant increase in population density in urban habitats over time.

Growing pains: status of emergency medicine in Nicaragua.

PubMed

Gaitan, M; Mendez, W; Sirker, N E; Green, G B

1998-03-01

Nicaragua is one of the poorest nations in the Western Hemisphere. The health of the population suffers as a result of poor nutrition, epidemic diseases, natural and manmade disasters, sporadic violence, urban industrial growth, and inadequate government funding for even basic medical equipment and supplies. Within this environment, emergency services development has been recognized as an important and cost-effective public health intervention. In recent years, government and nongovernmental agencies working together have had a dramatic positive impact on the quality of emergency care provided.

Invasive pneumococcal disease and socioeconomic deprivation: a population study from the North East of England.

PubMed

Chapman, K E; Wilson, D; Gorton, R

2013-12-01

Some communicable diseases disproportionately affect poor and vulnerable groups. Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality; however, the relationship between IPD and deprivation has not been well described. Population based study assessing the relationship between incidence of IPD and deprivation in the North East of England using data from an enhanced IPD surveillance system and the 2010 Indices of Multiple Deprivation and the Rural and Urban Area Classification. The incidence of IPD increased linearly with increasing deprivation from 7.0 per 100 000 population to 13.6 per 100 000 population. This association was demonstrated for the 16-64 and ≥65 year age groups, but not the <16 year age group. IPD incidence was strongly associated with all individual domains of deprivation except for the 'barriers to housing and services' domain. IPD incidence was higher in urban than rural areas. The risk of IPD is strongly associated with deprivation in adults, but not children. The mechanisms producing the associations observed remain unclear and require further investigation. Findings from this study reinforce the need to address social inequalities to reduce the burden of disease. Targeting vaccination at adults living in deprived areas could reduce the burden of IPD.

Assessing air quality index awareness and use in Mexico City.

PubMed

Borbet, Timothy C; Gladson, Laura A; Cromar, Kevin R

2018-04-23

The Mexico City Metropolitan Area has an expansive urban population and a long history of air quality management challenges. Poor air quality has been associated with adverse pulmonary and cardiac health effects, particularly among susceptible populations with underlying disease. In addition to reducing pollution concentrations, risk communication efforts that inform behavior modification have the potential to reduce public health burdens associated with air pollution. This study investigates the utilization of Mexico's IMECA risk communication index to inform air pollution avoidance behavior among the general population living in the Mexico City Metropolitan Area. Individuals were selected via probability sampling and surveyed by phone about their air quality index knowledge, pollution concerns, and individual behaviors. The results indicated reasonably high awareness of the air quality index (53% of respondents), with greater awareness in urban areas, among older and more educated individuals, and for those who received air quality information from a healthcare provider. Additionally, behavior modification was less influenced by index reports as it was by personal perceptions of air quality, and there was no difference in behavior modification among susceptible and non-susceptible groups. Taken together, these results suggest there are opportunities to improve the public health impact of risk communication through an increased focus on susceptible populations and greater encouragement of public action in response to local air quality indices.

A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children.

PubMed

Uzma, Nazia; Kumar, B Santhosh; Khaja Mohinuddin Salar, B M; Zafar, Mohammed Atheshm; Reddy, V Devender

2009-06-01

To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India. Population-based, cross-sectional study. A total of 3314 school children, 1789 from urban areas and 1525 from rural areas. The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation. In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (< or = 20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children. Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.

Are area-level and individual-level socioeconomic factors associated with self-rated health in adult urban citizens? Evidence from Slovak and Dutch cities.

PubMed

Behanova, Martina; Reijneveld, Sijmen A; Nagyova, Iveta; Katreniakova, Zuzana; van Ameijden, Erik J C; Dijkshoorn, Henriëtte; van Dijk, Jitse P

2017-05-01

Evidence shows that living in disadvantaged areas is associated with poor health. This may be due to the socioeconomic (SE) characteristics of both these residents and the areas where they live. Evidence regarding this on Central European (CE) countries is scarce. Our aim was to assess whether the prevalence of poor self-rated health (SRH) was higher in deprived urban areas, whether this can be explained by individual SE status (SES) and whether this differed between Slovakia and the Netherlands per age group. We examined the association of urban-level data and individual-level SE factors from different urban areas in different countries (Slovakia, the Netherlands) using comparable urban health indicators and area indicators. We also obtained unique data from the EU-FP7 EURO-URHIS 2 project. Multilevel logistic regression showed that poor SRH was associated with area deprivation in both countries. Regarding age by country, poor SRH occurred more frequently in the more deprived areas for the younger age group (≤64) in the Netherlands but for the older age group (≥65 years) in Slovakia. Moreover, Slovak citizens reported poor SRH significantly more often than Dutch residents. Individual SES was significantly associated with poor SRH in both age groups and both countries for most area-level SE measures. Individual SES is associated with SRH more strongly than area deprivation. Therefore, it is important to account for relative deprivation at an individual level when considering health-enhancing activities. Moreover, the effect of urban-area deprivation seems to differ between CE and WE countries. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the Line of Fire

PubMed Central

Rosshandler, Yasmin; Hall, Brian J.; Canetti, Daphna

2016-01-01

Objective Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. Method Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations due to conflict exposure from 1990 to present were included. Results A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared to urban areas, poor family and peer relations and poor coping skills were associated with PTSD symptoms. Conclusions The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socio-ecological levels that have received limited attention. PMID:26950012

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the line of fire.

PubMed

Rosshandler, Yasmin; Hall, Brian J; Canetti, Daphna

2016-09-01

Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations because of conflict exposure from 1990 to present were included. A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared with urban areas, poor family and peer relations, and poor coping skills were associated with PTSD symptoms. The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socioecological levels that have received limited attention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Determinants of eating at local and western fast-food venues in an urban Asian population: a mixed methods approach.

PubMed

Naidoo, Nasheen; van Dam, Rob M; Ng, Sheryl; Tan, Chuen Seng; Chen, Shiqi; Lim, Jia Yi; Chan, Mei Fen; Chew, Ling; Rebello, Salome A

2017-05-25

Like several Southeast Asian countries, Singapore has a complex eating-out environment and a rising eating-out prevalence. However the determinants and drivers of eating-out in urban Asian environments are poorly understood. We examined the socio-demographic characteristics of persons who frequently ate away from home in local eateries called hawker centres and Western fast-food restaurants, using data from 1647 Singaporean adults participating in the National Nutrition Survey (NNS) 2010. We also assessed the underlying drivers of eating out and evaluated if these were different for eating at local eateries compared to Western fast-food restaurants using 18 focus group discussions of women (130 women). Participants reported a high eating-out frequency with 77.3% usually eating either breakfast, lunch or dinner at eateries. Main venues for eating-out included hawker centres (61.1% usually ate at least 1 of 3 daily meals at this venue) and school/workplace canteens (20.4%). A minority of participants (1.9%) reported usually eating at Western fast-food restaurants. Younger participants and those of Chinese and Malay ethnicity compared to Indians were more likely to eat at Western fast-food restaurants. Chinese and employed persons were more likely to eat at hawker centres. The ready availability of a large variety of affordable and appealing foods appeared to be a primary driver of eating out, particularly at hawker centres. Our findings highlight the growing importance of eating-out in an urban Asian population where local eating venues play a more dominant role compared with Western fast-food chains. Interventions focusing on improving the food quality at venues for eating out are important to improve the diet of urban Asian populations.

Roundtable on Urban Living Environment Research (RULER).

PubMed

Vlahov, David; Agarwal, Siddharth Raj; Buckley, Robert M; Caiaffa, Waleska Teixeira; Corvalan, Carlos F; Ezeh, Alex Chika; Finkelstein, Ruth; Friel, Sharon; Harpham, Trudy; Hossain, Maharufa; de Faria Leao, Beatriz; Mboup, Gora; Montgomery, Mark R; Netherland, Julie C; Ompad, Danielle C; Prasad, Amit; Quinn, Andrew T; Rothman, Alexander; Satterthwaite, David E; Stansfield, Sally; Watson, Vanessa J

2011-10-01

For 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO's Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health-namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya.

PubMed

Mutisya, Maurice; Kandala, Ngianga-Bakwin; Ngware, Moses Waithanji; Kabiru, Caroline W

2015-10-13

Millions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya. We use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below -2 standard deviation were categorized as stunted. We used Cox regression to analyse the data. The prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting. Our results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to reduce the high rates of child malnutrition in the urban informal settlements.

Effect of poverty on the relationship between personal exposures and ambient concentrations of air pollutants in Ho Chi Minh City

NASA Astrophysics Data System (ADS)

Mehta, Sumi; Sbihi, Hind; Dinh, Tuan Nguyen; Xuan, Dan Vu; Le Thi Thanh, Loan; Thanh, Canh Truong; Le Truong, Giang; Cohen, Aaron; Brauer, Michael

2014-10-01

Socioeconomic factors often affect the distribution of exposure to air pollution. The relationships between health, air pollution, and poverty potentially have important public health and policy implications, especially in areas of Asia where air pollution levels are high and income disparity is large. The objective of the study was to characterize the levels, determinants of exposure, and relationships between children personal exposures and ambient concentrations of multiple air pollutants amongst different socioeconomic segments of the population of Ho Chi Minh City, Vietnam. Using repeated (N = 9) measures personal exposure monitoring and determinants of exposure modeling, we compared daily average PM2.5, PM10, PM2.5 absorbance and NO2 concentrations measured at ambient monitoring sites to measures of personal exposures for (N = 64) caregivers of young children from high and low socioeconomic groups in two districts (urban and peri-urban), across two seasons. Personal exposures for both PM sizes were significantly higher among the poor compared to non-poor participants in each district. Absolute levels of personal exposures were under-represented by ambient monitors with median individual longitudinal correlations between personal exposures and ambient concentrations of 0.4 for NO2, 0.6 for PM2.5 and PM10 and 0.7 for absorbance. Exposures of the non-poor were more highly correlated with ambient concentrations for both PM size fractions and absorbance while those for NO2 were not significantly affected by socioeconomic position. Determinants of exposure modeling indicated the importance of ventilation quality, time spent in the kitchen, air conditioner use and season as important determinant of exposure that are not fully captured by the differences in socioeconomic position. Our results underscore the need to evaluate how socioeconomic position affects exposure to air pollution. Here, differential exposure to major sources of pollution, further influenced by characteristics of Ho Chi Minh City's rapidly urbanizing landscape, resulted in systematically higher PM exposures among the poor.

Frequency of Dental Caries in Four Historical Populations from the Chalcolithic to the Middle Ages

PubMed Central

Grimoud, A.-M.; Lucas, S.; Sevin, A.; Georges, P.; Passarrius, O.; Duranthon, F.

2011-01-01

The majority of dental carie studies over the course of historical period underline mainly the prevalence evolution, the role of carbohydrates consumption and the impact of access to dietary resources. The purpose of the present investigation was to compare population samples from two archaeological periods the Chacolithic and Middle Age taking into account the geographical and socio economical situation. The study concerned four archaelogical sites in south west France and population samples an inlander for the Chalcolithic Age, an inlander, an costal and urban for the Middle Age. The materials studied included a total of 127 maxillaries, 103 mandibles and 3316 teeth. Data recorded allowed us to display that the Chalcolithic population sample had the lowest carie percentage and the rural inlander population samples of Middle Age the highest; in all cases molars were teeth most often affected. These ones differences could be explained according to time period, carious lesions were usually less recorded in the Chalcolithic Age than the Middle because of a lesser cultivation of cereals like in les Treilles Chacolithic population sample. In the Middle Age population samples, the rural inland sample Marsan showed the highest frequency of caries and ate more cereal than the coastal Vilarnau and the poor urban St Michel population samples, the first one ate fish and Mediterranean vegetal and fruits and the second one met difficulties to food access, in both cases the consumption of carbohydrates was lesser than Marsan population sample who lived in a geographical land convice to cereals cultivation. PMID:22145000

The urban health transition hypothesis: empirical evidence of an avian influenza Kuznets curve in Vietnam?

PubMed

Spencer, James Herbert

2013-04-01

The literature on development has focused on the concept of transition in understanding the emergent challenges facing poor but rapidly developing countries. Scholars have focused extensively on the health and urban transitions associated with this change and, in particular, its use for understanding emerging infectious diseases. However, few have developed explicit empirical measures to quantify the extent to which a transitions focus is useful for theory, policy, and practice. Using open source data on avian influenza in 2004 and 2005 and the Vietnam Census of Population and Housing, this paper introduces the Kuznets curve as a tool for empirically estimating transition and disease. Findings suggest that the Kuznets curve is a viable tool for empirically assessing the role of transitional dynamics in the emergence of new infectious diseases.

Urbanization and biological invasion shape animal personalities.

PubMed

Lapiedra, Oriol; Chejanovski, Zachary; Kolbe, Jason J

2017-02-01

Novel selective pressures derived from human activities challenge the persistence of animal populations worldwide. Behavior is expected to be a major factor driving animals' responses to global change because it largely determines how animals interact with the environment. However, the role of individual variation in behavior to facilitate the persistence of animals in changing environments remains poorly understood. Here, we adopted an animal personality approach to investigate whether different behavioral traits allow animals to deal with two major components of global change: urbanization and biological invasions. By studying six populations of Anolis sagrei lizards, we found for the first time that anoles vary consistently in their behavior across different times and contexts. Importantly, these animal personalities were consistent in the wild and in captivity. We investigated whether behavioral traits are pulled in different directions by different components of global change. On the one hand, we found that lizards from urban areas differ from nearby forest lizards in that they were more tolerant of humans, less aggressive, bolder after a simulated predator attack, and they spent more time exploring new environments. Several of these risk-taking behaviors constituted a behavioral syndrome that significantly differed between urban and forest populations. On the other hand, the behavior of urban A. sagrei coexisting with the invasive predatory lizard Leiocephalus carinatus was associated with dramatic changes in their foraging niche. Overall, we provide evidence that differences in animal personalities facilitate the persistence of animals under novel selective regimes by producing adaptive behaviors relevant to their ecology such as predator avoidance. Our results suggest that natural selection can favor certain behaviors over others when animals are confronted with different ecological challenges posed by global change. Therefore, we underscore the need to incorporate behavioral ecology into the study of how animals adaptively respond to human-induced environmental changes. © 2016 John Wiley & Sons Ltd.

Population at high-risk of indoor heatstroke: the usage of cooling appliances among urban elderlies in Japan.

PubMed

Kondo, Masahide; Ono, Masaji; Nakazawa, Kouichi; Kayaba, Momoko; Minakuchi, Emiko; Sugimoto, Kazutoshi; Honda, Yasushi

2013-05-01

Heatstroke due to a heat wave during the summer is one of the commonly known health impacts of climate change in Japan. The elderly are particularly at high-risk of developing indoor heatstroke with poor prognosis. This study aims to describe the population among elderlies at high-risk of indoor heatstroke by focusing on the usage of cooling appliances. We conducted a web-based household survey in eight urban areas during the winter season of 2011. Households with a person aged 65 and over were selected as samples from panel members of a research firm, and the oldest member of the household was queried about his/her usage of cooling appliances. The population at high-risk of indoor heatstroke is defined as the elderly staying in a room without cooling appliances, or not using the installed cooling appliances, or turning the cooling appliances on only when the room temperature is above 28 °C. 15.4 and 19.1 % of the elderlies living in urban areas of Japan are identified as at high-risk of indoor heatstroke during activity time and sleeping time, respectively, according to the definition of high-risk of indoor heatstroke in this study. These figures are not negligible since the consequences of heatstroke are grave, but its risk can be eliminated by an appropriate usage of cooling appliances. The preventive interventions are needed to protect the elderlies at high-risk of heatstroke.

Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries.

PubMed

Basu, Sanjay; Stuckler, David; McKee, Martin; Galea, Gauden

2013-01-01

Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. Data were obtained from 173 countries. Population-based survey recipients were the basis for diabetes prevalence and food market data. We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.

Depression among the urban poor in Peninsular Malaysia: a community based cross-sectional study.

PubMed

Tan, Kok Leong; Yadav, Hematram

2013-01-01

This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.

Opportunities for making ends meet and upward mobility: differences in organizational deprivation across urban and suburban poor neighborhoods.

PubMed

Murphy, Alexandra K; Wallace, Danielle

2010-01-01

Objectives. Given the recent rise of poverty in U.S. suburbs, this study asks: What poor neighborhoods are most disadvantageous, those in the city or those in the suburbs? Building on recent urban sociological work demonstrating the importance of neighborhood organizations for the poor, we are concerned with one aspect of disadvantage—the lack of availability of organizational resources oriented toward the poor. By breaking down organizations into those that promote mobility versus those that help individuals meet their daily subsistence needs, we seek to explore potential variations in the type of disadvantage that may exist.Methods. We test whether poor urban or suburban neighborhoods are more likely to be organizationally deprived by breaking down organizations into three types: hardship organizations, educational organizations, and employment organizations. We use data from the 2000 U.S. County Business Patterns and the 2000 U.S. Census and test neighborhood deprivation using logistic regression models.Results. We find that suburban poor neighborhoods are more likely to be organizationally deprived than are urban poor neighborhoods, especially with respect to organizations that promote upward mobility. Interesting racial and ethnic composition factors shape this more general finding.Conclusion. Our findings suggest that if a poor individual is to live in a poor neighborhood, with respect to access to organizational resources, he or she would be better off living in the central city. Suburban residence engenders isolation from organizations that will help meet one's daily needs and even more so from those offering opportunities for mobility.

Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

PubMed Central

Thorsen, Rikke Stamp; Pouliot, Mariève

2016-01-01

Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610

Assessment of Urban Ecosystem Health Based on Matter Element Analysis: A Case Study of 13 Cities in Jiangsu Province, China.

PubMed

Xie, Xuefeng; Pu, Lijie

2017-08-21

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000-2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city's UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel's coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province.

Rural-urban disparity in knowledge and compliance with traffic signs among young commercial motorcyclists in selected local government areas in Oyo State, Nigeria.

PubMed

Olumide, Adesola O; Owoaje, Eme T

2017-06-01

This study compared knowledge and compliance with traffic signs among young commercial motorcyclists in rural and urban communities in Oyo state, Nigeria. Information on knowledge and compliance with 10 common traffic signs was obtained from 149 rural and 113 urban commercial motorcyclists aged 18-35 years. Aggregate knowledge scores were computed and categorized as good (≥5) and poor (<5) knowledge. Overall, 98.7% rural versus 61.1% urban motorcyclists had poor knowledge of traffic signs (p < 0.05). After controlling for age, level of education and years of commercial riding, motorcyclists in the rural areas were more likely to have poor knowledge of the traffic signs (OR = 58.15; 95% CI = 11.96-282.79). A higher proportion of rural than urban motorcyclists never obeyed any of the traffic signs. Young rural commercial motorcyclists' knowledge and compliance with the road signs was poorer than their urban counterparts. Interventions to improve the rural motorcyclists' knowledge and ultimately compliance with road signs are urgently required.

[Urbanization mechanisms in bird species: population systems transformations or adaptations at the individual level?].

PubMed

Fridman, V S; Eremkin, G S; Zakharova-Kubareva, N Iu

2008-01-01

The present research deals with urbanization of wild bird and mammal species. Forms and mechanisms of population steadiness in the urban landscape have been examined. The urbanization process turned out to be a directed change of the population system forming de novo in the urbolandscape leading to a sustainable organization peculiar for the particular environment. The population organization of different types in urbolandscape is found to provide its stability under conditions of directed and fast changes accompanied with instability and heterogenous structure of habitats. It is shown that the same type of population organization meets the corresponding demands among different species settling in the urban environment. Its features are "openness" and "flowage" of the groups, far order of settlement levels and other units of population system, constant movements of the individuals between the groups as a respond to the signals of urboenvironment significant changes. The "urban" variant of the population system organization turns out to be opposite to that of the same species in the non-urban habitats. After formation of the urban types by the species and successful developing of the town, the urban population becomes separated from the maternal local population and begins to exist independently in the urban landscape. The variety of adaptation aberrations in ecology, behavior, and mode of life of urban birds is the population system stability function in the urban landscape and is not a results of individual selection. It is shown that the urbanization process of the species goes firstly on the population level being the system structure transformation developed by the species towards the most stable state in the town (city) territory. Only after the appearance of stable urban population, the urban individuals show the rapid growth of different changes in ecology, behavior, mode of life that was traditionally described by naturalists as species adaptation to the city conditions. The key features of urban population stability/instability are described. Their application to closely related species allows us to distinguish potential urbanists from instable and vulnerable species that could be soon pushed out of the city. The application of corresponding criteria to the urban populations of such species constituting one guild allows us to predict if their developing in the given town would be successful or unsuccessful. The latter is very important since close species are, as a rule, ecologically indistinguishable in the urbanized landscapes. So one can not predict successful/unsuccessful urbanization taking into account the differences in the range of habitats, breeding success, and other external features.

Acceptance-based behavior therapy to promote HIV medication adherence.

PubMed

Moitra, Ethan; Herbert, James D; Forman, Evan M

2011-12-01

A significant number of adults with HIV in the USA do not maintain adherence to highly active antiretroviral therapy (HAART) at adequate levels. Although traditional cognitive behavioral interventions have shown promise in promoting HAART adherence, acceptance-based behavior therapy (ABBT) may be particularly useful in this population. ABBT has the potential to overcome common avoidance-based barriers associated with poor adherence, including denial of various illness-related factors and avoidance of stigmatization. We describe the rationale for promoting psychological and behavioral acceptance in HIV-positive populations; outline an ABBT to promote HAART adherence targeting primary care patients from urban, minority, low socioeconomic backgrounds; and report preliminary qualitative observations of treatment feasibility and acceptability.

Urbanization shapes the demographic history of a native rodent (the white-footed mouse, Peromyscus leucopus) in New York City.

PubMed

Harris, Stephen E; Xue, Alexander T; Alvarado-Serrano, Diego; Boehm, Joel T; Joseph, Tyler; Hickerson, Michael J; Munshi-South, Jason

2016-04-01

How urbanization shapes population genomic diversity and evolution of urban wildlife is largely unexplored. We investigated the impact of urbanization on white-footed mice,Peromyscus leucopus,in the New York City (NYC) metropolitan area using coalescent-based simulations to infer demographic history from the site-frequency spectrum. We assigned individuals to evolutionary clusters and then inferred recent divergence times, population size changes and migration using genome-wide single nucleotide polymorphisms genotyped in 23 populations sampled along an urban-to-rural gradient. Both prehistoric climatic events and recent urbanization impacted these populations. Our modelling indicates that post-glacial sea-level rise led to isolation of mainland and Long Island populations. These models also indicate that several urban parks represent recently isolated P. leucopus populations, and the estimated divergence times for these populations are consistent with the history of urbanization in NYC. © 2016 The Author(s).

Health care utilisation under the 30-Baht Scheme among the urban poor in Mitrapap slum, Khon Kaen, Thailand: a cross-sectional study

PubMed Central

Coronini-Cronberg, Sophie; Laohasiriwong, Wongsa; Gericke, Christian A

2007-01-01

Background In 2001, the Government of Thailand introduced a universal coverage scheme with the aim of ensuring equitable health care access for even the poorest citizens. For a flat user fee of 30 Baht per consultation, or for free for those falling into exemption categories, every scheme participant may access registered health services. The exemption categories include children under 12 years of age, senior citizens aged 60 years and over, the very poor, and volunteer health workers. The functioning of these exemption mechanisms and the effect of the scheme on health service utilisation among the poor is controversial. Methods This cross-sectional study investigated the prevalence of 30-Baht Scheme registration and subsequent self-reported health service utilisation among an urban poor population in the Teparuk community within the Mitrapap slum in Khon Kaen city, northeastern Thailand. Furthermore, the effectiveness of the exemption mechanisms in reaching the very poor and the elderly was examined. Factors for users' choice of health facilities were identified. Results Overall, the proportion of the Teparuk community enrolled with the 30-Baht Scheme was high at 86%, with over one quarter of these exempted from paying the consultation fee. User fee exemption was significantly more frequent among households with an above-poverty-line income (64.7%) compared to those below the poverty line (35.3%), χ2 (df) = 5.251 (1); p-value = 0.018. In addition, one third of respondents over 60 years of age were found to be still paying user fees. Self-reported use of registered medical facilities in case of illness was stated to be predominantly due to the service being available through the scheme, with service quality not a chief consideration. Overall consumer satisfaction was high, especially among those not required to pay the 30 Baht user fee. Conclusion Whilst the 30-Baht Scheme seems to cover most of the poor population of Mitrapap slum in Khon Kaen, the user fee exemption mechanism only works partially with regard to reaching the poorest and exempting senior citizens. Service utilisation and satisfaction are highest amongst those who are fee-exempt. Service quality was not an important factor influencing choice of health facility. Ways should be sought to improve the effectiveness of the current exemption mechanisms. PMID:17883874

Health in China and India: a cross-country comparison in a context of rapid globalisation.

PubMed

Dummer, Trevor J B; Cook, Ian G

2008-08-01

China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed.

Estimating changes in urban land and urban population using refined areal interpolation techniques

NASA Astrophysics Data System (ADS)

Zoraghein, Hamidreza; Leyk, Stefan

2018-05-01

The analysis of changes in urban land and population is important because the majority of future population growth will take place in urban areas. U.S. Census historically classifies urban land using population density and various land-use criteria. This study analyzes the reliability of census-defined urban lands for delineating the spatial distribution of urban population and estimating its changes over time. To overcome the problem of incompatible enumeration units between censuses, regular areal interpolation methods including Areal Weighting (AW) and Target Density Weighting (TDW), with and without spatial refinement, are implemented. The goal in this study is to estimate urban population in Massachusetts in 1990 and 2000 (source zones), within tract boundaries of the 2010 census (target zones), respectively, to create a consistent time series of comparable urban population estimates from 1990 to 2010. Spatial refinement is done using ancillary variables such as census-defined urban areas, the National Land Cover Database (NLCD) and the Global Human Settlement Layer (GHSL) as well as different combinations of them. The study results suggest that census-defined urban areas alone are not necessarily the most meaningful delineation of urban land. Instead, it appears that alternative combinations of the above-mentioned ancillary variables can better depict the spatial distribution of urban land, and thus make it possible to reduce the estimation error in transferring the urban population from source zones to target zones when running spatially-refined temporal areal interpolation.

Changing Urbania: Estimating Changes in Urban Land and Urban Population Using Refined Areal Interpolation Techniques

NASA Astrophysics Data System (ADS)

Zoraghein, H.; Leyk, S.; Balk, D.

2017-12-01

The analysis of changes in urban land and population is important because the majority of future population growth will take place in urban areas. The U.S. Census historically classifies urban land using population density and various land-use criteria. This study analyzes the reliability of census-defined urban lands for delineating the spatial distribution of urban population and estimating its changes over time. To overcome the problem of incompatible enumeration units between censuses, regular areal interpolation methods including Areal Weighting (AW) and Target Density Weighting (TDW), with and without spatial refinement, are implemented. The goal in this study is to estimate urban population in Massachusetts in 1990 and 2000 (source zones), within tract boundaries of the 2010 census (target zones), respectively, to create a consistent time series of comparable urban population estimates from 1990 to 2010. Spatial refinement is done using ancillary variables such as census-defined urban areas, the National Land Cover Database (NLCD) and the Global Human Settlement Layer (GHSL) as well as different combinations of them. The study results suggest that census-defined urban areas alone are not necessarily the most meaningful delineation of urban land. Instead it appears that alternative combinations of the above-mentioned ancillary variables can better depict the spatial distribution of urban land, and thus make it possible to reduce the estimation error in transferring the urban population from source zones to target zones when running spatially-refined temporal areal interpolation.

Fuzzy B-spline optimization for urban slum three-dimensional reconstruction using ENVISAT satellite data

NASA Astrophysics Data System (ADS)

Marghany, Maged

2014-06-01

A critical challenges in urban aeras is slums. In fact, they are considered a source of crime and disease due to poor-quality housing, unsanitary conditions, poor infrastructures and occupancy security. The poor in the dense urban slums are the most vulnerable to infection due to (i) inadequate and restricted access to safety, drinking water and sufficient quantities of water for personal hygiene; (ii) the lack of removal and treatment of excreta; and (iii) the lack of removal of solid waste. This study aims to investigate the capability of ENVISAT ASAR satellite and Google Earth data for three-dimensional (3-D) slum urban reconstruction in developed countries such as Egypt. The main objective of this work is to utilize some 3-D automatic detection algorithm for urban slum in ENVISAT ASAR and Google Erath images were acquired in Cairo, Egypt using Fuzzy B-spline algorithm. The results show that the fuzzy algorithm is the best indicator for chaotic urban slum as it can discriminate between them from its surrounding environment. The combination of Fuzzy and B-spline then used to reconstruct 3-D of urban slum. The results show that urban slums, road network, and infrastructures are perfectly discriminated. It can therefore be concluded that the fuzzy algorithm is an appropriate algorithm for chaotic urban slum automatic detection in ENVSIAT ASAR and Google Earth data.

A Study of Preservice Educators' Dispositions to Change Behavior Management Strategies

ERIC Educational Resources Information Center

Shook, Alison C.

2012-01-01

Student behavior problems contribute to poor academic achievement and poor teacher retention. This study investigated preservice teachers' dispositions to implement positive and proactive strategies for managing behavior in the general education elementary urban classroom. The author interviewed 19 preservice teachers in a large urban school…

The Consortium for Climate Risk in the Urban Northeast: A NOAA RISA Project

NASA Astrophysics Data System (ADS)

Rosenzweig, C.

2011-12-01

The Consortium for Climate Risk in the Urban Northeast, or CCRUN, was funded in October 2010 under NOAA's Regional Integrated Sciences and Assessments (RISA) program to serve stakeholder needs in assessing and managing risks from climate variability and change. It is currently also the only RISA team with a principal focus on climate change adaptation in urban settings. While CCRUN's initial focus is on the major cities of the urban Northeast corridor (Philadelphia, New York and Boston), its work will ultimately expand to cover small and medium-sized cities in the relevant portions of Massachusetts, Rhode Island, Connecticut, New York, New Jersey and Pennsylvania as well, so that local needs for targeted climate-risk information can be served in a coordinated way. CCRUN is designed to address the complex challenges that are associated with densely populated, highly interconnected urban areas, including such as urban heat island effects; poor air quality; intense coastal development, and multifunctional settlement along inland waterways; complex overlapping institutional jurisdictions; integrated infrastructure systems; and highly diverse, and in some cases, fragile socio-economic communities. These challenges can best be addressed by the stakeholder-driven interdisciplinary approach taken by the CCRUN RISA team. As an important added benefit, the research accomplishments and lessons learned through stakeholder engagement will provide a foundation for managing climate risks in other urban areas in the United States. CCRUN's initial projects are focused in three broad sectors: Water, Coasts, and Health. Research in each of these sectors is linked through the cross-cutting themes of climate change and community vulnerability, the latter of which is especially important in considerations of environmental justice and equity. CCRUN's stakeholder-driven approach to research can therefore support investigations of the impacts of a changing climate, population growth, and urban and economic policies on the social, racial and ethnic dimensions of livelihoods and of communities in the urban Northeast corridor. Disadvantaged socio-economic groups have been particularly underserved in the area of climate change, and one of CCRUN's long-term goals is the building of adaptive capacity among such groups to current and future climate extremes.

Factors that determine the use of skilled care during delivery in India: implications for achievement of MDG-5 targets.

PubMed

Hazarika, Indrajit

2011-11-01

The objective of this study is to identify individual level factors that determine the use of skilled birth attendants in India. Data from the cross-sectional, population-based NFHS 3 Survey 2005-06 was used. A sample of 31,797 women, aged 15-49 years, who gave births in the 3 months preceding the survey and for whom information was available on most variables, were included in the analysis. Both bivariate and multivariate techniques were used to determine factors associated with the use of skilled attendants at birth. In the study we found that wealth is one of the strongest determinants of skilled birth attendant use, with the poor being at a disadvantage. There are significant differences in the use of skilled delivery care among the urban and rural populations in India. Women in urban areas are more likely to use skilled attendants. Muslim women and women with lower levels of education are also less likely to avail skilled delivery services. The use of skilled care depended significantly on the place of delivery. Women who gave history of antenatal visits were more likely to have skilled attendants at birth. Our analysis demonstrates that there are several financial, social, regional and cultural barriers to skilled birth attendant use in India. Effective strategies need to be planned to generate demand for skilled birth attendants and reduce barriers to care seeking, especially among rural poor.

Song convergence in multiple urban populations of silvereyes (Zosterops lateralis)

PubMed Central

Potvin, Dominique A; Parris, Kirsten M

2012-01-01

Recent studies have revealed differences between urban and rural vocalizations of numerous bird species. These differences include frequency shifts, amplitude shifts, altered song speed, and selective meme use. If particular memes sung by urban populations are adapted to the urban soundscape, “urban-typical” calls, memes, or repertoires should be consistently used in multiple urban populations of the same species, regardless of geographic location. We tested whether songs or contact calls of silvereyes (Zosterops lateralis) might be subject to such convergent cultural evolution by comparing syllable repertoires of geographically dispersed urban and rural population pairs throughout southeastern Australia. Despite frequency and tempo differences between urban and rural calls, call repertoires were similar between habitat types. However, certain song syllables were used more frequently by birds from urban than rural populations. Partial redundancy analysis revealed that both geographic location and habitat characteristics were important predictors of syllable repertoire composition. These findings suggest convergent cultural evolution: urban populations modify both song and call syllables from their local repertoire in response to noise. PMID:22957198

Song convergence in multiple urban populations of silvereyes (Zosterops lateralis).

PubMed

Potvin, Dominique A; Parris, Kirsten M

2012-08-01

Recent studies have revealed differences between urban and rural vocalizations of numerous bird species. These differences include frequency shifts, amplitude shifts, altered song speed, and selective meme use. If particular memes sung by urban populations are adapted to the urban soundscape, "urban-typical" calls, memes, or repertoires should be consistently used in multiple urban populations of the same species, regardless of geographic location. We tested whether songs or contact calls of silvereyes (Zosterops lateralis) might be subject to such convergent cultural evolution by comparing syllable repertoires of geographically dispersed urban and rural population pairs throughout southeastern Australia. Despite frequency and tempo differences between urban and rural calls, call repertoires were similar between habitat types. However, certain song syllables were used more frequently by birds from urban than rural populations. Partial redundancy analysis revealed that both geographic location and habitat characteristics were important predictors of syllable repertoire composition. These findings suggest convergent cultural evolution: urban populations modify both song and call syllables from their local repertoire in response to noise.

Urban Growth Modeling Using Anfis Algorithm: a Case Study for Sanandaj City, Iran

NASA Astrophysics Data System (ADS)

Mohammady, S.; Delavar, M. R.; Pijanowski, B. C.

2013-10-01

Global urban population has increased from 22.9% in 1985 to 47% in 2010. In spite of the tendency for urbanization worldwide, only about 2% of Earth's land surface is covered by cities. Urban population in Iran is increasing due to social and economic development. The proportion of the population living in Iran urban areas has consistently increased from about 31% in 1956 to 68.4% in 2006. Migration of the rural population to cities and population growth in cities have caused many problems, such as irregular growth of cities, improper placement of infrastructure and urban services. Air and environmental pollution, resource degradation and insufficient infrastructure, are the results of poor urban planning that have negative impact on the environment or livelihoods of people living in cities. These issues are a consequence of improper land use planning. Models have been employed to assist in our understanding of relations between land use and its subsequent effects. Different models for urban growth modeling have been developed. Methods from computational intelligence have made great contributions in all specific application domains and hybrid algorithms research as a part of them has become a big trend in computational intelligence. Artificial Neural Network (ANN) has the capability to deal with imprecise data by training, while fuzzy logic can deal with the uncertainty of human cognition. ANN learns from scratch by adjusting the interconnections between layers and Fuzzy Inference Systems (FIS) is a popular computing framework based on the concept of fuzzy set theory, fuzzy logic, and fuzzy reasoning. Fuzzy logic has many advantages such as flexibility and at the other sides, one of the biggest problems in fuzzy logic application is the location and shape and of membership function for each fuzzy variable which is generally being solved by trial and error method. In contrast, numerical computation and learning are the advantages of neural network, however, it is not easy to obtain the optimal structure. Since, in this type of fuzzy logic, neural network has been used, therefore, by using a learning algorithm the parameters have been changed until reach the optimal solution. Adaptive Neuro Fuzzy Inference System (ANFIS) computing due to ability to understand nonlinear structures is a popular framework for solving complex problems. Fusion of ANN and FIS has attracted the growing interest of researchers in various scientific and engineering areas due to the growing need of adaptive intelligent systems to solve the real world problems. In this research, an ANFIS method has been developed for modeling land use change and interpreting the relationship between the drivers of urbanization. Our study area is the city of Sanandaj located in the west of Iran. Landsat images acquired in 2000 and 2006 have been used for model development and calibration. The parameters used in this study include distance to major roads, distance to residential regions, elevation, number of urban pixels in a 3 by 3 neighborhood and distance to green space. Percent Correct Match (PCM) and Figure of Merit were used to assess model goodness of fit were 93.77% and 64.30%, respectively.

Newborn healthcare in urban India

PubMed Central

Sharma, J; Osrin, D; Patil, B; Neogi, S B; Chauhan, M; Khanna, R; Kumar, R; Paul, V K; Zodpey, S

2016-01-01

The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood. PMID:27924107

Newborn healthcare in urban India.

PubMed

Sharma, J; Osrin, D; Patil, B; Neogi, S B; Chauhan, M; Khanna, R; Kumar, R; Paul, V K; Zodpey, S

2016-12-01

The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood.

The effects of urbanization on population density, occupancy, and detection probability of wild felids.

PubMed

Lewis, Jesse S; Logan, Kenneth A; Alldredge, Mat W; Bailey, Larissa L; VandeWoude, Sue; Crooks, Kevin R

2015-10-01

Urbanization is a primary driver of landscape conversion, with far-reaching effects on landscape pattern and process, particularly related to the population characteristics of animals. Urbanization can alter animal movement and habitat quality, both of which can influence population abundance and persistence. We evaluated three important population characteristics (population density, site occupancy, and species detection probability) of a medium-sized and a large carnivore across varying levels of urbanization. Specifically, we studied bobcat and puma populations across wildland, exurban development, and wildland-urban interface (WUI) sampling grids to test hypotheses evaluating how urbanization affects wild felid populations and their prey. Exurban development appeared to have a greater impact on felid populations than did habitat adjacent to a major urban area (i.e., WUI); estimates of population density for both bobcats and pumas were lower in areas of exurban development compared to wildland areas, whereas population density was similar between WUI and wildland habitat. Bobcats and pumas were less likely to be detected in habitat as the amount of human disturbance associated with residential development increased at a site, which was potentially related to reduced habitat quality resulting from urbanization. However, occupancy of both felids was similar between grids in both study areas, indicating that this population metric was less sensitive than density. At the scale of the sampling grid, detection probability for bobcats in urbanized habitat was greater than in wildland areas, potentially due to restrictive movement corridors and funneling of animal movements in landscapes influenced by urbanization. Occupancy of important felid prey (cottontail rabbits and mule deer) was similar across levels of urbanization, although elk occupancy was lower in urbanized areas. Our study indicates that the conservation of medium- and large-sized felids associated with urbanization likely will be most successful if large areas of wildland habitat are maintained, even in close proximity to urban areas, and wildland habitat is not converted to low-density residential development.

Prevalence and Risk Factors of Poor Sleep Quality among Chinese Elderly in an Urban Community: Results from the Shanghai Aging Study

PubMed Central

Zhao, Qianhua; Guo, Qihao; Meng, Haijiao; Hong, Zhen; Ding, Ding

2013-01-01

Background Sleep disorders causes a significant negative effect on mental and physical health, particularly among the elderly. The disease burden and risk factors of poor sleep quality of the elderly need to be verified using a validated form of measurement in urban mainland China. Methods This study included 1086 community residents aged ≥60 years who completed the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleeper was defined by a CPSQI global score of >5. Subjects also accepted the neurological and neuropsychological assessments, including the Mini-Mental State Examination, Center for Epidemiological Studies Depression Scale, and Zung Self-Rating Anxiety Scale (ZSAS). A history of chronic diseases was confirmed by the medical records of each participant. Results The prevalence of poor sleep quality in this population was 41.5% (95% confidence interval (CI) = 38.6–44.5%), with a higher rate observed in elderly females (45.8% [95% CI = 41.9–49.7%]) than that in elderly males (35.8% [95% CI = 31.4–40.1%]). The prevalence rate increased with age, from 32.1% (95% CI = 27.8–36.4%) in those aged 60–69 years to 52.5% (95% CI = 45.9–59.1%) in those aged ≥80 years (p value for trend<0.001). Multivariate logistic regression analysis indicated that age (OR = 1.03[95% CI = 1.01–1.05], p<0.001), less education duration (OR = 1.04 [95% CI = 1.01–1.08, p = 0.014), living alone (OR = 1.62 [95% CI = 1.02–2.58], p = 0.04), anxiety (ZSAS score: OR = 1.09 [95% CI = 1.05–1.12], p<0.001), number of chronic disease (OR = 1.18 [95% CI = 1.07–1.30], p = 0.14) and arthritis (OR = 1.45[95% CI = 1.05–2.01], p = 0.025) were risk factors of poor sleep quality. Conclusions Poor sleep quality is highly prevalent among elderly Chinese residents in urban Shanghai. Growing attention and comprehensive countermeasures involving psycho-social and personal activities might alleviate the sleep problem in the elderly. PMID:24282576

An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

2017-03-21

Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while visiting urban hospitals, primarily for transportation and food. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.

Consolidating Data of Global Urban Populations: a Comparative Approach

NASA Astrophysics Data System (ADS)

Blankespoor, B.; Khan, A.; Selod, H.

2017-12-01

Global data on city populations are essential for the study of urbanization, city growth and the spatial distribution of human settlements. Such data are either gathered by combining official estimates of urban populations from across countries or extracted from gridded population models that combine these estimates with geospatial data. These data sources provide varying estimates of urban populations and each approach has its advantages and limitations. In particular, official figures suffer from a lack of consistency in defining urban units (across both space and time) and often provide data for jurisdictions rather than the functionally meaningful urban area. On the other hand, gridded population models require a user-imposed definition to identify urban areas and are constrained by the modelling techniques and input data employed. To address these drawbacks, we combine these approaches by consolidating information from three established sources: (i) the Citypopulation.de (Brinkhoff, 2016); (ii) the World Urban Prospects data (United Nations, 2014); and (iii) the Global Human Settlements population grid (GHS-POP) (EC - JRC, 2015). We create urban footprints with GHS-POP and spatially merge georeferenced city points from both UN WUP and Citypopulation.de with these urban footprints to identify city points that belong to a single agglomeration. We create a consolidated dataset by combining population data from the UN WUP and Citypopulation.de. The flexible framework outlined can incorporate information from alternative inputs to identify urban clusters e.g. by using night-time lights, built-up area or alternative gridded population models (e.g WorldPop or Landscan) and the parameters employed (e.g. density thresholds for urban footprints) may also be adjusted, e.g., as a function of city-specific characteristics. Our consolidated dataset provides a wider and more accurate coverage of city populations to support studies of urbanization. We apply the data to re-examine Zipf's Law. Brinkhoff, Thomas. 2016. City Population.EC - JRC; Columbia University, CIESIN. 2015. GHS population grid, derived from GPW4, multi-temporal (1975, 1990, 2000, 2015).United Nations, Department of Economic and Social Affairs, Population Division. 2014. World Urbanization Prospects: 2014 Revision.

Population density controls on microbial pollution across the Ganga catchment.

PubMed

Milledge, D G; Gurjar, S K; Bunce, J T; Tare, V; Sinha, R; Carbonneau, P E

2018-01-01

For millions of people worldwide, sewage-polluted surface waters threaten water security, food security and human health. Yet the extent of the problem and its causes are poorly understood. Given rapid widespread global urbanisation, the impact of urban versus rural populations is particularly important but unknown. Exploiting previously unpublished archival data for the Ganga (Ganges) catchment, we find a strong non-linear relationship between upstream population density and microbial pollution, and predict that these river systems would fail faecal coliform standards for irrigation waters available to 79% of the catchment's 500 million inhabitants. Overall, this work shows that microbial pollution is conditioned by the continental-scale network structure of rivers, compounded by the location of cities whose growing populations contribute c. 100 times more microbial pollutants per capita than their rural counterparts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impacts of Modernizing Urban Stormwater Systems on Nutrient and Carbon Dynamics

NASA Astrophysics Data System (ADS)

Filippelli, G. M.; Jacinthe, P. A.; Druschel, G.

2015-12-01

Over 200 cities throughout the U.S. are undergoing the painful and expensive transition from Combined Sewer Outflows (CSOs) to modern stormwater systems. The infrastructure of CSOs is frequently a century old, with a design adapted to stormwater conditions of smaller, more pervious cities. Normal rainfall events of less 1 cm per hour can now exceed the CSO capacities in many urban sub-watersheds, leading to streamwater conditions that exceed human health standards for pathogens. Although much focus has been placed on the plumbing aspects of urban stormwater modernization, less has been focused on local, and indeed regional, implications of nutrient and carbon dynamic changes. Indianapolis, Indiana, with a metropolitan population of over 1 million, is a case study of CSO modernization. Most CSO systems in the city were built almost 100 years ago, and the city has experienced classic patterns of growth of impervious surface area, population growth, and enhanced use of chemical fertilizers. The result of these changes has been frequent failure of the CSO system, and release of sewage water into suburban and urban streams, rivers and reservoirs. Driven largely by modern environmental regulations, the city is now "footing the bill" for a century of poor planning and growth, with the real costs seen by ratepayers in the form of steeply growing wastewater fees. The mitigation approach to this problem is largely one of subsurface engineering on a mega scale, with less attention (i.e., money) placed on complementary land-use and nutrient management efforts on the surface. Several examples illustrate the relatively straightforward nature of changing plumbing, in contrast to the complex result of these changes on nutrient pathways, and the implications that this has on oxygenation, nutrient cycling, and carbon release/sequestration dynamics in riparian and urban reservoir systems.

Socioeconomic and geographical disparities in under-five and neonatal mortality in Uttar Pradesh, India.

PubMed

Dettrick, Zoe; Jimenez-Soto, Eliana; Hodge, Andrew

2014-05-01

As a part of the Millennium Development Goals, India seeks to substantially reduce its burden of childhood mortality. The success or failure of this goal may depend on outcomes within India's most populous state, Uttar Pradesh. This study examines the level of disparities in under-five and neonatal mortality across a range of equity markers within the state. Estimates of under-five and neonatal mortality rates were computed using five datasets, from three available sources: sample registration system, summary birth histories in surveys, and complete birth histories. Disparities were evaluated via comparisons of mortality rates by rural-urban location, ethnicity, wealth, and districts. While Uttar Pradesh has experienced declines in both rates of under-five (162-108 per 1,000 live births) and neonatal (76-49 per 1,000 live births) mortality, the rate of decline has been slow (averaging 2 % per annum). Mortality trends in rural and urban areas are showing signs of convergence, largely due to the much slower rate of change in urban areas. While the gap between rich and poor households has decreased in both urban and rural areas, trends suggest that differences in mortality will remain. Caste-related disparities remain high and show no signs of diminishing. Of concern are also the signs of stagnation in mortality amongst groups with greater ability to access services, such as the urban middle class. Notwithstanding the slow but steady reduction of absolute levels of childhood mortality within Uttar Pradesh, the distribution of the mortality by sub-state populations remains unequal. Future progress may require significant investment in quality of care provided to all sections of the community.

The SocioDemographic Characteristics of the Communities Served by Retail Clinics

PubMed Central

Rudavsky, Rena; Mehrotra, Ateev

2010-01-01

PURPOSE As a rapidly growing new health care delivery model in the United States, retail clinics have been the subject of much debate and controversy. Located physically within a retail store, retail clinics provide simple acute and preventive services for a fixed price and without an appointment. Some hope that retail clinics can be a new safety-net provider for the poor and those without a primary care physician. To better understand the potential for retail clinics to achieve this goal, we describe the socio-demographic characteristics of the communities in which they operate. METHODS We created an inventory of all retail clinics in the United States and determined the proportion that are in Health Profession Shortage Area (HPSA). We defined each retail clinic’s catchment area as all census blocks that were less than a five-minute driving distance from the clinic. We compared the socio-demographic characteristics of the population within and outside of these retail clinic catchment areas. RESULTS Of the 982 clinics in 32 states, 88.4% were in an urban area and 12.5% were in a HPSA (20.9% of the US population lives within a HPSA). Compared to the rest of the urban population, the population living within a retail clinic catchment area has a higher median household income ($52,849 vs. $46,080), is better educated (32.6% vs. 24.9% with a college degree), and is as likely to be uninsured (17.7% vs. 17.0%). In a multivariate model, the census block’s median household income had the strongest association with whether the census block was in a retail clinic catchment area (OR 3.63 (95% CI 3.26–4.05) median income ≥$54,779 vs. median income –003C;$30,781) CONCLUSIONS We find that relatively few retail clinics are located in HPSAs and compared to the rest of the urban population, the population living in close proximity to a retail clinic has a higher income. PMID:20051541

Spatial variation of air quality index and urban driving factors linkages: evidence from Chinese cities.

PubMed

Pu, Haixia; Luo, Kunli; Wang, Pin; Wang, Shaobin; Kang, Shun

2017-02-01

Daily air quality index (AQI) of 161 Chinese cities obtained from the Ministry of Environmental Protection of China in 2015 is conducted. In this study, to better explore spatial distribution and regional characteristic of AQI, global and local spatial autocorrelation is utilized. Pearson's correlation is introduced to determine the influence of single urban indicator on AQI value. Meanwhile, multiple linear stepwise regression is chosen to estimate quantitatively the most influential urban indicators on AQI. The spatial autocorrelation analysis indicates that the AQI value of Chinese 161 cities shows a spatial dependency. Higher AQI is mainly located in north and northwest regions, whereas low AQI is concentrated in the south and the Qinghai-Tibet regions. The low AQI and high AQI values in China both exhibit relative immobility through seasonal variation. The influence degree of three adverse urban driving factors on AQI value is ranked from high to low: coal consumption of manufacturing > building area > coal consumption of the power industry. It is worth noting that the risk of exposed population to poor quality is greater in the northern region than in other regions. The results of the study provide a reference for the formulation of urban policy and improvement of air quality in China.

Spatial distribution of diesel transit bus emissions and urban populations: implications of coincidence and scale on exposure.

PubMed

Gouge, Brian; Ries, Francis J; Dowlatabadi, Hadi

2010-09-15

Macroscale emissions modeling approaches have been widely applied in impact assessments of mobile source emissions. However, these approaches poorly characterize the spatial distribution of emissions and have been shown to underestimate emissions of some pollutants. To quantify the implications of these limitations on exposure assessments, CO, NO(X), and HC emissions from diesel transit buses were estimated at 50 m intervals along a bus rapid transit route using a microscale emissions modeling approach. The impacted population around the route was estimated using census, pedestrian count and transit ridership data. Emissions exhibited significant spatial variability. In intervals near major intersections and bus stops, emissions were 1.6-3.0 times higher than average. The coincidence of these emission hot spots and peaks in pedestrian populations resulted in a 20-40% increase in exposure compared to estimates that assumed homogeneous spatial distributions of emissions and/or populations along the route. An additional 19-30% increase in exposure resulted from the underestimate of CO and NO(X) emissions by macroscale modeling approaches. The results of this study indicate that macroscale modeling approaches underestimate exposure due to poor characterization of the influence of vehicle activity on the spatial distribution of emissions and total emissions.

Stable isotopes reveal links between human food inputs and urban ant diets.

PubMed

Penick, Clint A; Savage, Amy M; Dunn, Robert R

2015-05-07

The amount of energy consumed within an average city block is an order of magnitude higher than that consumed in any other ecosystem over a similar area. This is driven by human food inputs, but the consequence of these resources for urban animal populations is poorly understood. We investigated the role of human foods in ant diets across an urbanization gradient in Manhattan using carbon and nitrogen stable isotopes. We found that some-but not all-ant species living in Manhattan's most urbanized habitats had δ(13)C signatures associated with processed human foods. In particular, pavement ants (Tetramorium sp. E) had increased levels of δ(13)C similar to δ(13)C levels in human fast foods. The magnitude of this effect was positively correlated with urbanization. By contrast, we detected no differences in δ(15)N, suggesting Tetramorium feeds at the same trophic level despite shifting to human foods. This pattern persisted across the broader ant community; species in traffic islands used human resources more than park species. Our results demonstrate that the degree urban ants exploit human resources changes across the city and among species, and this variation could play a key role in community structure and ecosystem processes where human and animal food webs intersect. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Factors Influencing the Academic Achievement of the Turkish Urban Poor

ERIC Educational Resources Information Center

Engin-Demir, Cennet

2009-01-01

This study estimates the individual and combined effects of selected family, student and school characteristics on the academic achievement of poor, urban primary-school students in the Turkish context. Participants of the study consisted of 719 sixth, seventh, and eighth grade primary-school students from 23 schools in inner and outer city…

Behavioral Problems and Reading Difficulties among Language Minority and Monolingual Urban Elementary School Students

ERIC Educational Resources Information Center

Pierce, Margaret E.; Wechsler-Zimring, Adrianna; Noam, Gil; Wolf, Maryanne; Katzir, Tami

2013-01-01

This study examined the potentially compounding effect of language minority (LM) status on problem behaviors among urban second and third grade-level poor readers. Univariate analyses showed that a disproportionate percentage of both LM and English monolingual (L1) poor readers already displayed clinically significant levels of anxiety, social…

Impact of land use and land cover changes on the ambient temperature in a middle scale city, Takamatsu, in Southwest Japan.

PubMed

Nonomura, Atsuko; Kitahara, Mutsuko; Takuro Masuda

2009-08-01

There is a lack of information on urban heat island impact on the thermal environment due to low populated urban sprawl, although densely populated urban sprawl impact has been identified by several researchers. The Takamatsu area has recently developed in a low populated urban sprawl style without any increase in population. This paper examined the impact of a low populated urban sprawl on the thermal environment through an analysis of the last 30 years data set and investigated the contribution of vegetation fraction and population density to the temperature trend. As a consequence, it was shown that one of the most significant causative factors of temperature increase is an expansion of non-vegetated area even without population growth. This result implied that vegetated zones should be maintained in urban areas in order to realize sustainable urbanization.

Health insurance subscription among women in reproductive age in Ghana: do socio-demographics matter?

PubMed

Amu, Hubert; Dickson, Kwamena Sekyi

2016-12-01

Premised that health insurance schemes in Africa have only been introduced recently and continue evolving, various concerns have been raised regarding their effectiveness in improving utilisation of orthodox health care and the reduction of out-of-pocket expenditures for their population, particularly women. To examine the effects of socio-demographics on health insurance subscription among women in Ghana. The study draws on the 2014 Ghana Demographic and Health Survey. Bivariate descriptive analysis and binary logistic regression were used to analyse the data. Wealth status, age, religion, birth parity, marriage and ecological zone were found to have significantly predicted health insurance subscription among women in reproductive age in Ghana. Urban dwellers, women who are nulliparous, those with no or low levels of education, African traditionalists and the poor were those who largely did not subscribe to the scheme. The findings underscore the need for the National Health Insurance Authority to carry out more education in association with the National Commission for Civic Education and the Information Services Department to recruit more urban dwellers, nulliparous women, those with no or low levels of education, African traditionalists and the poor unto the scheme.

Homicide in post-Soviet Belarus: urban-rural trends.

PubMed

Stickley, Andrew; Leinsalu, Mall; Razvodovsky, Yury E

2009-01-01

To investigate the occurrence of homicide in urban and rural regions of Belarus in the post-Soviet period. All-age male and female homicide mortality and population data were obtained for the years 1990, 1995, 2000 and 2005 for urban and rural regions of Belarus. These data were recalculated into three age categories and directly standardised. To assess relative changes in rural-urban homicide rates across time Poisson regression models were used to calculate rate ratios. Between 1990 and 1995 homicide rates rose sharply in urban and rural regions although the rise was greater in the former. Although there was little change in homicide rates in 2000, a notable divergence had occurred by 2005. While homicide rates rose slightly in rural areas, a large fall occurred in the rates of both men and women in urban areas. This resulted in significantly higher rural homicide rate ratios at the end of the study period. With some variations age-specific homicide rates followed this overall general pattern resulting in significantly higher homicide rate ratios in all rural groups aged 15 and above in 2005. It is probable that a combination of factors such as high levels of poverty, the effects of alcohol consumption, as well as the poor provision of emergency medical services underlie both the high levels of lethal violence and the growing rural-urban divergence in homicide rates in contemporary Belarus. Urgent action is now needed to address the deteriorating social and economic conditions underpinning violence, especially in rural regions.

Knowledge, attitude and practice of modern contraception among single women in a rural and urban community in southeast Nigeria.

PubMed

Ozumba, B C; Obi, S N; Ijioma, N N

2005-04-01

The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.

Air quality and urban form in U.S. urban areas: evidence from regulatory monitors.

PubMed

Clark, Lara P; Millet, Dylan B; Marshall, Julian D

2011-08-15

The layout of an urban area can impact air pollution via changes in emissions and their spatial distribution. Here, we explore relationships between air quality and urban form based on cross-sectional observations for 111 U.S. urban areas. We employ stepwise linear regression to quantify how long-term population-weighted outdoor concentrations of ozone, fine particulate matter (PM(2.5)), and other criteria pollutants measured by the U.S. Environmental Protection Agency depend on urban form, climate, transportation, city size, income, and region. Aspects of urban form evaluated here include city shape, road density, jobs-housing imbalance, population density, and population centrality. We find that population density is associated with higher population-weighted PM(2.5) concentrations (p < 0.01); population centrality is associated with lower population-weighted ozone and PM(2.5) concentrations (p < 0.01); and transit supply is associated with lower population-weighted PM(2.5) concentrations (p < 0.1). Among pollutants, interquartile range changes in urban form variables are associated with 4%-12% changes in population-weighted concentrations-amounts comparable, for example, to changes in climatic factors. Our empirical findings are consistent with prior modeling research and suggest that urban form could potentially play a modest but important role in achieving (or not achieving) long-term air quality goals.

A prediction of the trend of population development in urban and rural areas in China.

PubMed

Hu, Y

1998-01-01

This study predicts trends in population growth, urbanization, and age structure in China. Data were obtained from the 1990 Census. Population totaled 1.22 billion at the end of 1996. The fertility model predicts future fertility by variant and parity; parameters are provided in a table. High, medium, and low fertility variants, respectively, are based on the total regressive fertility rates (TRFR) of 2.23, 1.9, and 1.6. The medium variant assumes 2 children in rural areas. The low variant is ideal and assumes no third parity in rural areas. Urbanization means an annual average increase of 0.5% after 1996 at pace I and 0.8% at pace II. Urban population will be 57.8% of total population by 2050. Under these three variants, population size in 2000 will be 898 million in rural and 403 million in urban areas, 869 million in rural and 400 million in urban areas, and 856 million in rural and 398 million in urban areas, respectively. Population will peak at 1.7 billion in 2050, at 1.48 billion in 2033, and at 1.38 billion in 2023, respectively. During the period 2000-2020, about 10-14 million rural migrants will move to urban areas; 10 million will move thereafter. The elderly aged over 60 years will reach 7% by 2000 and 20% by 2040. Rural population will age faster than urban population. The working age population will reach 775 million in 2000, peak at 868 million in 2016, and will always be over 60% of total population. School-age population will amount to over 300 million by 2030. Young population will always be more than 25% in rural areas, which is nearly 17 percentage points higher than in urban areas.

Explaining differences in education-related inequalities in health between urban and rural areas in Mongolia.

PubMed

Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

2015-12-22

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; however, there is lack of evidence on socioeconomic-related inequality in health across the country. The aim of this paper is to evaluate the education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008. This paper used a nationwide cross-sectional data, the Household Socio-Economic Survey 2007/2008, collected by the National Statistical Office. We employed the Erreygers' concentration index to assess the degree of education-related inequality in adult health in urban and rural areas. Our results suggest that a lower education level was associated with poor self-reported health. The concentration indices of physical limitation and chronic disease were significantly less than zero in both areas. On the other hand, ill-health was concentrated among the less educated groups. The decomposition results show education, economic activity status and income were the main contributors to education-related inequalities in physical limitation and chronic disease removing age-sex related contributions. Improving accessibility and quality of education, especially for the lower socioeconomic groups may reduce socioeconomic-related inequality in health in both rural and urban areas of Mongolia.

County-level cumulative environmental quality associated with cancer incidence.

PubMed

Jagai, Jyotsna S; Messer, Lynne C; Rappazzo, Kristen M; Gray, Christine L; Grabich, Shannon C; Lobdell, Danelle T

2017-08-01

Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. Cancer 2017;123:2901-8. © 2017 American Cancer Society. © 2017 American Cancer Society.

Space Applications in Support of Future Urban Development in Armenia

NASA Astrophysics Data System (ADS)

Alhaddad, Bahaaeddin; Reppucci, Antonio; Moreno, Laura

2016-08-01

The fast growing of some cities has produced important changes in the urban sectors not always following sustainability criteria. As results, most urban growth falls outside formal planning controls and many cities suffer poor urban services management, traffic, and congestion, loss of green areas, poor air quality, and noise. The main advantages of satellite-based EO products are to support the decision-making process, and the development and operation of smart services. Satellite-based urban morphology analysis can help to identify the transformation of the urban development and evolution. The pilot presented here is a demonstration in the framework of the collaboration between ESA and ADB, called EOTAP "Earth Observation for a Transforming Asia Pacific". Aim of the pilot is to exploit satellite Earth observation data for sustainable growth and help preparing a series of city development and investment plans.

Residential segregation and the survival of U.S. urban public hospitals.

PubMed

Ko, Michelle; Needleman, Jack; Derose, Kathryn Pitkin; Laugesen, Miriam J; Ponce, Ninez A

2014-06-01

Residential segregation is associated geographic disparities in access to care, but its impact on local health care policy, including public hospitals, is unknown. We examined the effects of racial residential segregation on U.S. urban public hospital closures from 1987 to 2007, controlling for hospital, market, and policy characteristics. We found that a high level of residential segregation moderated the protective effects of Black population composition, such that a high level of residential segregation, in combination with a high percentage of poor residents, conferred a higher likelihood of hospital closure. More segregated and poorer communities face disadvantages in access to care that may be compounded as a result of instability in the health care safety net. Policy makers should consider the influence of social factors such as residential segregation on the allocation of the safety net resources.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh.

PubMed

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-03-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5-6 days/week, but close by 4-5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Sanitation investments in Ghana: An ethnographic investigation of the role of tenure security, land ownership and livelihoods.

PubMed

Awunyo-Akaba, Y; Awunyo-Akaba, J; Gyapong, M; Senah, K; Konradsen, F; Rheinländer, T

2016-07-18

Ghana's low investment in household sanitation is evident from the low rates of improved sanitation. This study analysed how land ownership, tenancy security and livelihood patterns are related to sanitation investments in three adjacent rural and peri-urban communities in a district close to Accra, Ghana's capital. Qualitative data was gathered for this comparative ethnographic study over seven months, (June, 2011-January, 2012) using an average of 43 (bi-weekly) participant observation per community and 56 in-depth interviews. Detailed observational data from study communities were triangulated with multiple interview material and contextual knowledge on social structures, history of settlement, land use, livelihoods, and access to and perceptions about sanitation. This study shows that the history of settlement and land ownership issues are highly correlated with people's willingness and ability to invest in household sanitation across all communities. The status of being a stranger i.e. migrant in the area left some populations without rights over the land they occupied and with low incentives to invest in sanitation, while indigenous communities were challenged by the increasing appropriation of their land for commercial enterprises and for governmental development projects. Interview responses suggest that increasing migrant population and the high demand for housing in the face of limited available space has resulted in general unwillingness and inability to establish private sanitation facilities in the communities. The increasing population has also created high demand for cheap accommodation, pushing tenants to accept informal tenancy agreements that provided for poor sanitation facilities. In addition, poor knowledge of tenancy rights leaves tenants in no position to demand sanitation improvements and therefore landlords feel no obligation or motivation to provide and maintain domestic sanitation facilities. The study states that poor land rights, the history of settlements, in-migration and insecure tenancy are key components that are associated with local livelihoods and investments in private sanitation in rapidly changing rural and peri-urban communities of Ghana. Sanitation policy makers and programme managers must acknowledge that these profound local, ethnic and economic forces are shaping people's abilities and motivations for sanitation investments.

Knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among urban high-risk groups: findings of a cross-sectional study in Dhaka, Bangladesh

PubMed Central

2013-01-01

Background In endemic countries such as Bangladesh, consequences of cholera place an enormous financial and social burden on patients and their families. Cholera vaccines not only provide health benefits to susceptible populations but also have effects on the earning capabilities and financial stability of the family. Community-based research and evaluations are necessary to understand perceptions about and practices of the community relating to cholera and oral cholera vaccines. This may help identify the ways in which such vaccines may be successfully introduced, and other preventive measures can be implemented. The present study assessed the knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among an urban population residing in a high cholera-prone setting in Dhaka, Bangladesh. Methods This cross-sectional study was conducted in an area of high cholera prevalence in 15 randomly-selected clusters in Mirpur, Dhaka city. A study team collected data through a survey and in-depth interviews during December 2010–February 2011. Results Of 2,830 families included in the final analysis, 23% could recognize cholera as acute watery diarrhea and 16% had ever heard of oral cholera vaccine. About 54% of the respondents had poor knowledge about cholera-related issues while 97% had a positive attitude toward cholera and oral cholera vaccine. One-third showed poor practice relating to the prevention of cholera. The findings showed a significant (p < 0.05) association between the respondents’ knowledge and sex, education, occupation, monthly overall household expenditure, attitudes and practice. In the adjusted model, male sex, having a lower monthly overall household expenditure, and having a less positive attitude toward cholera were the significant predictors to having poor knowledge. Conclusions The findings suggest the strengthening of health education activities to improve knowledge on cholera, its prevention and treatment and information on cholera vaccination among high-risk populations. The data also underscore the potential of mass cholera vaccination to prevent and control cholera. PMID:23509860

Risk behaviors of 15–21 year olds in Mexico lead to a high prevalence of sexually transmitted infections: results of a survey in disadvantaged urban areas

PubMed Central

Gutierrez, Juan-Pablo; Bertozzi, Stefano M; Conde-Glez, Carlos J; Sanchez-Aleman, Miguel-Angel

2006-01-01

Background Due to the fact that adolescents are more likely to participate in high-risk behaviors, this sector of the population is particularly vulnerable to contracting sexually transmitted infections (STIs) and resultant health problems. Methods A survey was carried out among adolescents from poor homes in 204 small-urban areas of Mexico. Information was collected in relation to risk behaviors and socio-economic environment. A sub-group of the participants also provided blood and urine samples which were analyzed to detect sexually transmitted infections. Results The presence of Chlamydia was detected in nearly 8% of participants who had stated that they were sexually active (18%) and approximately 12% were positive for herpes type 2-specific antibodies. For both, a greater proportion of girls resulted positive compared to boys. The presence of these biological outcomes of sexual risk behavior was associated with other risk behaviors (smoking), but not with self-reported indicators of protected sex (reported use of condom during most recent sexual activity). Conclusion The results presented in this study show a startlingly high prevalence of HSV-2 among sexually active Mexican adolescents in poor urban areas, suggesting that this group has participated to a great extent in risky sexual practices. The relationships between socioeconomic environment and adolescent risk behavior need to be better understood if we are to design preventive interventions that modify the determinants of risk behaviors. PMID:16504147

Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors.

PubMed

Zhong, B L; Liu, T B; Chan, S S M; Jin, D; Hu, C Y; Dai, J; Chiu, H F K

2018-06-01

Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers. A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs. The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70). CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.

Urbanization, cities, and health: The challenges to Nigeria - A review.

PubMed

Aliyu, Alhaji A; Amadu, Lawal

2017-01-01

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living.

Urbanization, Cities, and Health: The Challenges to Nigeria – A Review

PubMed Central

Aliyu, Alhaji A.; Amadu, Lawal

2017-01-01

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living. PMID:29063897

Challenging Educational Injustice: "Grassroots" Privatisation in South Asia and Sub-Saharan Africa

ERIC Educational Resources Information Center

Tooley, James

2013-01-01

The phenomenon of low-cost private schools "mushrooming" in poor areas of sub-Saharan Africa and South Asia, and elsewhere, is now well-documented. Findings from research by the author's teams and others show that these schools are serving a majority (urban and peri-urban) or significant minority (rural) of the poor, including…

The Peregrine Falcon and the Urban Poor. Some Sociological Interrelations.

ERIC Educational Resources Information Center

Burch, William R., Jr.

It is shown what the peregrine falcon, threatened with extinction by DDT, and the urban poor have in common. Specifically, a study in New Haven, Connecticut was done to explore the relation between social class and the average emissions for the air pollutants: carbon monoxide, hydrocarbons, nitrogen oxides, sulfur oxides, and particulate matter.…

Gifted Programming for Poor or Minority Urban Students: Issues and Lessons Learned

ERIC Educational Resources Information Center

Olszewski-Kubilius, Paula; Thomson, Dana L.

2010-01-01

Gaps in the achievement between poor and more advantaged children and minority and nonminority students of all ages continue to be the most central problem in the field of education. Achievement differences by racial/ethnic group and socioeconomic status (SES) level are especially pronounced and pervasive within the major urban school districts in…

Metropolitan Growth and Economic Opportunity for the Poor: If You're Poor Does Place Matter?

ERIC Educational Resources Information Center

Foster-Bey, John A.

This paper focuses on why metropolitan areas vary in their capacity to translate generally high employment rates into economic opportunity for the disadvantaged. Data come from the Urban Institute's Urban Underclass Database, which includes poverty and employment data for 1980 and 1990 for the 100 largest metropolitan areas down to the Census…

The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States.

PubMed

McGeehin, M A; Mirabelli, M

2001-05-01

Heat and heat waves are projected to increase in severity and frequency with increasing global mean temperatures. Studies in urban areas show an association between increases in mortality and increases in heat, measured by maximum or minimum temperature, heat index, and sometimes, other weather conditions. Health effects associated with exposure to extreme and prolonged heat appear to be related to environmental temperatures above those to which the population is accustomed. Models of weather-mortality relationships indicate that populations in northeastern and midwestern U.S. cities are likely to experience the greatest number of illnesses and deaths in response to changes in summer temperature. Physiologic and behavioral adaptations may reduce morbidity and mortality. Within heat-sensitive regions, urban populations are the most vulnerable to adverse heat-related health outcomes. The elderly, young children, the poor, and people who are bedridden or are on certain medications are at particular risk. Heat-related illnesses and deaths are largely preventable through behavioral adaptations, including the use of air conditioning and increased fluid intake. Overall death rates are higher in winter than in summer, and it is possible that milder winters could reduce deaths in winter months. However, the relationship between winter weather and mortality is difficult to interpret. Other adaptation measures include heat emergency plans, warning systems, and illness management plans. Research is needed to identify critical weather parameters, the associations between heat and nonfatal illnesses, the evaluation of implemented heat response plans, and the effectiveness of urban design in reducing heat retention.

[Food and population: study of three countries].

PubMed

1988-12-01

In 1985, despite a nearly 25% worldwide surplus of cereals, more than 700 million poor people had insufficient food and some 17 million children died of malnutrition or related causes. 16% of the developing world's population is undernourished. Rapid population growth is a major reason for the world's hunger. Large families exhaust the resources of many urban couples and rural couples with little land. Closely spaced pregnancies deplete the nutritional resources of the mother and lead to low birth weight babies and inadequate lactation. Population growth in already densely populated countries reduces the land available for each family, inevitably contributing to poverty and rural malnutrition. Unemployment and underemployment reach alarming proportions in the city, where the combination of high fertility rates and migration from the countryside have produced growth twice that of the world population as a whole. Few developing countries have been able to generate sufficient investment to create new jobs for all seeking them. Unstable governments attempt to pacify urban unrest by subsidizing food prices and concentrating social and economic investments in the cities, causing further deterioration in rural conditions. Today more than 60 countries have food deficits, although not all are suffering. India, Kenya, and Mexico are 3 countries that have had some success in balancing population growth and food production, but each still has undernourished population sectors because of economic policies that fail to provide sufficient help to their poor and because of implacable population growth. Ending malnutrition in the 3 countries will require reducing the cost of food for households and increasing their incomes, but both objectives are made more difficult by rapid population growth. As a result of the green revolution and other factors, food production in India has tripled since 1950, but population has almost doubled in the same years. With rapid population growth, per capita agricultural productivity increased much more slowly than production. Kenya has enjoyed impressive economic growth since independence, but its rate of population growth of 4.2%/year, the highest in the world, has meant that per capita income increases have been modest. Average nutritional status has declined in Kenya since 1968. The rate of population growth in Mexico has declined to 2.3-2.6%/year in 1986 from the 3.5% of 1974, but population growth will be rapid for decades to come because of the young age structure. Agricultural production has increased but has not kept pace with population growth. Kenya, India, and Mexico have the human and natural resources to make further economic gains in the coming decades. The difficulty of feeding their populations adequately will increase to the extent that they fail to curb their rapid population increase.

Meeting the Needs for More Fish Through Aquaculture

NASA Astrophysics Data System (ADS)

Giap, D. H.; Lam, T. J.

2015-10-01

Fish is one of the major sources of animal protein. Due to rising world populations, increasing income and urbanization, demand for fish has been increasing. In order to meet the need for more fish, aquaculture has become increasingly important as wild populations and production from capture fisheries have declined due to overfishing and poor management. In recent years, production from aquaculture has increased rapidly to address the shortfalls in capture fisheries, especially in Asia where aquaculture production accounts for about 90% of world aquaculture production by volume. This paper reviews the status of the world’s fish production, provides an update on Asian aquaculture, and highlights developments that are contributing to sustainable fish production, particularly integrated multi-trophic aquaculture and aquaponics.

The role of population density on the impact of urbaniza-tion on GHG emissions in China

NASA Astrophysics Data System (ADS)

Liu, Yonghong; Gao, Chaochao; Lu, Yingying

2017-04-01

Urbanization directly drives rural to urban population migration and indirectly causes west to east migration in China, two phenomena that may significantly impact China's greenhouse gas emissions given its huge population and vast difference between the western rural and eastern urban areas. These two phenomena were analyzed by using emissions as a per capita term, and extending the impact from the traditional urbanization rate effect to include population density effect. The results show that population density has actually been the dominant demographic player in changing per capita emissions for the past two decades in China, and its elasticity changed from positive in economically less-developed provinces to negative for the developed provinces. This study provides a new perspective in the study of the relationship between urbanization and greenhouse gas emissions, and the results indicate that population density change should be taken into account to accurately assess the impact of urbanization.

Disparities in child mortality trends in two new states of India.

PubMed

Minnery, Mark; Jimenez-Soto, Eliana; Firth, Sonja; Nguyen, Kim-Huong; Hodge, Andrew

2013-08-27

India has the world's highest total number of under-five deaths of any nation. While progress towards Millennium Development Goal 4 has been documented at the state level, little information is available for greater disaggregation of child health markers within states. In 2000, new states were created within the country as a partial response to political pressures. State-level information on child health trends in the new states of Chhattisgarh and Jharkhand is scarce. To fill this gap, this article examines under-five and neonatal mortality across various equity markers within these two new states, pre-and post-split. Both direct and indirect estimation using pooled data from five available sources were undertaken. Inter-population disparities were evaluated by mortality data stratification of rural-urban location, ethnicity, wealth and districts. Both states experienced an overall reduction in under-five and neonatal mortality, however, this has stagnated post-2001 and various disparities persist. In cases where disparities have declined, such as between urban-rural populations and low- and high-income groups, this has been driven by modest declines within the disadvantaged groups (i.e. low-income rural households) and stagnation or worsening of outcomes within the advantaged groups. Indeed, rising trends in mortality are most prevalent in urban middle-income households. The results suggest that rural health improvements may have come at the expense of urban areas, where poor performance may be attributed to factors such as lack of access to quality private health facilities. In addition, the disparities may in part be associated with geographical access, traditional practices and district-level health resource allocation.

Urban Children in Distress: An Introduction to the Issues. Innocenti Occasional Papers. The Urban Child Series, Number 2.

ERIC Educational Resources Information Center

Blanc, Cristina S.

This publication presents a discussion of the status of poor urban children world-wide and the design of a five-nation study of the condition of distressed urban children. Following an introduction, Section 2 describes the urban child project designed to study and advance the plight of urban children in developing nations. Section 3 outlines the…

Urban and rural land use in Puerto Rico

Treesearch

Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez; Maya Quinones; Michael E. Jimenez

2008-01-01

We have developed three land use regions for Puerto Rico: Urban, Suburban, and Rural (Gould et al. 2008; Martinuzzi et al. 2007). These three regions can also be considered urban, densely-populated rural, and sparsely-populated rural or as urban and wildland with a wildland-urban interface. The suburban use is the most dynamic in terms of population growth and land...

[The health system of Chile].

PubMed

Becerril-Montekio, Víctor; Reyes, Juan de Dios; Manuel, Annick

2011-01-01

This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70% of the population, including the rural and urban poor, the low middle-class, the retired, and the self-employed professionals and technicians.The private sector covers 17.5% of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around l0% of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer, ischaemic heart disease, HIV/AIDS and diabetes.

Genetic diversity and population structure in contemporary house sparrow populations along an urbanization gradient

PubMed Central

Vangestel, C; Mergeay, J; Dawson, D A; Callens, T; Vandomme, V; Lens, L

2012-01-01

House sparrow (Passer domesticus) populations have suffered major declines in urban as well as rural areas, while remaining relatively stable in suburban ones. Yet, to date no exhaustive attempt has been made to examine how, and to what extent, spatial variation in population demography is reflected in genetic population structuring along contemporary urbanization gradients. Here we use putatively neutral microsatellite loci to study if and how genetic variation can be partitioned in a hierarchical way among different urbanization classes. Principal coordinate analyses did not support the hypothesis that urban/suburban and rural populations comprise two distinct genetic clusters. Comparison of FST values at different hierarchical scales revealed drift as an important force of population differentiation. Redundancy analyses revealed that genetic structure was strongly affected by both spatial variation and level of urbanization. The results shown here can be used as baseline information for future genetic monitoring programmes and provide additional insights into contemporary house sparrow dynamics along urbanization gradients. PMID:22588131

Genetic diversity and population structure in contemporary house sparrow populations along an urbanization gradient.

PubMed

Vangestel, C; Mergeay, J; Dawson, D A; Callens, T; Vandomme, V; Lens, L

2012-09-01

House sparrow (Passer domesticus) populations have suffered major declines in urban as well as rural areas, while remaining relatively stable in suburban ones. Yet, to date no exhaustive attempt has been made to examine how, and to what extent, spatial variation in population demography is reflected in genetic population structuring along contemporary urbanization gradients. Here we use putatively neutral microsatellite loci to study if and how genetic variation can be partitioned in a hierarchical way among different urbanization classes. Principal coordinate analyses did not support the hypothesis that urban/suburban and rural populations comprise two distinct genetic clusters. Comparison of FST values at different hierarchical scales revealed drift as an important force of population differentiation. Redundancy analyses revealed that genetic structure was strongly affected by both spatial variation and level of urbanization. The results shown here can be used as baseline information for future genetic monitoring programmes and provide additional insights into contemporary house sparrow dynamics along urbanization gradients.

Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect.

PubMed

Tüzün, Nedim; Op de Beeck, Lin; Brans, Kristien I; Janssens, Lizanne; Stoks, Robby

2017-12-01

The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.

Urban High School Classroom Management: A Humanistic Approach.

ERIC Educational Resources Information Center

Matus, Don E.

This paper identifies conditions in the lives of poor urban high school students that may cause classroom management problems. Urban student teachers are urged to look at these conditions from a humanistic perspective to help them understand their students and deal effectively with those problems. Specific urban secondary classroom management…

Child Nutritional Status by Rural/Urban Residence: A Cross-National Analysis

ERIC Educational Resources Information Center

Fox, Kiira; Heaton, Tim B.

2012-01-01

Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for…

Urban climate archipelagos: a new framework for urban impacts on climate

Treesearch

J. Marshall Shepherd; T. Andersen; Chris Strother; A. Horst; L. Bounoua; C. Mitra

2013-01-01

Earth is increasingly an “urbanized” planet. The “World Population Clock” registered a Population of 7,175,309,538 at 8:30 pm (LST) on Oct. 6, 2013. Current and future trends suggest that this population will increasingly reside in cities. Currently, 52 percent of the world population is urban, which means we are a majority “urbanized” society. Figure 1 indicates...

[State of the world population, 1986].

PubMed

1987-01-01

The majority of the world population will soon reside in urban areas. At present, over 40% of the world's people are urban, and 50% will be urban soon after the year 2000. The proportion urban in developed countries has exceeded 50% since the mid-20th century, and in developing countries this level will be reached in the 1st quarter of the next century. Developing countries in Asia and Africa have less than 30% of their population urban. While over 70% of Latin America's population is urban. Within the next 50 years, the predominantly rural character of the developing countries will disappear forever. Currently the majority of the world's urban population lives in developing countries. In 1970, 695 million urban dwellers were in developed countries vs. 666 million in developing countries, but by 1985, there were only 849 million urban dwellers in developed countries vs. 1164 million in developing countries. By the year 2025, there will be nearly 4 times as many urban dwellers in developing countries. An increasing proportion of the urban population will reside in the largest cities. Around 2025, almost 30% of the urban population in developing countries will live in cities of over 4 million. Around 2000 there will be 5 cities of 15 million or more, 3 of them in developing countries. The proportion of the 20 largest cities in developing countries will increase from 9 in 1970 to 16 in 2000. The close relationship between city size and economic development that existed until the recent past is disappearing. It is possible that the very largest cities will no longer be at the center of international political and economic networks. Many developing countries will have to develop plans for cities of sizes never imagined in the developed countries of today. High rates of population increase in the developing countries are an inseparable aspect of their urbanization. Growth of the urban population in developing countries will continue to be rapid until well into the 21st century. The world rate of urban growth will continue to be about 2.5%/year during the 1st quarter of sthe 21st century. The annual rate of urban growth is 3.5% in developing countries and is highest in Africa, especially West Africa where it reaches 6.5%/year. Despite migration to cities, the rural population in developing countries will continue to grow at a rate of about 1%/year through the end of the century. In many rural areas, population density is already very high, and continued growth will hamper efforts to reduce urban migration. In developing countries, the increase in the urban population is due more to natural increase than to migration.

Population issues surface at human settlements conference.

PubMed

1996-01-01

This news brief focuses on the debate about population issues at the UN Conference on Human Settlements, held in Istanbul, Turkey, in June 1996. The Istanbul Declaration on Human Settlements was adopted by world leaders at the conference. Leaders were committed to programs to improve standards of living, the right of citizens to adequate housing, and the mobilization of new financial resources. Dr. Sadik, as Executive Director of the UN Population Fund, stressed that natural increase accounts for 60% of urban population growth. Mr. Boutros Boutros-Ghali, as UN Secretary General, stressed that over 50% of world population would live in urban centers by the year 2000, and almost 75% might do so by 2025. He indicated that all nations are interrelated; the poor and refugees from political conflict from one country travel to safer and richer countries. Dr. Sadik referred to the agreement at the 1994 International Conference on Population and Development (ICPD) on stabilizing world population in the shortest time possible. This would require meeting the needs of men and women for health, education, and the power of personal decision making. The most important item was the satisfaction of women's need for reproductive health information and services and women's power to use services. Dr. Sadik urged that women be given the right to hold and inherit property and to obtain credit. It was pointed out that the language of Habitat's plan of action on population and development issues was frequently bracketed; consequently, the plan suffered from a lack of consensus. The debate between countries would end, if the language were not bracketed. Dr. Sadik recommended family planning for developing sustainable and liveable cities.

Urban geomorphological heritage - A new field of research

NASA Astrophysics Data System (ADS)

Reynard, Emmanuel; Pica, Alessia; Coratza, Paola

2017-04-01

Urbanization is one of the major challenges that the world faces. In 2015, 54% of the world population was living in urban areas and in some countries this percentage is close to 100% (Singapore 100%; Qatar 99%; Belgium 98%). In several parts of the world annual urbanization rates exceed 5% (e.g. Oman 8.54%; Rwanda 6.43%; Burkina Faso 5.87%), which means that urban sprawl is a widespread phenomenon. Urbanization and correlated infrastructure building highly impact and sometimes completely destroy natural landforms. Geomorphological heritage research has traditionally focused on rural or natural regions, in particular protected areas (nature parks, geoparks). We consider that urban areas, which have been poorly investigated until now, are particularly interesting in a geomorphological heritage point of view for almost three reasons: (i) The geomorphological context (site) of some cities is part of their "image" and their fame (e.g. the sugarloaf of Rio de Janeiro); (ii) Urban sprawl often interacts with landforms, which addresses the challenge of geoheritage protection in fast urbanizing areas; (iii) Cities are often tourist destinations, which creates a potential for a geotourist promotion of their geomorphological heritage. This study addresses the main challenges research on geomorphological heritage is facing in urban contexts: (i) the complex interrelationships between natural landforms and urban forms; (ii) the partial or total invisibility of landforms and sediments that are covered or destroyed by urban infrastructures; (iii) man-made landforms as part of urban geomorphological heritage; (iv) the suitability of some landforms (valleys, gullies, mounts) for specific urban uses; (v) the geomorphic constraints of landforms on urban development; and (vi) the importance of some landforms for the urban landscape and the image of the cities. To address these challenges a methodological framework is proposed, which combines: (i) the geomorphological analysis of the urban landscape through geomorphological mapping (with use of a specific legend for man-made landforms) and geohistorical analysis of landscape evolution (historical maps processing); (ii) the selection, characterization and assessment of urban geomorphosites; (iii) proposals for the conservation and promotion (geotourism) of the urban geomorphological heritage.

Introduction: population migration and urbanization in developing countries.

PubMed

Kojima, R

1996-12-01

This introductory article discusses the correlation between migration and rapid urbanization and growth in the largest cities of the developing world. The topics include the characteristics of urbanization, government policies toward population migration, the change in absolute size of the rural population, and the problems of maintaining megacities. Other articles in this special issue are devoted to urbanization patterns in China, South Africa, Iran, Korea and Taiwan as newly industrialized economies (NIEs), informal sectors in the Philippines and Thailand, and low-income settlements in Bogota, Colombia, and India. It is argued that increased urbanization is produced by natural population growth, the expansion of the urban administrative area, and the in-migration from rural areas. A comparison of urbanization rates of countries by per capita gross national product (GNP) reveals that countries with per capita GNP of under US$2000 have urbanization rates of 10-60%. Rates are under 30% in Africa, the Middle East, South Asia, China, and Indonesia. Rapid urbanization appears to follow the economic growth curve. The rate of urbanization in Latin America is high enough to be comparable to urbanization in Europe and the US. Taiwan and Korea have high rates of urbanization that surpass the rate of industrialization. Thailand and Malaysia have low rates of urbanization compared to the size of their per capita GNP. Urbanization rates under 20% occur in countries without economic development. Rates between 20% and 50% occur in countries with or without industrialization. East Asian urbanization is progressing along with industrialization. Africa and the Middle East have urbanization without industrialization. In 1990 there were 20 developing countries and 5 developed countries with populations over 5 million. In 10 of 87 developing countries rural population declined in absolute size. The author identifies and discusses four patterns of urban growth.

Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru.

PubMed

Lazo-Porras, Maria; Ortiz-Soriano, Victor; Moscoso-Porras, Miguel; Runzer-Colmenares, Fernando M; Málaga, German; Jaime Miranda, J

2017-10-26

Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. We performed a secondary analysis using data from the "Encuesta de Salud y Bienestar del Adulto Mayor", a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban) were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR) and 95% confidence interval (95% CI) adjusting for confounders. Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%-2.1%). There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33-1.23). The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.

Drivers and Pattern of Social Vulnerability to Flood in Metropolitan Lagos, Nigeria

NASA Astrophysics Data System (ADS)

Fasona, M.

2016-12-01

Lagos is Africa's second largest city and a city-state in southwest Nigeria. Population and economic activities in the city are concentrated in the greater Lagos metropolitan area - a group of barrier islands less than a thousand square kilometer. Several physical factors and critical human-environmental conditions contribute to high flood vulnerability across the city. Flood impact is highly denominated and the poor tend to suffer more due to higher risk of exposure and poor adaptive capacity. In this study we present the pattern of social vulnerability to flooding across the Lagos metropolis and argued that the pattern substantially reflects the pattern and severity of flooding impact on people across the metropolis. Twenty nine social indicators and experiences including poverty profile, housing conditions, education, population and demography, social network, and communication, among others, were considered. The data were collated through field survey and subjected to principal component analysis. The results were processed into raster surfaces using GIS for social vulnerability characterization at neighborhood levels. The results suggest the social status indicators, neighborhood standing and social networks indictors, the indicators of emergency responses and security, and the neighborhood conditions, in that order, are the most important determinants of social vulnerability. Six of the 16 LGAs in metropolitan Lagos have high social vulnerability. Neighborhoods that combine poor social status indicators and poor neighborhood standing and social networks are found to have high social vulnerability whereas other poor neighborhoods with strong social networks performed better. We conclude that improved human living condition and social network and communication in poor urban neighborhoods are important to reducing social vulnerability to flooding in the metropolis.

Improved Reproductive Health Equity Between the Poor and the Rich: An Analysis of Trends in 46 Low- and Middle-Income Countries.

PubMed

Ross, John

2015-09-07

While several indicators for reproductive health have improved for entire populations, few analyses are available for trends over time in the gaps between the poor and the rich. This paper tracks improvements in the equitable distribution of reproductive health indicators according to wealth quintiles, especially for contraceptive use, in 46 low- and middle-income countries based on national population-based surveys conducted between 1990 and 2013. It focuses on the gaps between the poorest and richest quintiles in the earliest and latest survey rounds across a number of reproductive health indicators related to family planning, fertility desires, antenatal care, and infant and child mortality, as well as on improvements in the absolute levels of contraceptive use by the poorest quintile. Gap changes were decomposed to show how the gaps can either diminish or grow due to either the bottom or top quintile, or both. In addition, bivariate correlation analysis was conducted to examine the relationship of the gaps, and of contraceptive use by the poor, to national family planning program efforts. Overall, the gaps between the poorest and richest have narrowed, due primarily to faster improvements among the poor than the rich. For example, the gap between the richest and poorest in the modern contraceptive prevalence rate has declined by 25%, from a 20.4 percentage point difference to a 15.4 point difference. And the gap has decreased more where family planning programs have been stronger. Across most of 18 other reproductive health indicators, the gaps have also been narrowing. For instance, the poor-rich gap for antenatal care decreased by over a third, from a difference of 30.7 percentage points to 19.6 percentage points. Gaps in infant and child mortality also have declined by about one-third. The pattern for contraceptive use in sub-Saharan Africa, however, has been mixed, with the gap actually increasing in some countries with strong programs. This disparity may largely reflect that family planning in the region is generally at an earlier stage in its history, and so programs may initially be reaching better-off clients, especially in urban areas. To promote additional equity, programs should emphasize efforts to increase access to voluntary family planning services to the least well-off, including those in rural and peri-urban areas. © Ross.

Improved Reproductive Health Equity Between the Poor and the Rich: An Analysis of Trends in 46 Low- and Middle-Income Countries

PubMed Central

2015-01-01

While several indicators for reproductive health have improved for entire populations, few analyses are available for trends over time in the gaps between the poor and the rich. This paper tracks improvements in the equitable distribution of reproductive health indicators according to wealth quintiles, especially for contraceptive use, in 46 low- and middle-income countries based on national population-based surveys conducted between 1990 and 2013. It focuses on the gaps between the poorest and richest quintiles in the earliest and latest survey rounds across a number of reproductive health indicators related to family planning, fertility desires, antenatal care, and infant and child mortality, as well as on improvements in the absolute levels of contraceptive use by the poorest quintile. Gap changes were decomposed to show how the gaps can either diminish or grow due to either the bottom or top quintile, or both. In addition, bivariate correlation analysis was conducted to examine the relationship of the gaps, and of contraceptive use by the poor, to national family planning program efforts. Overall, the gaps between the poorest and richest have narrowed, due primarily to faster improvements among the poor than the rich. For example, the gap between the richest and poorest in the modern contraceptive prevalence rate has declined by 25%, from a 20.4 percentage point difference to a 15.4 point difference. And the gap has decreased more where family planning programs have been stronger. Across most of 18 other reproductive health indicators, the gaps have also been narrowing. For instance, the poor-rich gap for antenatal care decreased by over a third, from a difference of 30.7 percentage points to 19.6 percentage points. Gaps in infant and child mortality also have declined by about one-third. The pattern for contraceptive use in sub-Saharan Africa, however, has been mixed, with the gap actually increasing in some countries with strong programs. This disparity may largely reflect that family planning in the region is generally at an earlier stage in its history, and so programs may initially be reaching better-off clients, especially in urban areas. To promote additional equity, programs should emphasize efforts to increase access to voluntary family planning services to the least well-off, including those in rural and peri-urban areas. PMID:26374803

Educational Equity in Poor Urban Contexts--Exploring Issues of Place/Space and Young People's Identity and Agency

ERIC Educational Resources Information Center

Raffo, Carlo

2011-01-01

An enduring concern for educational policy in many affluent countries is the endemic nature of educational inequalities that are predominately located in poor urban contexts. Given the inabilities of school reform "per se" to deal with these inequalities, the paper focuses on issues of scarcity and spatial processes that are implicated…

Low Birth Weight and Cognitive Outcomes: Evidence for a Gradient Relationship in an Urban, Poor, African American Birth Cohort

ERIC Educational Resources Information Center

Dombrowski, Stefan C.; Noonan, Kelly; Martin, Roy P.

2007-01-01

This study is one of the first to investigate the relationship between low birth weight and cognitive outcomes in an urban, poor, prospectively designed African-American birth cohort. Multivariate analyses of the Pathways to Adulthood study, a subset of the Johns Hopkins Collaborative Perinatal study, compared low birth weight African-American…

"I Want to Help Girls Like Me": An Exploration of the Educational Aspirations of Teenage Girls in Kolkata Slums

ERIC Educational Resources Information Center

Ipe, Rebecca

2016-01-01

This qualitative study used participatory visual research in order to develop an understanding of the educational experiences of urban poor adolescent girls in Kolkata and to elicit their capabilities. The sample comprised urban poor girls who were undergoing formal education at a religious, philanthropic primary school in Kolkata. Findings from…

Town and country reptiles: A review of reptilian responses to urbanization.

PubMed

French, Susannah S; Webb, Alison C; Hudson, Spencer B; Virgin, Emily E

2018-06-04

The majority of the world population is now inhabiting urban areas, and with staggering population growth urbanization is also increasing. While work studying the effects of changing landscapes and specific urban pressures on wildlife is beginning to amass, the majority of this work focuses on avian or mammalian species. However, the effects of urbanization likely vary substantially across taxonomic groups due to differences in habitat requirements and life history. The current paper aims first to broaden the review of urban effects across reptilian species; second, to summarize the responses of reptilian fauna to specific urban features; and third, to assess the directionality of individual and population level responses to urbanization in reptile species. Based on our findings, urban research in reptilian taxa is lacking in the following areas: 1) investigating interactive or additive urban factors 2) measuring multiple morphological, behavioral and physiological endpoints within an animal, 3) linking individual to population-level responses, and 4) testing genetic/genomic differences across an urban environment as evidence for selective pressures.

Advancing Community–Based Research with Urban American Indian Populations: Multidisciplinary Perspectives

PubMed Central

Hartmann, William E.; Wendt, Dennis C.; Saftner, Melissa A.; Marcus, John; Momper, Sandra L.

2014-01-01

The U.S. has witnessed significant growth among urban AI populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations. PMID:24659391

Comparing the microbial risks associated with household drinking water supplies used in peri-urban communities of Phnom Penh, Cambodia.

PubMed

Thomas, K; McBean, E; Shantz, A; Murphy, H M

2015-03-01

Most Cambodians lack access to a safe source of drinking water. Piped distribution systems are typically limited to major urban centers in Cambodia, and the remaining population relies on a variety of surface, rain, and groundwater sources. This study examines the household water supplies available to Phnom Penh's resettled peri-urban residents through a case-study approach of two communities. A quantitative microbial risk assessment is performed to assess the level of diarrheal disease risk faced by community members due to microbial contamination of drinking water. Risk levels found in this study exceed those associated with households consuming piped water. Filtered and boiled rain and tank water stored in a kettle, bucket/cooler, bucket with spigot or a 500 mL bottle were found to provide risk levels within one order-of-magnitude to the piped water available in Phnom Penh. Two primary concerns identified are the negation of the risk reductions gained by boiling due to prevailing poor storage practices and the use of highly contaminated source water.

Neighborhood Social Inequalities in Road Traffic Injuries: The Influence of Traffic Volume and Road Design

PubMed Central

Gauvin, Lise; Plante, Céline; Fournier, Michel; Morency, Catherine

2012-01-01

Objectives. We examined the extent to which differential traffic volume and road geometry can explain social inequalities in pedestrian, cyclist, and motor vehicle occupant injuries across wealthy and poor urban areas. Methods. We performed a multilevel observational study of all road users injured over 5 years (n = 19 568) at intersections (n = 17 498) in a large urban area (Island of Montreal, Canada). We considered intersection-level (traffic estimates, major roads, number of legs) and area-level (population density, commuting travel modes, household income) characteristics in multilevel Poisson regressions that nested intersections in 506 census tracts. Results. There were significantly more injured pedestrians, cyclists, and motor vehicle occupants at intersections in the poorest than in the richest areas. Controlling for traffic volume, intersection geometry, and pedestrian and cyclist volumes greatly attenuated the event rate ratios between intersections in the poorest and richest areas for injured pedestrians (−70%), cyclists (−44%), and motor vehicle occupants (−44%). Conclusions. Roadway environment can explain a substantial portion of the excess rate of road traffic injuries in the poorest urban areas. PMID:22515869

Urban air pollution in Sub-Saharan Africa: Time for action.

PubMed

Amegah, A Kofi; Agyei-Mensah, Samuel

2017-01-01

Air quality in cities of Sub-Saharan African (SSA) countries has deteriorated with the situation driven by rapid population growth and its attendant increased vehicle ownership, increased use of solid fuels for cooking and heating, and poor waste management practices. Industrial expansion in these cities is also a major contributor to the worsening air pollution. Exposure to ambient air pollution is a major threat to human health in SSA with 176,000 deaths and 626,000 DALYs in the region attributable to ambient air pollution exposure. These estimates are however likely to be much higher than reported due to the limited data emanating from the region. Recently, the adoption of the World Health Assembly resolution on air pollution and health, and Sustainable Development Goals are a welcome boost for urban air pollution control efforts in SSA. In this article, we have outlined within the broad framework of these international policy instruments, measures for addressing urban air pollution and its associated health impacts in SSA sustainably. Copyright © 2016 Elsevier Ltd. All rights reserved.

Habitat Composition and Connectivity Predicts Bat Presence and Activity at Foraging Sites in a Large UK Conurbation

PubMed Central

Hale, James D.; Fairbrass, Alison J.; Matthews, Tom J.; Sadler, Jon P.

2012-01-01

Background Urbanization is characterized by high levels of sealed land-cover, and small, geometrically complex, fragmented land-use patches. The extent and density of urbanized land-use is increasing, with implications for habitat quality, connectivity and city ecology. Little is known about densification thresholds for urban ecosystem function, and the response of mammals, nocturnal and cryptic taxa are poorly studied in this respect. Bats (Chiroptera) are sensitive to changing urban form at a species, guild and community level, so are ideal model organisms for analyses of this nature. Methodology/Principal Findings We surveyed bats around urban ponds in the West Midlands conurbation, United Kingdom (UK). Sites were stratified between five urban land classes, representing a gradient of built land-cover at the 1 km2 scale. Models for bat presence and activity were developed using land-cover and land-use data from multiple radii around each pond. Structural connectivity of tree networks was used as an indicator of the functional connectivity between habitats. All species were sensitive to measures of urban density. Some were also sensitive to landscape composition and structural connectivity at different spatial scales. These results represent new findings for an urban area. The activity of Pipistrellus pipistrellus (Schreber 1774) exhibited a non-linear relationship with the area of built land-cover, being much reduced beyond the threshold of ∼60% built surface. The presence of tree networks appears to mitigate the negative effects of urbanization for this species. Conclusions/Significance Our results suggest that increasing urban density negatively impacts the study species. This has implications for infill development policy, built density targets and the compact city debate. Bats were also sensitive to the composition and structure of the urban form at a range of spatial scales, with implications for land-use planning and management. Protecting and establishing tree networks may improve the resilience of some bat populations to urban densification. PMID:22428015

Habitat composition and connectivity predicts bat presence and activity at foraging sites in a large UK conurbation.

PubMed

Hale, James D; Fairbrass, Alison J; Matthews, Tom J; Sadler, Jon P

2012-01-01

Urbanization is characterized by high levels of sealed land-cover, and small, geometrically complex, fragmented land-use patches. The extent and density of urbanized land-use is increasing, with implications for habitat quality, connectivity and city ecology. Little is known about densification thresholds for urban ecosystem function, and the response of mammals, nocturnal and cryptic taxa are poorly studied in this respect. Bats (Chiroptera) are sensitive to changing urban form at a species, guild and community level, so are ideal model organisms for analyses of this nature. We surveyed bats around urban ponds in the West Midlands conurbation, United Kingdom (UK). Sites were stratified between five urban land classes, representing a gradient of built land-cover at the 1 km(2) scale. Models for bat presence and activity were developed using land-cover and land-use data from multiple radii around each pond. Structural connectivity of tree networks was used as an indicator of the functional connectivity between habitats. All species were sensitive to measures of urban density. Some were also sensitive to landscape composition and structural connectivity at different spatial scales. These results represent new findings for an urban area. The activity of Pipistrellus pipistrellus (Schreber 1774) exhibited a non-linear relationship with the area of built land-cover, being much reduced beyond the threshold of ∼60% built surface. The presence of tree networks appears to mitigate the negative effects of urbanization for this species. Our results suggest that increasing urban density negatively impacts the study species. This has implications for infill development policy, built density targets and the compact city debate. Bats were also sensitive to the composition and structure of the urban form at a range of spatial scales, with implications for land-use planning and management. Protecting and establishing tree networks may improve the resilience of some bat populations to urban densification.

Trends in mortality and biological stress in a medieval polish urban population.

PubMed

Betsinger, Tracy K; DeWitte, Sharon

2017-12-01

Urbanization in pre-modern populations may have had a variety of consequences related to population crowding. However, research on the effects of urbanization have provided inconsistent results regarding the biological impact of this transition on human populations. The purpose of this study is to test the hypothesis that urbanization caused an increase in overall biological stress in a medieval (10th-13th centuries AD) Polish population. A human skeletal sample (n=164) was examined for the presence of porotic hyperostosis, cribra orbitalia, linear enamel hypoplasia, periosteal reaction, and specific infectious diseases. Prevalence rates were compared among three temporal samples: initial urbanization, early urbanization, and later urbanization. Results indicate no significant trends for any of the pathological conditions. Cox proportional hazards analyses, however, revealed a significant increase in the risk of death over time, which supports the hypothesis. These results reflect the necessity of using multiple analyses to address bioarchaeological questions. The lack of significant results from skeletal indicators may be due to an earlier urbanization trend in the population. This study illustrates that the association of urbanization with elevated biological stress is complicated and dependent on various factors, including culture and time period. Copyright © 2017 Elsevier Inc. All rights reserved.

The housing, geography, and mobility of Latin American urban poor: the prevailing model and the case of Quito, Ecuador.

PubMed

Klak, T; Holtzclaw, M

1993-01-01

In this study of the constraints of low-income migrants in securing decent housing in Quito, Ecuador (a rapidly growing city), there is a literature review of Latin American intraurban mobility and housing, the development of a theoretical model, and a bivariate analysis. John Turner's model of the three stages in the life cycle of migrants and the three concentric zones of urbanization provides the initial framework for examining Quito migration. Quito differs from other Third World and Latin American cities in that its origins are pre-Colombian, and physical barriers surround the city. Data were obtained from housing data collected independently in 1990 and 1991 and survey data on households living in 1000 inadequate housing units in 1989. 35.5% of Quito's population live in inadequate housing (poor building materials, poor construction, deterioration, or lack of basic services). Three concentric and elongated zones are constructed based on distance from the center city and periphery and are representative of shelter types (rented rooms, shanty, house, and apartment). Shelter improves with type of ownership status. The attitudes of local officials influences the proportion of the poor living in rental or self-help housing. 36% of Quito's low-income residents live in rented rooms, and 38% live in shanties and houses. Bridgeheaders (new migrants who are usually young single males) tend to live in rented rooms for under five years and to move over time to shanties and then houses. Colonial preservation in central Quito and landlords' incentives for encouraging migrants to stay in rental housing interferes with the third phase of the model. Mixed housing throughout the city fits the third phase. Local laws prevent squatters and self-help housing. Rented rooms are primarily in the central city. Occupant income increases with shifts from rented rooms, to shanties, to houses. Shelter, geographic, and mobility patterns that do not fit the model are identified. Urban circumstance may not be linear and evolutionary as predicted, but the pattern is not diverse enough to warrant abandoning the model. The recommendation is for a flexible model for adapting a universal model to local and global conditions.

Perspectives on urban conditions and population health.

PubMed

Vlahov, David; Galea, Sandro; Gibble, Emily; Freudenberg, Nicholas

2005-01-01

The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

Genetic Diversity and Differentiation in Urban and Indigenous Populations of Mexico: Patterns of Mitochondrial DNA and Y-Chromosome Lineages.

PubMed

González-Sobrino, Blanca Z; Pintado-Cortina, Ana P; Sebastián-Medina, Leticia; Morales-Mandujano, Fabiola; Contreras, Alejandra V; Aguilar, Yasnaya E; Chávez-Benavides, Juan; Carrillo-Rodríguez, Aurelio; Silva-Zolezzi, Irma; Medrano-González, Luis

2016-01-01

Aside from the admixture between indigenous people and people from overseas, populations in Mexico changed drastically after the Spanish conquest of the sixteenth century, forming an intricate history that has been underutilized in understanding the genetic population structure of Mexicans. To infer historical processes of isolation, dispersal, and assimilation, we examined the phylogeography of mitochondrial (mt) DNA and Y-chromosome lineages in 3,026 individuals from 10 urban and nine indigenous populations by identifying single nucleotide polymorphisms. A geographic array with a predominance of Amerindian lineages was observed for mtDNA, with northern indigenous populations being divergent from the central and southern indigenous populations; urban populations showed low differentiation with isolation by distance. Y-chromosome variation distinguished urban and indigenous populations through the Amerindian haplogroup Q frequency. The MtDNA and the Y-chromosome together primarily distinguished urban and indigenous populations, with different geographic arrays for both. Gene flow across geographical distance and between the urban and indigenous realms appears to have altered the pre-Hispanic phylogeography in central and southern Mexico, mainly by displacement of women, while maintaining the indigenous isolation in the north, southeast, and Zapotec regions. Most Amerindian mtDNA diversity currently occurs in urban populations and appears to be reduced among indigenous people.

Tobacco and alcohol billboards in 50 Chicago neighborhoods: market segmentation to sell dangerous products to the poor.

PubMed

Hackbarth, D P; Silvestri, B; Cosper, W

1995-01-01

This paper describes a study of billboard advertising of tobacco and alcohol products in the city of Chicago. All billboards were counted and their advertising themes noted. These data were matched with information on population and race from the 1990 census in order to document which geographic areas of the city, if any, had excess tobacco or alcohol billboards. The data revealed that minority wards were burdened with three times as many tobacco billboards and five times as many alcohol billboards when compared to white wards. The findings are congruent with studies conducted in other urban areas, which demonstrate a consistent pattern of tobacco and alcohol advertisers targeting poor and minority neighborhoods for outdoor advertising of their dangerous products. Chicago legislative initiatives based on the billboard study are described.

Paradox of Migration in Kolkata: A Megacity in GBM Delta

NASA Astrophysics Data System (ADS)

Das, S.; Hazra, S.; Ghosh, T.

2015-12-01

Contrary to other coastal cities (Mumbai, Chennai, Bhubaneswar etc.) in India, Kolkata, the largest city of India until 1990, has been showing a persistent trend of out-migration over the last decade. The situation is more paradoxical when compared to Dhaka in Bangladesh, the other coastal city in Ganga-Brahmaputra-Meghna (GBM) delta. Exacerbating impacts of Climate Change like accelerated sea level rise, impact of cyclones, rising temperature and high rainfall events and waterlogging, vis-à-vis the density of poor population in slums, Kolkata has been assessed as one of the most vulnerable cities of the world. However, Kolkata has long been a preferred destination for migrants for its port based economy, existence of industrial belt with labour intensive industries. The city and its surrounding districts attracted a massive influx of trans-border migrants when India and Bangladesh gained Independence in 1947 and 1971 respectively. The paper attempts to explore reasons behind the present trend of depopulation in the erstwhile preferred migration destination. This paper distinguishes between 'Kolkata City' (census district) with 4.5 million residents and 'Kolkata Megacity' which encompasses also the peri-urban areas and home to almost 14.1 million people according to Census 2011. Analysing migration as an ongoing research activity under DECCMA project, an overall 'in-migration' pattern can be deciphered in Kolkata 'megacity'. On the contrary, the Kolkata 'city' located right in the heart of the megacity exhibits negative net migration (-5.11%) i.e. high 'out-migration'. Plausible causes can be movement of people from Kolkata 'city' to peri-urban areas and satellite towns (urban to urban migration) probably due to closure of labour intensive industries, comparatively lower land prices, availability of space and accommodation, lower costs of living, development of different modes of commutation and communication. Further growth of population in the Kolkata Megacity area is accomplished by rural to urban migration from vulnerable areas of Sundarban. Thus in spite of the declining population in Kolkata city, Kolkata megacity is emerging as a 'major setting of human habitation' in a 21st century world stressed by climate change.

Outcomes of Cataract Surgery in Urban and Rural Population in the South Indian State of Andhra Pradesh: Rapid Assessment of Visual Impairment (RAVI) Project.

PubMed

Marmamula, Srinivas; Khanna, Rohit C; Shekhar, Konegari; Rao, Gullapalli N

2016-01-01

To assess the visual outcomes after cataract surgery among urban and rural population aged ≥40 years in the South India state of Andhra Pradesh. A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and one urban location. Visual Acuity was assessed and eye examination were performed by trained personnel. A questionnaire was used to collect personal and demographic information, and history of cataract surgery. Blindness and moderate Visual Impairment (MVI) was defined as presenting VA <6/60 and <6/18 to 6/60 in the better eye respectively. In total, 7378 (94.6%) were examined. Of these, 1228 eyes of 870 individuals were operated for cataract. The mean age of operated subjects was 63.7 years (SD: 10.7 years). Overall, 56.3% of those operated were women, 76% were illiterate and 42% of them were using spectacles after cataract surgery. Even after surgery, 12.2% of the operated eyes had MVI and blindness was seen in 14.7% of the eyes. A significantly higher proportion of subjects in urban area had good outcome as compared to those in the rural area (p = 0.01). Uncorrected refractive error (58.7%) was the leading cause of MVI, and posterior segment disease (34.3%) was the leading cause of blindness. On applying multiple logistic regression, risk factors for poor outcomes were age ≥ 70 years (OR: 1.9, 95% CI: 1.3-2.8), rural residence (OR: 1.3, 95% CI:1.0-1.8) and presence of aphakia (OR: 8.9, 95% CI: 5.7-13.8). Post cataract surgery, refractive errors remain an important correctable cause of MVI, in the south Indian state of Andhra Pradesh. The correction of refractive errors is required to provide good visual recovery and achieve the benefit of cataract surgery.

Measurement of overweight and obesity an urban slum setting in sub-Saharan Africa: a comparison of four anthropometric indices.

PubMed

Haregu, Tilahun Nigatu; Oti, Samuel; Egondi, Thaddaeus; Kyobutungi, Catherine

2016-01-01

As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Accordingly, globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting. Data from a cardiovascular disease risk factor assessment study in urban slums of Nairobi were analyzed. In the major study, data were collected from 5190 study participants. We considered four anthropometric markers of overweight and obesity: Body Mass Index, Waist Circumference, Waist to Hip Ratio, and Waist to Height Ratio. Pairwise correlations and kappa statistics were used to assess the relationship and agreement among these markers, respectively. Discordances between the indices were also analyzed. The weighted prevalence of above normal body composition was 21.6 % by body mass index, 28.9 % by waist circumference, 45.5 % by waist to hip ratio, and 38.9 % by waist to height ratio. The overall inter-index correlation was +0.44. Waist to hip ratio generally had lower correlation with the other anthropometric indices. High level of discordance exists between body mass index and waist to hip ratio. Combining the four indices shows that 791 (16.1 %) respondents had above normal body composition in all four indices. Waist circumference better predicted hypertension and hyperglycemia while waist to height ratio better predicted hypercholesterolemia. There exists a moderate level of correlation and a remarkable level of discordance among the four anthropometric indices with regard to the ascertainment of abnormal body composition in an urban slum setting in Africa. Waist circumference is a better predictor of cardio-metabolic risk.

Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

PubMed Central

Sabbah, Ibtissam; Drouby, Nabil; Sabbah, Sanaa; Retel-Rude, Nathalie; Mercier, Mariette

2003-01-01

Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL. PMID:12952543

St. Louis Encephalitis virus mosquito vectors dynamics in three different environments in relation to remotely sensed environmental conditions.

PubMed

Batallán, Gonzalo P; Estallo, Elizabet L; Flores, Fernando S; Sartor, Paolo; Contigiani, Marta S; Almirón, Walter R

2015-06-01

In Argentina the St. Louis Encephalitis virus (SLEV) is an endemic and widely distributed pathogen transmitted by the cosmopolitan mosquito Culex quinquefasciatus. During two outbreaks in Córdoba city, in 2005 and 2010, Culex interfor was also found infected, but its role as vector of SLEV is poorly known. This mosquito species is distributed from central Argentina to southern Brazil. The primary aim of this study was to analyze the population dynamic of Cx. interfor and Cx. quinquefasciatus in three different environments (urban, suburban and non-urban) in relation to remotely sensed environmental data for vegetation (NDVI and NDWI) and temperature (brightness temperature). Cx. quinquefasciatus and Cx. interfor were found at the three sampled sites, being both the most abundant Culex species, with peaks in early and midsummer. Temporal distribution patterns of both mosquito species were highly correlated in a non-urban area of high SLEV risk transmission. Cx. quinquefasciatus and Cx. interfor were associated with the most urbanized site and the non-urban environment, respectively; high significant correlations were detected between vegetation indices and abundance of both mosquito species confirming these associations. These data provide a foundation for building density maps of these two SLEV mosquito vectors using remotely sensed data to help inform vector control programs. Copyright © 2015 Elsevier B.V. All rights reserved.

Socio-economic, environmental and nutritional characteristics of urban and rural South Indian women in early pregnancy: findings from the South Asian Birth Cohort (START).

PubMed

Dwarkanath, Pratibha; Vasudevan, Anil; Thomas, Tinku; Anand, Sonia S; Desai, Dipika; Gupta, Milan; Menezes, Gladys; Kurpad, Anura V; Srinivasan, Krishnamachari

2018-06-01

High frequency of low birth weight (LBW) is observed in rural compared with urban Indian women. Since maternal BMI is known to be associated with pregnancy outcomes, the present study aimed to investigate factors associated with BMI in early pregnancy of urban and rural South Indian women. Prospective observational cohort. A hospital-based study conducted at an urban and a rural health centre in Karnataka State. Pregnant women (n 843) aged 18-40 years recruited in early pregnancy from whom detailed sociodemographic, environmental, anthropometric and dietary intake information was collected. A high proportion of low BMI (32 v. 26 %, P<0·000) and anaemia (48 v. 23 %, P<0·000) was observed in the rural v. the urban cohort. Rural women were younger, had lower body weight, tended to be shorter and less educated. They lived in poor housing conditions, had less access to piped water and good sanitation, used unrefined fuel for cooking and had lower standard of living score. The age (β=0·21, 95 % CI 0·14, 0·29), education level of their spouse (β=1·36, 95 % CI 0·71, 2·71) and fat intake (β=1·24, 95 % CI 0·20, 2·28) were positively associated with BMI in urban women. Our findings indicate that risk factors associated with BMI in early pregnancy are different in rural and urban settings. It is important to study population-specific risk factors in relation to perinatal health.

A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis

PubMed Central

Schnippel, Kathryn; Sharp, Alana

2016-01-01

Objective Identifying those infected with tuberculosis (TB) is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context. Methods We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing. Findings Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p < 0.0001, R2 = 0.133), lower mobile phone access (β1 = -0.053, p < 0.001, R2 = 0.089), lower unemployment rates (β1 = -0.020, p = 0.003, R2 = 0.048), and a lower proportion of low-income households (β1 = -0.048, p < 0.0001, R2 = 0.084). Municipalities with more low-income households also have marginally higher TB testing rates, however, this association is not statistically significant (β1 = -0.025, p = 0.676, R2 = 0.001). There is no relationship between TB prevalence and the proportion of informal settlement households (β1 = 0.021, p = 0.136, R2 = 0.014). Conclusions These analyses reveal that the set of characteristics identified by the Global Plan as defining key populations do not adequately predict populations with high TB burden. For example, we find that higher TB prevalence is correlated with more urbanized municipalities but not with informal settlements. We highlight several factors that are counter-intuitively those most associated with high TB burdens and which should therefore play a large role in any effective targeting strategy. Targeting active case finding to key populations at higher risk of infection or poor clinical outcomes may prove more cost effective than broad efforts. However, these results should increase caution in current targeting of active case finding interventions. PMID:27732606

A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis.

PubMed

McLaren, Zoë M; Schnippel, Kathryn; Sharp, Alana

2016-01-01

Identifying those infected with tuberculosis (TB) is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context. We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing. Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p < 0.0001, R2 = 0.133), lower mobile phone access (β1 = -0.053, p < 0.001, R2 = 0.089), lower unemployment rates (β1 = -0.020, p = 0.003, R2 = 0.048), and a lower proportion of low-income households (β1 = -0.048, p < 0.0001, R2 = 0.084). Municipalities with more low-income households also have marginally higher TB testing rates, however, this association is not statistically significant (β1 = -0.025, p = 0.676, R2 = 0.001). There is no relationship between TB prevalence and the proportion of informal settlement households (β1 = 0.021, p = 0.136, R2 = 0.014). These analyses reveal that the set of characteristics identified by the Global Plan as defining key populations do not adequately predict populations with high TB burden. For example, we find that higher TB prevalence is correlated with more urbanized municipalities but not with informal settlements. We highlight several factors that are counter-intuitively those most associated with high TB burdens and which should therefore play a large role in any effective targeting strategy. Targeting active case finding to key populations at higher risk of infection or poor clinical outcomes may prove more cost effective than broad efforts. However, these results should increase caution in current targeting of active case finding interventions.

Implications of rural-urban migration for conservation of the Atlantic Forest and urban growth in Misiones, Argentina (1970-2030).

PubMed

Izquierdo, Andrea E; Grau, Héctor R; Aide, T Mitchell

2011-05-01

Global trends of increasing rural-urban migration and population urbanization could provide opportunities for nature conservation, particularly in regions where deforestation is driven by subsistence agriculture. We analyzed the role of rural population as a driver of deforestation and its contribution to urban population growth from 1970 to the present in the Atlantic Forest of Argentina, a global conservation priority. We created future land-use-cover scenarios based on human demographic parameters and the relationship between rural population and land-cover change between 1970 and 2006. In 2006, native forest covered 50% of the province, but by 2030 all scenarios predicted a decrease that ranged from 18 to 39% forest cover. Between 1970 and 2001, rural migrants represented 20% of urban population growth and are expected to represent less than 10% by 2030. This modeling approach shows how rural-urban migration and land-use planning can favor nature conservation with little impact on urban areas.

Creating a Global Building Inventory for Earthquake Loss Assessment and Risk Management

USGS Publications Warehouse

Jaiswal, Kishor; Wald, David J.

2008-01-01

Earthquakes have claimed approximately 8 million lives over the last 2,000 years (Dunbar, Lockridge and others, 1992) and fatality rates are likely to continue to rise with increased population and urbanizations of global settlements especially in developing countries. More than 75% of earthquake-related human casualties are caused by the collapse of buildings or structures (Coburn and Spence, 2002). It is disheartening to note that large fractions of the world's population still reside in informal, poorly-constructed & non-engineered dwellings which have high susceptibility to collapse during earthquakes. Moreover, with increasing urbanization half of world's population now lives in urban areas (United Nations, 2001), and half of these urban centers are located in earthquake-prone regions (Bilham, 2004). The poor performance of most building stocks during earthquakes remains a primary societal concern. However, despite this dark history and bleaker future trends, there are no comprehensive global building inventories of sufficient quality and coverage to adequately address and characterize future earthquake losses. Such an inventory is vital both for earthquake loss mitigation and for earthquake disaster response purposes. While the latter purpose is the motivation of this work, we hope that the global building inventory database described herein will find widespread use for other mitigation efforts as well. For a real-time earthquake impact alert system, such as U.S. Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER), (Wald, Earle and others, 2006), we seek to rapidly evaluate potential casualties associated with earthquake ground shaking for any region of the world. The casualty estimation is based primarily on (1) rapid estimation of the ground shaking hazard, (2) aggregating the population exposure within different building types, and (3) estimating the casualties from the collapse of vulnerable buildings. Thus, the contribution of building stock, its relative vulnerability, and distribution are vital components for determining the extent of casualties during an earthquake. It is evident from large deadly historical earthquakes that the distribution of vulnerable structures and their occupancy level during an earthquake control the severity of human losses. For example, though the number of strong earthquakes in California is comparable to that of Iran, the total earthquake-related casualties in California during the last 100 years are dramatically lower than the casualties from several individual Iranian earthquakes. The relatively low casualties count in California is attributed mainly to the fact that more than 90 percent of the building stock in California is made of wood and is designed to withstand moderate to large earthquakes (Kircher, Seligson and others, 2006). In contrast, the 80 percent adobe and or non-engineered masonry building stock with poor lateral load resisting systems in Iran succumbs even for moderate levels of ground shaking. Consequently, the heavy death toll for the 2003 Bam, Iran earthquake, which claimed 31,828 lives (Ghafory-Ashtiany and Mousavi, 2005), is directly attributable to such poorly resistant construction, and future events will produce comparable losses unless practices change. Similarly, multistory, precast-concrete framed buildings caused heavy casualties in the 1988 Spitak, Armenia earthquake (Bertero, 1989); weaker masonry and reinforced-concrete framed construction designed for gravity loads with soft first stories dominated losses in the Bhuj, India earthquake of 2001 (Madabhushi and Haigh, 2005); and adobe and weak masonry dwellings in Peru controlled the death toll in the Peru earthquake of 2007 (Taucer, J. and others, 2007). Spence (2007) after conducting a brief survey of most lethal earthquakes since 1960 found that building collapses remains a major cause of earthquake mortality and unreinforced masonry buildings are one of the mos

City-Dwellers and Country Folks: Lack of Population Differentiation Along an Urban-Rural Gradient in the Mosquito Culex pipiens (Diptera: Culicidae).

PubMed

Honnen, Ann-Christin; Monaghan, Michael T; Sharakhov, Igor

2017-09-01

Mosquitoes (Diptera, Culicidae) occur in natural, urban, and peri-urban areas throughout the globe. Although the characteristics of urban and peri-urban habitats differ from those of natural habitats in many ways (e.g., fragmentation, pollution, noise, and light), few studies have examined the population connectivity of mosquitoes in urban areas. To obtain an overview of the species composition, we sampled mosquitoes from 23 sites in and around the city of Berlin, Germany. Of 23 species, five occurred in urban, 10 in peri-urban, and 20 in rural areas. Culex pipiens Linnaeus (Diptera: Culicidae) was the most common species collected (75% of all individuals) and occurred in all habitats. Hence this species was selected to be analysed at 10 microsatellite markers. There was no significant differentiation (FST = 0.016, P = 0.9) or isolation by distance (P = 0.06) among Cx. pipiens populations along an urban-rural gradient. The only significant differences detected were between Cx. pipiens and a laboratory population of Cx. pipiens f. molestus (pairwise FST = 0.114-0.148, P ≤ 0.001 in all comparisons), suggesting that the markers chosen were suitable for the identification of population differentiation. Our results indicate that Cx. pipiens gene flow is widespread within and among urban, peri-urban, and rural areas and that urban habitat does not necessarily impede or enhance gene flow among these populations. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study.

PubMed

Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Shakil; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M

2016-08-22

Availability of Emergency Obstetric Care (EmOC) is crucial to avert maternal death due to life-threatening complications potentially arising during delivery. Research on the determinants of utilization of EmOC has neglected urban settings, where traffic congestion can pose a significant barrier to the access of EmOC facilities, particularly for the urban poor due to costly and limited transportation options. This study investigates the impact of travel time to EmOC facilities on the utilization of facility-based delivery services among mothers living in urban poor settlements in Sylhet, Bangladesh. A cross-sectional EmOC health-seeking behavior survey from 39 poor urban clusters was geo-spatially linked to a comprehensive geo-referenced dataset of EmOC facility locations. Geo-spatial techniques and logistic regression were then applied to quantify the impact of travel time on place of delivery (EmOC facility or home), while controlling for confounding socio-cultural and economic factors. Increasing travel time to the nearest EmOC facility is found to act as a strong deterrent to seeking care for the urban poor in Sylhet. Logistic regression results indicate that a 5-min increase in travel time to the nearest EmOC facility is associated with a 30 % decrease (0.655 odds ratio, 95 % CI: 0.529-0.811) in the likelihood of delivery at an EmOC facility rather than at home. Moreover, the impact of travel time varies substantially between public, NGO and private facilities. A 5-min increase in travel time from a private EmOC facility is associated with a 32.9 % decrease in the likelihood of delivering at a private facility, while for public and Non-Government Organizations (NGO) EmOC facilities, the impact is lower (28.2 and 28.6 % decrease respectively). Other strong determinants of delivery at an EmOC facility are the use of antenatal care and mother's formal education, while Muslim mothers are found to be more likely to deliver at home. Geospatial evidence points to the need to strengthen referral and emergency transport systems in order to reduce urban travel time, and establish or relocate EmOC facilities closer to where the poor reside. However, female education and antenatal care coverage remain the most important determinants of facility delivery.

Poverty and blindness in Pakistan: results from the Pakistan national blindness and visual impairment survey.

PubMed

Gilbert, Clare E; Shah, S P; Jadoon, M Z; Bourne, R; Dineen, B; Khan, M A; Johnson, G J; Khan, M D

2008-01-05

To explore the association between blindness and deprivation in a nationally representative sample of adults in Pakistan. Cross sectional population based survey. 221 rural and urban clusters selected randomly throughout Pakistan. Nationally representative sample of 16 507 adults aged 30 or above (95.3% response rate). Associations between visual impairment and poverty assessed by a cluster level deprivation index and a household level poverty indicator; prevalence and causes of blindness; measures of the rate of uptake and quality of eye care services. 561 blind participants (<3/60 in the better eye) were identified during the survey. Clusters in urban Sindh province were the most affluent, whereas rural areas in Balochistan were the poorest. The prevalence of blindness in adults living in affluent clusters was 2.2%, compared with 3.7% in medium clusters and 3.9% in poor clusters (P<0.001 for affluent v poor). The highest prevalence of blindness was found in rural Balochistan (5.2%). The prevalence of total blindness (bilateral no light perception) was more than three times higher in poor clusters than in affluent clusters (0.24% v 0.07%, P<0.001). The prevalences of blindness caused by cataract, glaucoma, and corneal opacity were lower in affluent clusters and households. Reflecting access to eye care services, cataract surgical coverage was higher in affluent clusters (80.6%) than in medium (76.8%) and poor areas (75.1%). Intraocular lens implantation rates were significantly lower in participants from poorer households. 10.2% of adults living in affluent clusters presented to the examination station wearing spectacles, compared with 6.7% in medium clusters and 4.4% in poor cluster areas. Spectacle coverage in affluent areas was more than double that in poor clusters (23.5% v 11.1%, P<0.001). Blindness is associated with poverty in Pakistan; lower access to eye care services was one contributory factor. To reduce blindness, strategies targeting poor people will be needed. These interventions may have an impact on deprivation in Pakistan.

Population-based intervention for cardiovascular diseases related knowledge and behaviours in Asian Indian women

PubMed Central

Pandey, Ravindra Mohan; Agrawal, Aachu; Misra, Anoop; Vikram, Naval Kishore; Misra, Puneet; Dey, Sanjit; Rao, Shobha; Vasantha Devi, K.P.; Usha Menon, V.; Revathi, R.; Sharma, Vinita; Gupta, Rajeev

2013-01-01

Background & objectives There is poor knowledge and behaviors regarding chronic diseases related nutritional and lifestyle factors among women in low income countries. To evaluate efficacy of a multilevel population-based intervention in improving knowledge and practices for related factors we performed a study in India. Methods Population based study among women 35–70 years was performed in four urban and five rural locations. Stratified sampling was performed and we enrolled 4624 (rural 2616, urban 2008) of eligible 8000 women (58%). Demographic details, medical history, diet, physical activity and anthropometry were recorded and blood hemoglobin, glucose and total cholesterol determined. Knowledge and behaviors regarding diet in chronic diseases were inquired in a randomly selected 100 women at each site (n = 900). A systematic multilevel population based intervention (using posters, handouts, street plays, public lectures, group lectures and focused group discussions) was administered over 6 months at each site. The questionnaire was re-administered at the end in random 100 women (n = 900) and differences determined. Descriptive statistics are reported. Comparison of parameters before and after intervention was assessed using Mann Whitney test. Results Prevalence (%) of chronic disease related lifestyles and risk factors in rural/urban women, respectively, was illiteracy in 63.6/29.4, smoking/tobacco use 39.3/18.9, high fat intake 93.6/93.4, high salt intake 18.2/12.6, low physical activity 59.5/70.2, overweight/obesity 22.5/45.6, truncal obesity 13.0/44.3, hypertension 31.6/48.2, hypercholesterolemia 13.5/27.7, and diabetes in 4.3/15.1 percent. Composite chronic diseases knowledge at baseline vs after intervention increased significantly in overall (32.0 vs 62.0), rural (29.0 vs 63.5) and urban (39.5 vs 60.5) groups (p < 0.001). Significant increase in knowledge regarding diet in hypertension, diabetes, heart disease and anemia as well as importance of dietary proteins, fats, fibres and fruits was observed (p < 0.001). There was insignificant change in most of the practices regarding intake of low fat, high protein, high fibre diet except sieving the flour which declined significantly (80.1 vs 53.6, p < 0.001). Conclusions A short-term multilevel population-wide intervention among women in rural and urban locations in India increased chronic disease knowledge but failed to influence practices. PMID:23438611

Population-based intervention for cardiovascular diseases related knowledge and behaviours in Asian Indian women.

PubMed

Pandey, Ravindra Mohan; Agrawal, Aachu; Misra, Anoop; Vikram, Naval Kishore; Misra, Puneet; Dey, Sanjit; Rao, Shobha; Vasantha Devi, K P; Usha Menon, V; Revathi, R; Sharma, Vinita; Gupta, Rajeev

2013-01-01

There is poor knowledge and behaviors regarding chronic diseases related nutritional and lifestyle factors among women in low income countries. To evaluate efficacy of a multilevel population-based intervention in improving knowledge and practices for related factors we performed a study in India. Population based study among women 35-70 years was performed in four urban and five rural locations. Stratified sampling was performed and we enrolled 4624 (rural 2616, urban 2008) of eligible 8000 women (58%). Demographic details, medical history, diet, physical activity and anthropometry were recorded and blood hemoglobin, glucose and total cholesterol determined. Knowledge and behaviors regarding diet in chronic diseases were inquired in a randomly selected 100 women at each site (n = 900). A systematic multilevel population based intervention (using posters, handouts, street plays, public lectures, group lectures and focused group discussions) was administered over 6 months at each site. The questionnaire was re-administered at the end in random 100 women (n = 900) and differences determined. Descriptive statistics are reported. Comparison of parameters before and after intervention was assessed using Mann Whitney test. Prevalence (%) of chronic disease related lifestyles and risk factors in rural/urban women, respectively, was illiteracy in 63.6/29.4, smoking/tobacco use 39.3/18.9, high fat intake 93.6/93.4, high salt intake 18.2/12.6, low physical activity 59.5/70.2, overweight/obesity 22.5/45.6, truncal obesity 13.0/44.3, hypertension 31.6/48.2, hypercholesterolemia 13.5/27.7, and diabetes in 4.3/15.1 percent. Composite chronic diseases knowledge at baseline vs after intervention increased significantly in overall (32.0 vs 62.0), rural (29.0 vs 63.5) and urban (39.5 vs 60.5) groups (p < 0.001). Significant increase in knowledge regarding diet in hypertension, diabetes, heart disease and anemia as well as importance of dietary proteins, fats, fibres and fruits was observed (p < 0.001). There was insignificant change in most of the practices regarding intake of low fat, high protein, high fibre diet except sieving the flour which declined significantly (80.1 vs 53.6, p < 0.001). A short-term multilevel population-wide intervention among women in rural and urban locations in India increased chronic disease knowledge but failed to influence practices. Copyright © 2013. Published by Elsevier B.V.

Impacts of urbanization on stream water quantity and quality in the United States

Treesearch

Ge Sun; Peter Caldwell

2015-01-01

Since the 1950s, the world’s urban population has grown more than 400% to 3.9 billion today. About 60% of the total population is expected to live in urban areas by the year 2025. For the United States (U.S.), 80% of the population lives in urban areas. The Earth has entered into the Anthropocene, a new geological epoch dominated by urbanization and people.

Low genetic variability, female-biased dispersal and high movement rates in an urban population of Eurasian badgers Meles meles.

PubMed

Reeve, John D; Frantz, Alain C; Dawson, Deborah A; Burke, Terry; Roper, Timothy J

2008-09-01

1. Urban and rural populations of animals can differ in their behaviour, both in order to meet their ecological requirements and due to the constraints imposed by different environments. The study of urban populations can therefore offer useful insights into the behavioural flexibility of a species as a whole, as well as indicating how the species in question adapts to a specifically urban environment. 2. The genetic structure of a population can provide information about social structure and movement patterns that is difficult to obtain by other means. Using non-invasively collected hair samples, we estimated the population size of Eurasian badgers Meles meles in the city of Brighton, England, and calculated population-specific parameters of genetic variability and sex-specific rates of outbreeding and dispersal. 3. Population density was high in the context of badger densities reported throughout their range. This was due to a high density of social groups rather than large numbers of individuals per group. 4. The allelic richness of the population was low compared with other British populations. However, the rate of extra-group paternity and the relatively frequent (mainly temporary) intergroup movements suggest that, on a local scale, the population was outbred. Although members of both sexes visited other groups, there was a trend for more females to make intergroup movements. 5. The results reveal that urban badgers can achieve high densities and suggest that while some population parameters are similar between urban and rural populations, the frequency of intergroup movements is higher among urban badgers. In a wider context, these results demonstrate the ability of non-invasive genetic sampling to provide information about the population density, social structure and behaviour of urban wildlife.

Financial Burden and Impoverishment Due to Cardiovascular Medications in Low and Middle Income Countries: An Illustration from India.

PubMed

Pandey, Kiran Raj; Meltzer, David O

2016-01-01

Health expenditures are a major financial burden for many persons in low and middle-income countries, where individuals often lack health insurance. We estimate the effect of purchasing cardiovascular medicines on poverty in low and middle-income populations using rural and urban India as an example. We created step-up treatment regimens for prevention of ischemic heart disease for the most common cardiovascular medications in India based on their cost and relative risk reduction. Cost was measured by Government of India mandated ceiling prices in rupees (Rs. 1 = $0·016) for essential medicines plus taxes. We calculated step-wise projected incidence and intensity of impoverishment due to medicine purchase. To do this we measured the resources available to individuals as daily per-capita expenditures from the latest National Sample Survey, subtracted daily medication costs, and compared this to 2014 poverty thresholds recommended by an expert group. Analysis of cost-effectiveness resulted in five primary prevention drug regimens, created by progressive addition of Aspirin 75 mg, Hydrochlorothiazide 12.5mg, Losartan 25 mg, and Atorvastatin 10 mg or 40mg. Daily cost from steps 1 to 5 increased from Rs. 0·13, Rs. 1.16, Rs. 3.81, Rs. 10.07, to Rs. 28.85. At baseline, 31% of rural and 27% percent of urban Indian population are poor at the designated poverty thresholds. The Rs. 28.85 regimen would be unaffordable to 81% and 58% of rural and urban people. A secondary prevention regimen with aspirin, hydrochlorothiazide, atenolol and atorvastatin could be unaffordable to 81% and 57% rural and urban people respectively. According to our estimates, 17% of the rural 32% of the urban adult population could benefit with these medications, and their out of pocket purchase could impoverish 17 million rural and 10 million urban people in India and increase respective poverty gaps by 2.9%. Medication costs for cardiovascular disease have the potential to cause financial burden to a significant proportion of people in India. These costs increase the likelihood that patients will forego needed treatment and emphasize the need for programs to reduce the costs of medications for cardiovascular patients in India, including by expansion of prescription drug coverage.

Financial Burden and Impoverishment Due to Cardiovascular Medications in Low and Middle Income Countries: An Illustration from India

PubMed Central

Pandey, Kiran Raj; Meltzer, David O.

2016-01-01

Background Health expenditures are a major financial burden for many persons in low and middle-income countries, where individuals often lack health insurance. We estimate the effect of purchasing cardiovascular medicines on poverty in low and middle-income populations using rural and urban India as an example. Methods We created step-up treatment regimens for prevention of ischemic heart disease for the most common cardiovascular medications in India based on their cost and relative risk reduction. Cost was measured by Government of India mandated ceiling prices in rupees (Rs. 1 = $0·016) for essential medicines plus taxes. We calculated step-wise projected incidence and intensity of impoverishment due to medicine purchase. To do this we measured the resources available to individuals as daily per-capita expenditures from the latest National Sample Survey, subtracted daily medication costs, and compared this to 2014 poverty thresholds recommended by an expert group. Findings Analysis of cost-effectiveness resulted in five primary prevention drug regimens, created by progressive addition of Aspirin 75 mg, Hydrochlorothiazide 12.5mg, Losartan 25 mg, and Atorvastatin 10 mg or 40mg. Daily cost from steps 1 to 5 increased from Rs. 0·13, Rs. 1.16, Rs. 3.81, Rs. 10.07, to Rs. 28.85. At baseline, 31% of rural and 27% percent of urban Indian population are poor at the designated poverty thresholds. The Rs. 28.85 regimen would be unaffordable to 81% and 58% of rural and urban people. A secondary prevention regimen with aspirin, hydrochlorothiazide, atenolol and atorvastatin could be unaffordable to 81% and 57% rural and urban people respectively. According to our estimates, 17% of the rural 32% of the urban adult population could benefit with these medications, and their out of pocket purchase could impoverish 17 million rural and 10 million urban people in India and increase respective poverty gaps by 2.9%. Conclusion Medication costs for cardiovascular disease have the potential to cause financial burden to a significant proportion of people in India. These costs increase the likelihood that patients will forego needed treatment and emphasize the need for programs to reduce the costs of medications for cardiovascular patients in India, including by expansion of prescription drug coverage. PMID:27159055

Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009.

PubMed

Singh, Gopal K; Siahpush, Mohammad

2014-04-01

This study examined trends in rural-urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural-urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural-urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005-2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005-2009 than in 1990-1992. Causes of death contributing most to the increasing rural-urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer's disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.

Sleep patterns and predictors of disturbed sleep in a large population of college students.

PubMed

Lund, Hannah G; Reider, Brian D; Whiting, Annie B; Prichard, J Roxanne

2010-02-01

To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents. One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use. Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality. These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.

The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana.

PubMed

Dake, Fidelia A A; Thompson, Amanda L; Ng, Shu Wen; Agyei-Mensah, Samuel; Codjoe, Samuel N A

2016-06-01

Obesity in the sub-Saharan Africa region has been portrayed as a problem of affluence, partly because obesity has been found to be more common in urban areas and among the rich. Recent findings, however, reveal rising prevalence among the poor particularly the urban poor. A growing body of literature mostly in Western countries shows that obesity among the poor is partly the result of an obesogenic-built environment. Such studies are lacking in the African context. This study examines the characteristics of the local food environment in an urban poor setting in Accra, Ghana and further investigates the associated risk of obesity for residents. Data on the local food environment was collected using geographic positioning system (GPS) technology. The body mass indices (BMI) of females (15-49 years) and males (15-59 years) were calculated from measured weight and height. Data on the socio-demographic characteristics and lifestyle behaviors of respondents was also collected through a household survey. Spatial analysis tools were used to examine the characteristics of the local food environment while the influence of the food environment on BMI was examined using a two-level multilevel model. The measures of the food environment constituted the level 2 factors while individual socio-demographic characteristics and lifestyle behaviors constituted the level 1 factors. The local food environment in the study communities is suggestive of an obesogenic food environment characterized by an abundance of out-of-home cooked foods, convenience stores, and limited fruits and vegetables options. The results of the multilevel analysis reveal a 0.2 kg/m(2) increase in BMI for every additional convenience store and a 0.1 kg/m(2) reduction in BMI for every out-of-home cooked food place available in the study area after controlling for individual socio-demographic characteristics, lifestyle behaviors, and community characteristics. The findings of this study indicate that the local food environment in urban poor Accra is associated with increased risk of obesity through providing access to convenience stores. In order to reduce the risk of obesity in these urban poor communities, there is the need to regulate the availability of and access to convenience stores while also encouraging healthier offerings in convenience stores.

Urban habitat fragmentation and genetic population structure of bobcats in coastal southern California

USGS Publications Warehouse

Ruell, E.W.; Riley, S.P.D.; Douglas, M.R.; Antolin, M.F.; Pollinger, J.R.; Tracey, J.A.; Lyren, L.M.; Boydston, E.E.; Fisher, R.N.; Crooks, K.R.

2012-01-01

Although habitat fragmentation is recognized as a primary threat to biodiversity, the effects of urban development on genetic population structure vary among species and landscapes and are not yet well understood. Here we use non-invasive genetic sampling to compare the effects of fragmentation by major roads and urban development on levels of dispersal, genetic diversity, and relatedness between paired bobcat populations in replicate landscapes in coastal southern California. We hypothesized that bobcat populations in sites surrounded by urbanization would experience reduced functional connectivity relative to less isolated nearby populations. Our results show that bobcat genetic population structure is affected by roads and development but not always as predicted by the degree that these landscape features surround fragments. Instead, we suggest that urban development may affect functional connectivity between bobcat populations more by limiting the number and genetic diversity of source populations of migrants than by creating impermeable barriers to dispersal.

Access to Health Services Among Slum Dwellers in an Industrial Township and Surrounding Rural Areas: A Rapid Epidemiological Assessment

PubMed Central

Banerjee, Amitav; Bhawalkar, J.S.; Jadhav, S.L.; Rathod, Hetal; Khedkar, D.T.

2012-01-01

Context: The biggest challenge in implementing the primary health care principles is of equitable distribution of health care to all. The rural masses and urban slum dwellers are most vulnerable to lack of access to health care. Aim: To study access to health services among slum dwellers and rural population. Setting and Design: A cross-sectional survey in an urban slum and surrounding rural areas in field practice area of a medical college. Materials and Methods: Structured instrument along with qualitative techniques such as focus group discussions, were used to collect information on access and utilization of health services from 865 individuals of both sexes and all ages selected from urban slums, villages, and indoor and outdoor patients. Access to basic determinants of good health such as housing, water, and sanitation was also elicited. Besides, health needs based on self-reported disease conditions were compiled. Results: More than 50% of respondents were living in poor housing and insanitary conditions. Besides the burden of communicable diseases and malnutrition (especially in children), risk of lifestyle diseases as evidenced by high Body mass index in 25% of adults surveyed was found. Private medical practitioners were more accessible than government facilities. More than 60% sought treatment from private medical facilities for their own ailments (for sickness in children this proportion was 74%). People who visited government facilities were more dissatisfied with the services (30.88%) than those who visited private facilities (18.31%). This difference was significant (OR=1.99, 95% confidence interval 1.40 to 2.88; χ2 =15.95, df=1, P=0.007). The main barriers to health care identified were waiting time long, affordability, poor quality of care, distance, and attitude of health workers. Conclusion: The underprivileged in India continue to have poor access to basic determinants of good health as well as to curative services from government sources during illness. PMID:24478995

Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

2016-12-01

The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India.

PubMed

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-07-01

In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively-with a focus, for example, on rural areas and urban slum areas-in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated.

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India

PubMed Central

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-01-01

Background In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. Methods A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Results Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. Conclusions In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively—with a focus, for example, on rural areas and urban slum areas—in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated. PMID:21653545

Urban forest justice and the rights to wild foods, medicines, and materials in the city

Treesearch

Melissa R. Poe; Rebecca J. McClain; Marla Emery; Patrick Hurley

2013-01-01

Urban forests are multifunctional socio-ecological landscapes, yet some of their social benefits remain poorly understood. This paper draws on ethnographic evidence from Seattle, Washington to demonstrate that urban forests contain nontimber forest products that contribute a variety of wild foods, medicines, and materials for the wellbeing of urban residents. We show...

Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.

PubMed

McNeil, Daniel W; Hayes, Sarah E; Randall, Cameron L; Polk, Deborah E; Neiswanger, Kathy; Shaffer, John R; Weyant, Robert J; Foxman, Betsy; Kao, Elizabeth; Crout, Richard J; Chapman, Stella; Brown, Linda J; Maurer, Jennifer L; Marazita, Mary L

2016-01-01

Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers. © The Author(s) 2015.

Fusing terrain and goals: agent control in urban environments

NASA Astrophysics Data System (ADS)

Kaptan, Varol; Gelenbe, Erol

2006-04-01

The changing face of contemporary military conflicts has forced a major shift of focus in tactical planning and evaluation from the classical Cold War battlefield to an asymmetric guerrilla-type warfare in densely populated urban areas. The new arena of conflict presents unique operational difficulties due to factors like complex mobility restrictions and the necessity to preserve civilian lives and infrastructure. In this paper we present a novel method for autonomous agent control in an urban environment. Our approach is based on fusing terrain information and agent goals for the purpose of transforming the problem of navigation in a complex environment with many obstacles into the easier problem of navigation in a virtual obstacle-free space. The main advantage of our approach is its ability to act as an adapter layer for a number of efficient agent control techniques which normally show poor performance when applied to an environment with many complex obstacles. Because of the very low computational and space complexity at runtime, our method is also particularly well suited for simulation or control of a huge number of agents (military as well as civilian) in a complex urban environment where traditional path-planning may be too expensive or where a just-in-time decision with hard real-time constraints is required.

Trace element content and molecular biodiversity in the epiphytic moss Leptodon smithii: two independent tracers of human disturbance.

PubMed

Spagnuolo, Valeria; Terracciano, Stefano; Giordano, Simonetta

2009-03-01

This paper focuses on chemical composition of the epiphytic moss Leptodon smithii, gathered on Quercus ilex bark, assessed in seven sites located in urban and extra-urban/remote areas of southern Italy, a poorly surveyed geographic area. The concentrations of Cr, Cu, Pb and Zn in moss tissue are generally more abundant in moss gathered in the urban sites; among extra-urban/remote sites Valle delle Ferriere showed the highest metal concentrations, mostly related to an industrial activity occurred in the past. L. smithii chemistry seems influenced by airborne dust locally enhanced by erosion phenomena, long-range transport of pollutants and marine aerosols. Element content in moss is compared with genetic variability of L. smithii estimated in the same sites. Pearson's correlation coefficient between gene diversity and total element load (r=-0.851; p=0.03) suggests that anthropogenic pressure, determining habitat disturbance and fragmentation, leads both to genetic impoverishment consequent to population shrink, and to a higher accumulation in moss tissues, as a consequence of increased airborne major/trace elements. Thus, the coupled evaluation of chemical composition in mosses and gene diversity may prove a useful tool to highlight environmental disturbance in a gradient of land use.

Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya

PubMed Central

Noor, A. M.; Zurovac, D.; Hay, S. I.; Ochola, S. A.; Snow, R. W.

2010-01-01

Summary Distance is a crucial feature of health service use and yet its application and utility to health care planning have not been well explored, particularly in the light of large-scale international and national efforts such as Roll Back Malaria. We have developed a high-resolution map of population-to-service access in four districts of Kenya. Theoretical physical access, based upon national targets, developed as part of the Kenyan health sector reform agenda, was compared with actual health service usage data among 1668 paediatric patients attending 81 sampled government health facilities. Actual and theoretical use were highly correlated. Patients in the larger districts of Kwale and Makueni, where access to government health facilities was relatively poor, travelled greater mean distances than those in Greater Kisii and Bondo. More than 60% of the patients in the four districts attended health facilities within a 5-km range. Interpolated physical access surfaces across districts highlighted areas of poor access and large differences between urban and rural settings. Users from rural communities travelled greater distances to health facilities than those in urban communities. The implications of planning and monitoring equitable delivery of clinical services at national and international levels are discussed. PMID:14516303

Spatial Equity in Trans Jogja Performance in the Yogyakarta Urbanized Area (YUA)

NASA Astrophysics Data System (ADS)

Ramadhani, D. P.; Herwangi, Y.

2018-05-01

The availability of facilities and supporting infrastructure in a region is an absolutely necessity. Public transportation is important in accommodating the movement of low-income groups or captive users who have limited mobility options. However, most of the low-income people in the Yogyakarta Urbanized Area (YUA) currently prefer to use motorcycles rather than Trans Jogja. This is expected to be caused by the poor quality of public transport and the lack of equity in Trans Jogja services. This research focuses on transport equity by overlaying the effectiveness of Trans Jogja as the public transportation and the distribution of low-income communities per sub-district in the YUA. This study found that the performance of Trans Jogja based on the indicators of affordability, availability, accessibility, and acceptability is already effective. However, in the agglomeration of Sleman and Bantul Regency, the affordability aspect is still less effective. Meanwhile, the appraisal of the public transport equity found that there are some areas that are fair, with a large low-income population and effective performance of Trans Jogja. Some other areas are considered unfair because the low-income population is high but the performance of Trans Jogja is less effective.

Determinants of childhood mortality in slums of Karachi, Pakistan.

PubMed

D'souza, R M; Bryant, J H

1999-01-01

Pakistan has an infant mortality rate (IMR) of 90.5/1000 live births, and the country's child mortality level of 117.5 is worse than in other South Asian countries. Rapid population growth combined with rural-to-urban migration has led to the creation of urban slums in which morbidity levels are usually higher than in rural populations. A study was conducted in January 1993 in 6 slums of Karachi where the Aga Khan University has operated primary health care programs since 1985. Researchers recorded the deaths of 347 children under age 5 years old due to diarrhea and acute respiratory infections (ARI) during 1989-93. 235 mothers of these children were interviewed. The following are discussed as risk factors for under-5 child mortality: the use of traditional healers, poor nutritional status, incomplete or no immunization, the quick change of healers, inappropriate child care arrangements, mother's literacy, who decides about outside treatment, short birth interval, bottle feeding, and nuclear family structure. Maternal autonomy, appropriate health-seeking behavior, and child-rearing processes identified in the study point to the need for intervention strategies which go beyond the usual primary health care initiatives and involve communities in developing social support systems for mothers.

Policies for friendly cities: the need for a new approach by governments and the donor community

NASA Astrophysics Data System (ADS)

Puccioni, V.

2018-03-01

Since the 1990s, the major issues in the world’s cities of Developing and Emerging Economy Countries have in some few cases improved in terms of the percentage of urban population living without appropriate housing and access to essential services- but in terms of numbers such population has severely increased. The theory by which economic development would automatically produce a trickle down effect that would take care of the needs of the poor has proved ineffective, and while the middle-lower classes have seen their lot improved, the lowest income groups are more destitute then ever- and more and more vulnerable to natural disasters. The approach of Governments and the donor community needs to be radically revisited, with a new urban policy agenda that should put emphasis on support to the lowest income groups, and relying on the informal sector as the main actor in implementing such support. The impacts of Climate Change and the increased frequency and severity of natural catastrophes also call for such a revised approach. The two-step approach to interventions in disasters situations – i.e. providing temporary shelters and only subsequently reconstructing homes- is ineffective and wasteful.

Hypersomnolence and Sleep-related Complaints in Metropolitan, Urban, and Rural Georgia

PubMed Central

Decker, Michael J.; Lin, Jin-Mann S.; Tabassum, Humyra

2009-01-01

Persistent daytime hypersomnolence is associated with significant morbidity and mortality, but its prevalence in the population has been poorly documented. This study sought to characterize the prevalence of persistent daytime hypersomnolence, difficulties initiating and maintaining sleep, unrefreshing sleep, snoring, and the presence of physician-diagnosed sleep disorders in metropolitan, urban, and rural US Georgia populations. Between September 2004 and July 2005, a total of 6,530 randomly selected well and unwell adults, identified by screening interviews of 10,837 households (contacted by random digit dialing), completed a detailed phone interview. Sixteen percent reported persistent problems staying awake during the day; 26% reported persistent problems falling asleep at night; 31% experienced problems sleeping through the night; 34% were bothered by unrefreshing sleep; and 33% reported that they snored. In spite of the high occurrence of reported persistent sleep problems, only 10% of the survey participants reported having been diagnosed with a sleep disorder. These study findings highlight the need for increased public and clinician awareness with respect to proactively indentifying signs and symptoms of sleep disorders, a better understanding of their adverse impact upon morbidity and mortality, and their negative impact upon socioeconomic and academic potential. PMID:19066308

Population Genetic Effects of Urban Habitat Fragmentation in the Perennial Herb Viola pubescens (Violaceae) using ISSR Markers

PubMed Central

Culley, Theresa M.; Sbita, Sarah J.; Wick, Anne

2007-01-01

Background and Aims Fragmentation of natural habitats can negatively impact plant populations by leading to reduced genetic variation and increased genetic distance as populations become geographically and genetically isolated from one another. To test whether such detrimental effects occur within an urban landscape, the genetic structure of six populations of the perennial herb Viola pubescens was characterized in the metropolitan area of Greater Cincinnati in southwestern Ohio, USA. Methods Using three inter-simple sequence repeat (ISSR) markers, 51 loci amplified across all urban populations. For reference, four previously examined agricultural populations in central/northern Ohio and a geographically distant population in Michigan were also included in the analysis. Key Results Urban populations retained high levels of genetic variation (percentage of polymorphic loci, Pp = 80·7 %) with similar genetic distances among populations and an absence of unique alleles. Geographic and genetic distances were correlated with one another, and all populations grouped according to region. Individuals from urban populations clustered together and away from individuals from agricultural populations and from the Michigan population in a principle coordinates analysis. Hierarchical analysis of molecular variance (AMOVA) revealed that most of the genetic variability was partitioned within populations (69·1 %) and among groups (22·2 %) of southwestern Ohio, central/northern Ohio and Michigan groups. Mean Fst was 0·308, indicating substantial population differentiation. Conclusions It is concluded that urban fragmentation does not appear to impede gene flow in V. pubescens in southwestern Ohio. These results are consistent with life history traits of this species and the possibility of high insect abundance in urban habitats due to diverse floral resources and nesting sites. Combined with the cleistogamous breeding system of this species, pollinator availability in the urban matrix may buffer populations against detrimental effects of habitat fragmentation, at least in larger forest fragments. Consequently, it may be inappropriate to generalize about genetic effects of fragmentation across landscapes or even across plant species with different pollination systems. PMID:17556381

Risk Factors for Enterovirus A71 Seropositivity in Rural Indigenous Populations in West Malaysia.

PubMed

NikNadia, Nmn; Sam, I-Ching; Khaidir, Nasibah; Ngui, Romano; Lim, Yvonne A L; Goh, Xiang Ting; Choy, Seow Huey; Chan, Yoke Fun

2016-01-01

Enterovirus A71 (EV-A71), which is transmitted by the fecal-oral route, causes hand, foot and mouth disease and, rarely, severe neurological complications. In Malaysia, the indigenous rural community (Orang Asli) has a high prevalence of parasitic diseases due to poor sanitation, water supply and hygiene practices. This cross-sectional study compared the seroepidemiology of EV-A71 among rural Orang Asli and urban Kuala Lumpur populations in West Malaysia, and determined the risk factors associated with EV-A71 seropositivity in rural Orang Asli. Seropositive rates were determined by neutralization assay. EV-A71 seropositivity was strongly associated with increasing age in both populations. Rural Orang Asli children ≤12 years had significantly higher EV-A71 seropositivity rates than urban Kuala Lumpur children (95.5% vs 57.6%, P < 0.001), and also higher rates in the age groups of 1-3, 4-6 and 7-12 years. Multivariate analysis confirmed that age ≤12 years (adjusted OR 8.1, 95% CI 3.2-20.7, P < 0.001) and using untreated water (adjusted OR 6.2, 95% CI 2.3-16.6, P < 0.001) were independently associated with EV-A71 seropositivity in the Orang Asli population. Supply of clean drinking water may reduce the risk of EV-A71 infection. With significantly higher EV-A71 seropositive rates, younger rural children should be a priority target for future vaccination programs in Malaysia.

Risk Factors for Enterovirus A71 Seropositivity in Rural Indigenous Populations in West Malaysia

PubMed Central

NikNadia, NMN; Sam, I-Ching; Khaidir, Nasibah; Ngui, Romano; Lim, Yvonne A. L.; Goh, Xiang Ting; Choy, Seow Huey; Chan, Yoke Fun

2016-01-01

Enterovirus A71 (EV-A71), which is transmitted by the fecal-oral route, causes hand, foot and mouth disease and, rarely, severe neurological complications. In Malaysia, the indigenous rural community (Orang Asli) has a high prevalence of parasitic diseases due to poor sanitation, water supply and hygiene practices. This cross-sectional study compared the seroepidemiology of EV-A71 among rural Orang Asli and urban Kuala Lumpur populations in West Malaysia, and determined the risk factors associated with EV-A71 seropositivity in rural Orang Asli. Seropositive rates were determined by neutralization assay. EV-A71 seropositivity was strongly associated with increasing age in both populations. Rural Orang Asli children ≤12 years had significantly higher EV-A71 seropositivity rates than urban Kuala Lumpur children (95.5% vs 57.6%, P < 0.001), and also higher rates in the age groups of 1–3, 4–6 and 7–12 years. Multivariate analysis confirmed that age ≤12 years (adjusted OR 8.1, 95% CI 3.2–20.7, P < 0.001) and using untreated water (adjusted OR 6.2, 95% CI 2.3–16.6, P < 0.001) were independently associated with EV-A71 seropositivity in the Orang Asli population. Supply of clean drinking water may reduce the risk of EV-A71 infection. With significantly higher EV-A71 seropositive rates, younger rural children should be a priority target for future vaccination programs in Malaysia. PMID:26866912

Determinants of Persistent Anemia in Poor, Urban Pregnant Women of Chandigarh City, North India: A Mixed Method Approach.

PubMed

Diamond-Smith, Nadia G; Gupta, Madhu; Kaur, Manmeet; Kumar, Rajesh

2016-06-01

Maternal anemia continues to be a public health problem in India, despite existence of multipronged governmental programs to combat it. This study explores the determinants of persistent anemia in poor pregnant women in an urban population in Chandigarh, India. A mixed method approach was used to examine the causes of maternal anemia. Three focus group discussions with pregnant women from different socioeconomic groups and 2 with female health workers were conducted to explore their perceptions and beliefs about maternal anemia and iron folic acid (IFA) tablets in urban settings in 2009. This was followed by interviews of 120 pregnant women about their nutrition knowledge and practices. Food frequency questionnaires were used to estimate daily consumption of nutrients. Finally, a follow-up survey in health clinics explored issues of stock-outs of IFA. Sixty-five percent of respondents had hemoglobin less than 11g/dL and were anemic. Only 35% respondents obtained free IFA through public health programs. While 53% of respondents knew that they should eat green leafy vegetables, only 8% reported daily consumption of these vegetables. Focus group discussions highlighted issues around lack of food, especially for slum women, and low decision-making power in the household. Stock-outs of IFA in facilities often pushed women to purchase IFA from chemist shops. Clear gaps emerged in pregnant women's knowledge and practice regarding diet and IFA tablet use. Lack of control over decision-making due to their low status of women was also hindering IFA use and healthy eating. © The Author(s) 2016.

Peri-Urban, but Not Urban, Residence in Bolivia Is Associated with Higher Odds of Co-Occurrence of Overweight and Anemia among Young Children, and of Households with an Overweight Woman and Stunted Child.

PubMed

Jones, Andrew D; Hoey, Lesli; Blesh, Jennifer; Janda, Kathryn; Llanque, Ramiro; Aguilar, Ana María

2018-04-01

Urban populations have grown globally alongside emerging simultaneous burdens of undernutrition and obesity. Yet, how heterogeneous urban environments are associated with this nutritional double burden is poorly understood. We aimed to determine: 1) the prevalence of the nutritional double burden and its components in urban, peri-urban, and rural areas of Bolivia; and 2) the association of residence in these areas with the nutritional double burden and its components. We surveyed 3946 randomly selected households from 2 metropolitan regions of Bolivia. Census data and remotely sensed imagery were used to define urban, peri-urban, and rural districts along a transect in each region. We defined 5 nutritional double burdens: concurrent overweight and anemia among women of reproductive age (15-49 y), and children (6-59 mo), respectively; concurrent overweight and stunting among children; and households with an overweight woman and, respectively, an anemic or stunted child. Capillary hemoglobin concentrations were measured to assess anemia (women: hemoglobin <120 g/L; children: hemoglobin <110 g/L), and overweight and stunting were calculated from height, weight, and age data. In multiple logistic regression models, peri-urban, but not urban residence, was associated with higher odds of concurrent overweight and anemia among children (OR: 1.8; 95% CI; 1.0, 3.2) and of households with an overweight woman and stunted child (1.8; 1.2, 2.7). Examining the components of the double burden, peri-urban women and children, respectively, had higher odds of overweight than rural residents [women (1.5; 1.2, 1.8); children (1.5; 1.0, 2.4)], and children from peri-urban regions had higher odds of stunting (1.5; 1.1, 2.2). Peri-urban, but not urban, residence in Bolivia is associated with a higher risk of the nutritional double burden than rural areas. Understanding how heterogeneous urban environments influence nutrition outcomes could inform integrated policies that simultaneously address both undernutrition and obesity.

Urbanization in Africa since independence.

PubMed

Tarver, J D

1994-01-01

Over 185 million inhabitants were added to the urban areas of Africa between 1950 and 1990. Botswana, Lesotho, Namibia, South Africa, and Swaziland is the most highly urbanized, with 55% in 1990; while less than a quarter of Eastern Africa's population is living in urban centers. By the year 2015 more than half of Africa's population will be living in urban areas. Many parts of Africa have suffered prolonged droughts, overgrazing, locust infestations, and desertification. Millions have become refugees from natural disasters, political oppression, and rural poverty. The large exodus from Africa's rural areas has gone to cities but the large cities have attracted disproportionately large numbers of destitute migrants. Alexandria (1 million), Cairo (2.4 million) and the Witwatersrand in South Africa were the only African urban agglomerations with at least one million inhabitants in 1950. By 1990 the two Egyptian cities together had 12.7 million inhabitants and the Witwatersrand some 5 million, whereas the other 25 urban agglomerations with a million inhabitants each in 1990 had a total population of about 51 million. Lagos, Kinshasa, and Algiers ranged from 3 to 7.7 million. The capitals are the largest cities in at least 54 of the 59 countries and territories. Lagos, Nairobi, and Dar es Salaam are disproportionately larger than the next most populous cities in their countries. The 28 urban agglomerations with at least one million inhabitants had a total population of 70 million in 1990, and are projected to reach 100 million in the year 2000. Overall, Africa's urban population is projected to increase by approximately 135 million in the 1990-2000 decade (from 217 million to 352 million). About 105 million of the growth probably will occur in the smaller urban centers. The total African urban population is likely to reach one billion inhabitants within the next 50 years. It stood at 32 million in 1950. Presently, the United Nations projects 912 million urban residents (57% of the total population) by 2025.

Evidence of cryptic individual specialization in an opportunistic insectivorous bat

USGS Publications Warehouse

Cryan, Paul M.; Stricker, Craig A.; Wunder, Michael B.

2012-01-01

Habitat use and feeding behaviors of cryptic animals are often poorly understood. Analyses of stable isotope ratios in animal body tissues can help reveal an individual's location and resource use during tissue growth. We investigated variation in stable isotope ratios of 4 elements (H, C, N, and S) in the hair of a sedentary species of insectivorous bat (Eptesicus fuscus) inhabiting a chemically complex urban landscape. Our objective was to quantify population-level isotopic variation and test for evidence of resource specialization by individuals. Bats were sampled over 3 annual molt cycles at maternity roosts in buildings and variance components analysis was used to test whether intraindividual isotopic variation among molts differed from interindividual variation, after controlling for year and roost-group effects. Consistent with prior evidence that E. fuscus is opportunistic in its habitat use and foraging at the population level, we observed wide population-level variation for all isotopes. This variation likely reflects the chemical complexity of the urban landscape studied. However, isotopic variation among years within marked individuals was lower than variation among marked individuals within year for all isotopes, and carbon signatures indicated resource specialization by roost groups and individuals. This is the 1st study to examine variation in stable isotope ratios of individual wild bats over multiple years. Although our results suggest this population tends toward opportunistic habitat use or prey selection, or both, during molt periods, results also indicate that individuals and groups of bats composing the population might be habitat or dietary specialists—a novel finding for insectivorous bats.

Overweight and Obesity among Women by Economic Stratum in Urban India

PubMed Central

Prusty, Ranjan Kumar

2014-01-01

Using data of the third round of the National Family Health Survey (NFHS) 2005-2006, this study examined the prevalence of overweight and obesity among women from different economic strata in urban India. The study used a separate wealth index for urban India constructed using principal components analysis (PCA). The result shows that prevalence of overweight and obesity is very high in urban areas, more noticeably among the non-poor households. Furthermore, overweight and obesity increase with age, education, and parity of women. The results of multinomial logistic regression show that non-poor women are about 2 and 3 times more at risk of being overweight and obese respectively. Marital status and media exposure are the other covariates associated positively with overweight and obesity. Thus, the growing demand which now appears before the Government or urban health planners is to address this rising urban epidemic with equal importance as given to other issues in the past. PMID:24847596

Generating global political priority for urban health: the role of the urban health epistemic community

PubMed Central

Shawar, Yusra Ribhi; Crane, Lani G

2017-01-01

Abstract Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community’s ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. PMID:28582532

Generating global political priority for urban health: the role of the urban health epistemic community.

PubMed

Shawar, Yusra Ribhi; Crane, Lani G

2017-10-01

Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community's ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story.

PubMed

Anastasi, Erin; Ekanem, Ekanem; Hill, Olivia; Adebayo Oluwakemi, Agnes; Abayomi, Oluwatosin; Bernasconi, Andrea

2017-01-01

Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos. The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected. Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894-1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility. The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in order to identify pockets of marginalization needing additional resources and tailored approaches to guarantee equitable treatment and timely access to quality health services for vulnerable groups. This study demonstrates the importance of sub-regional, disaggregated data to identify and redress inequities that exist among poor, remote, vulnerable populations-as in the urban slums of Lagos.

Convergence of prevalence rates of diabetes and cardiometabolic risk factors in middle and low income groups in urban India: 10-year follow-up of the Chennai Urban Population Study.

PubMed

Deepa, Mohan; Anjana, Ranjit Mohan; Manjula, Datta; Narayan, K M Venkat; Mohan, Viswanathan

2011-07-01

The aim of this study was to look for temporal changes in the prevalence of diabetes and cardiometabolic risk factors in two residential colonies in Chennai. Chennai Urban Population Study (CUPS) was carried out between 1996-1998 in Chennai in two residential colonies representing the middle income group (MIG) and lower income group (LIG), respectively. The MIG had twice the prevalence rate of diabetes as the LIG and higher prevalence rates of hypertension, obesity, and dyslipidemia. They were motivated to increase their physical activity, which led to the building of a park. The LIG was given standard lifestyle advice. Follow-up surveys of both colonies were performed after a period of 10 years. In the MIG, the prevalence of diabetes increased from 12.4 to 15.4% (24% increase), while in the LIG, it increased from 6.5 to 15.3% (135% increase, p < .001). In the LIG, the prevalence rates of central obesity (baseline vs follow-up, male: 30.8 vs 50.9%, p < .001; female: 16.9 vs 49.8%, p < .001), hypertension (8.4 vs 20.1%, p < .001), hypercholesterolemia (14.2 vs. 20.4%, p < .05), and hypertriglyceridemia (8.0 vs 23.5%, p < .001) significantly increased and became similar to that seen in the MIG. There is a rapid reversal of socioeconomic gradient for diabetes and cardiometabolic risk factors in urban India with a convergence of prevalence rates among people in the MIG and LIG. This could have a serious economic impact on poor people in developing countries such as India. © 2011 Diabetes Technology Society.

Hygiene, atopy and wheeze-eczema-rhinitis symptoms in schoolchildren from urban and rural Ecuador.

PubMed

Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

2014-03-01

Rural residence is protective against atopy and wheeze-rhinitis-eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze-rhinitis-eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9-10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

PubMed Central

Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

2014-01-01

Background Rural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. Methods We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Results Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Conclusions Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms. PMID:24105783

The Care of Corporal Punishment: Conceptions of Early Childhood Discipline Strategies among Parents and Grandparents in a Poor and Urban Area in Tanzania

ERIC Educational Resources Information Center

Frankenberg, Sofia Johnson; Holmqvist, Rolf; Rubenson, Birgitta

2010-01-01

This study investigates conceptions of early childhood discipline strategies discussed in focus groups with parents and grandparents in a poor urban area in Tanzania. A grounded theory analysis suggested a model that included four discipline strategies related to corporal punishment: to beat with care, to treat like an egg, as if beating a snake…

Sunlight upon a Dark Sky Haiti's Urban Poor Responds to Socio-Political and Socio-Cultural Conflicts: A Case Study of the Grande Ravine Community Human Rights Council

ERIC Educational Resources Information Center

Dimmett, Deborah Lynn

2010-01-01

This case study investigates the organizational characteristics of a Haitian grassroots community human rights council (CHRC) that emerged as a response to three politically motivated massacres. The impromptu grassroots response of this poor urban community is at the core of the following research question investigated in this study: "What…

Confronting Crisis. A Comparative Study of Household Responses to Poverty and Vulnerability in Four Poor Urban Communities. Environmentally Sustainable Development Studies and Monographs Series No. 8.

ERIC Educational Resources Information Center

Moser, Caroline O. N.

This volume presents the main findings of a comparative study of four poor urban communities in countries experiencing economic difficulties during the late 1980s: Chawama (Zambia), Cisne Dos (Ecuador), Commonwealth (the Philippines), and Angyalfold (Hungary). The study extended a longitudinal community panel study begun in Ecuador by using a…

Exploration of Urban Spatial Planning Evaluation Based on Humanland Harmony

NASA Astrophysics Data System (ADS)

Hu, X. S.; Ma, Q. R.; Liang, W. Q.; Wang, C. X.; Xiong, X. Q.; Han, X. H.

2017-09-01

This study puts forward a new concept, "population urbanization level forecast - driving factor analysis - urban spatial planning analysis" for achieving efficient and intensive development of urbanization considering human-land harmony. We analyzed big data for national economic and social development, studied the development trends of population urbanization and its influencing factors using the grey system model in Chengmai county of Hainan province, China. In turn, we calculated the population of Chengmai coming years based on the forecasting urbanization rate and the corresponding amount of urban construction land, and evaluated the urban spatial planning with GIS spatial analysis method in the study area. The result shows that the proposed concept is feasible for evaluation of urban spatial planning, and is meaningful for guiding the rational distribution of urban space, controlling the scale of development, improving the quality of urbanization and thus promoting highly-efficient and intensive use of limited land resource.

Health impact caused by poor water and sanitation in district Abbottabad.

PubMed

Jabeen, Sadia; Mahmood, Qaisar; Tariq, Sumbal; Nawab, Bahadar; Elahi, Noor

2011-01-01

Large proportions of people still do not have excess to safe drinking water and proper sanitation. Qualitative and quantitative approaches were used to assess the health impacts. Random households were selected. Information was collected from questionnaire through interview schedule method, group discussion and observation checklist. People rated water and sanitation condition in urban as: 10% very good, 27% good, 20% bad, 43% very bad, and none of them said we don't know While in rural areas they rated 10% very good, 36% good, 44% bad, 6% very bad, and 4% of them said we don't know. Water sources in selected urban and rural areas were different. 37% in urban and 68% in rural area depended on bore wells as water source, 22% depended on hand pumps. In urban areas, the disease ratio was typhoid 20%, hepatitis 13%, diarrhoea 27%, skin infection 23%, stomach problems 53% and allergies 33%. In rural areas, after stomach problems, diarrhoea, hepatitis and typhoid ratio was very high as compared to urban area. In rural community, 70% were unaware of poor water and sanitation consequences on health. The water and sanitation condition in urban as well as in rural community is poor but in rural community it is even worse The drinking water was contaminated with E. coli, Enterobacter, Salmonella and Clostridium. This observation was correlated with prevalence of many water born diseases especially in rural communities of Abbottabad.

Projected impact of urbanization on cardiovascular disease in China.

PubMed

Chan, Faye; Adamo, Susana; Coxson, Pamela; Goldman, Lee; Gu, Dongfeng; Zhao, Dong; Chen, Chung-Shiuan; He, Jiang; Mara, Valentina; Moran, Andrew

2012-10-01

The Coronary Heart Disease (CHD) Policy Model-China, a national scale cardiovascular disease computer simulation model, was used to project future impact of urbanization. Populations and cardiovascular disease incidence rates were stratified into four submodels: North-Urban, South-Urban, North-Rural, and South-Rural. 2010 was the base year, and high and low urbanization rate scenarios were used to project 2030 populations. Rural-to-urban migration, population growth, and aging were projected to more than double cardiovascular disease events in urban areas and increase events by 27.0-45.6% in rural areas. Urbanization is estimated to raise age-standardized coronary heart disease incidence by 73-81 per 100,000 and stroke incidence only slightly. Rural-to-urban migration will likely be a major demographic driver of the cardiovascular disease epidemic in China.

How do slums change the relationship between urbanization and the carbon intensity of well-being?

PubMed

McGee, Julius Alexander; Ergas, Christina; Greiner, Patrick Trent; Clement, Matthew Thomas

2017-01-01

This study examines how the relationship between urbanization (measured as the percentage of total population living in urban areas) and the carbon intensity of well-being (CIWB) (measured as a ratio of carbon dioxide emissions and life expectancy) in most nations from 1960-2013 varies based on the economic context and whereabouts of a substantial portion of a nation's urban population. To accomplish this, we use the United Nations' (UN) definition of slum households to identify developing countries that have substantial slum populations, and estimate a Prais-Winsten regression model with panel-corrected standard errors (PCSE), allowing for disturbances that are heteroskedastic and contemporaneously correlated across panels. Our findings indicate that the rate of increase in CIWB for countries without substantial slum populations begins to slow down at higher levels of urbanization, however, the association between urbanization and CIWB is much smaller in countries with substantial slum populations. Overall, while urbanization is associated with increases in CIWB, the relationship between urban development and CIWB is vastly different in developed nations without slums than in under-developed nations with slums.

How do slums change the relationship between urbanization and the carbon intensity of well-being?

PubMed Central

McGee, Julius Alexander

2017-01-01

This study examines how the relationship between urbanization (measured as the percentage of total population living in urban areas) and the carbon intensity of well-being (CIWB) (measured as a ratio of carbon dioxide emissions and life expectancy) in most nations from 1960–2013 varies based on the economic context and whereabouts of a substantial portion of a nation’s urban population. To accomplish this, we use the United Nations’ (UN) definition of slum households to identify developing countries that have substantial slum populations, and estimate a Prais-Winsten regression model with panel-corrected standard errors (PCSE), allowing for disturbances that are heteroskedastic and contemporaneously correlated across panels. Our findings indicate that the rate of increase in CIWB for countries without substantial slum populations begins to slow down at higher levels of urbanization, however, the association between urbanization and CIWB is much smaller in countries with substantial slum populations. Overall, while urbanization is associated with increases in CIWB, the relationship between urban development and CIWB is vastly different in developed nations without slums than in under-developed nations with slums. PMID:29220352

Soil Bacterial Diversity Is Associated with Human Population Density in Urban Greenspaces.

PubMed

Wang, Haitao; Cheng, Minying; Dsouza, Melissa; Weisenhorn, Pamela; Zheng, Tianling; Gilbert, Jack A

2018-05-01

Urban greenspaces provide extensive ecosystem services, including pollutant remediation, water management, carbon maintenance, and nutrient cycling. However, while the urban soil microbiota underpin these services, we still have limited understanding of the factors that influence their distribution. We characterized soil bacterial communities from turf-grasses associated with urban parks, streets, and residential sites across a major urban environment, including a gradient of human population density. Bacterial diversity was significantly positively correlated with the population density; and species diversity was greater in park and street soils, compared to residential soils. Population density and greenspace type also led to significant differences in the microbial community composition that was also significantly correlated with soil pH, moisture, and texture. Co-occurrence network analysis revealed that microbial guilds in urban soils were well correlated. Abundant soil microbes in high density population areas had fewer interactions, while abundant bacteria in high moisture soils had more interactions. These results indicate the significant influence of changes in urban demographics and land-use on soil microbial communities. As urbanization is rapidly growing across the planet, it is important to improve our understanding of the consequences of urban zoning on the soil microbiota.

Focus for Area Development Analysis: Urban Orientation of Counties.

ERIC Educational Resources Information Center

Bluestone, Herman

The orientation of counties to metropolitan systems and urban centers is identified by population density and percentage of urban population. This analytical framework differentiates 6 kinds of counties, ranging from most urban-oriented (group 1) to least urban-oriented (group 6). With this framework, it can be seen that the economic well-being of…

Urban Ecology: Patterns of Population Growth and Ecological Effects

Treesearch

Wayne C. Zipperer; Steward T.A. Pickett

2012-01-01

Currently, over 50% of the world’s population lives in urban areas. By 2050, this estimate is expected to be 70%. This urban growth, however, is not uniformly distributed around the world. The majority of it will occur in developing nations and create megacities whose populations exceed at least 10 million people. Not all urban areas, however, are growing. Some are...

[Urbanization and its consequences for socio-demographic structures in Tunisia].

PubMed

Taamallah, M

1986-01-01

Comparisons are made between rural and urban populations in Tunisia in terms of selected demographic and social factors using official and other published data for the late 1970s and early 1980s. The focus is on the consequences of imbalances created by Tunisia's urbanization for population composition, health, economic development, and certain social structures. The history of urbanization in Tunisia since the end of the nineteenth century is outlined. Urban and rural populations are compared on the basis of sex distribution, age distribution, mortality, and fertility. The relationships among urbanization and economic development, public health, and family structure are considered.

Repeatability and degree of territorial aggression differs among urban and rural great tits (Parus major).

PubMed

Hardman, Samuel I; Dalesman, Sarah

2018-03-22

Animals in urban habitats face many novel selection pressures such as increased human population densities and human disturbance. This is predicted to favour bolder and more aggressive individuals together with greater flexibility in behaviour. Previous work has focussed primarily on studying these traits in captive birds and has shown increased aggression and reduced consistency between traits (behavioural syndromes) in birds from urban populations. However, personality (consistency within a behavioural trait) has not been well studied in the wild. Here we tested whether urban free-living male great tits show greater territorial aggression than rural counterparts. We also tested predictions that both behavioural syndromes and personality would show lower consistency in urban populations. We found that urban populations were more aggressive than rural populations and urban birds appeared to show lower levels of individual behavioural repeatability (personality) as predicted. However, we found no effect of urbanisation on behavioural syndromes (correlations between multiple behavioural traits). Our results indicate that urban environments may favour individuals which exhibit increased territorial aggression and greater within-trait flexibility which may be essential to success in holding urban territories. Determining how urban environments impact key fitness traits will be important in predicting how animals cope with ongoing urbanisation.

Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal

PubMed Central

2017-01-01

Background Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified. Aim The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic. Setting The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal. Method This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients’ hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control. Results Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control. Conclusion Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence. PMID:29113443

São Paulo urban heat islands have a higher incidence of dengue than other urban areas.

PubMed

Araujo, Ricardo Vieira; Albertini, Marcos Roberto; Costa-da-Silva, André Luis; Suesdek, Lincoln; Franceschi, Nathália Cristina Soares; Bastos, Nancy Marçal; Katz, Gizelda; Cardoso, Vivian Ailt; Castro, Bronislawa Ciotek; Capurro, Margareth Lara; Allegro, Vera Lúcia Anacleto Cardoso

2015-01-01

Urban heat islands are characterized by high land surface temperature, low humidity, and poor vegetation, and considered to favor the transmission of the mosquito-borne dengue fever that is transmitted by the Aedes aegypti mosquito. We analyzed the recorded dengue incidence in Sao Paulo city, Brazil, in 2010-2011, in terms of multiple environmental and socioeconomic variables. Geographical information systems, thermal remote sensing images, and census data were used to classify city areas according to land surface temperature, vegetation cover, population density, socioeconomic status, and housing standards. Of the 7415 dengue cases, a majority (93.1%) mapped to areas with land surface temperature >28°C. The dengue incidence rate (cases per 100,000 inhabitants) was low (3.2 cases) in high vegetation cover areas, but high (72.3 cases) in low vegetation cover areas where the land surface temperature was 29±2°C. Interestingly, a multiple cluster analysis phenogram showed more dengue cases clustered in areas of land surface temperature >32°C, than in areas characterized as low socioeconomic zones, high population density areas, or slum-like areas. In laboratory experiments, A. aegypti mosquito larval development, blood feeding, and oviposition associated positively with temperatures of 28-32°C, indicating these temperatures to be favorable for dengue transmission. Thus, among all the variables studied, dengue incidence was most affected by the temperature. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

[Contribution of migrations to the process of urbanization].

PubMed

Bocquier, P

1997-10-01

An average of 22% of the populations of the Sahel countries resided in urban areas in the mid-1970s, a lower level than in the rest of sub-Saharan Africa. The proportion urban has increased by about 5.5% annually over the past 2 decades. By 1993, four Sahel countries had over 30% of their populations in urban areas, and only Burkina Faso had less than 20% urban. The landlocked Sahel countries of Burkina Faso, Mali, Niger, and Chad have maintained rates of urbanization comparable to those of the coastal countries (Cape Verde, Gambia, Mauritania, and Senegal), which had more significant levels of urbanization in the past. The rate of growth of the urban population of all of sub-Saharan Africa was around 5.0% during the past 20 years. Only Dakar among the Sahel capitals has a population of over 1 million. Cities are small, and the urban environment is usually limited to the capital. In Guinea-Bissau, for example, the capital concentrates nearly 85% of the urban population. The increased rates of urbanization are due mainly to migration. In the landlocked countries covered by surveys of the Migration and Urbanization Networks in Western Africa (Burkina Faso, Mali, and Niger), the rural exodus was directed primarily to other countries. In Senegal and Mauritania, on the other hand, around two-thirds of migrations were internal. Women contribute more than men to urban growth in the Sahel. Returning migrants also show a strong preference for capital cities. Labor markets are international for men but national for women. Urban unemployment rates in the Sahel countries studied were lower for migrants than nonmigrants.

Musculoskeletal trauma services in Uganda.

PubMed

Naddumba, E K

2008-10-01

Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda's population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development.

Quality: what do poor women want?

PubMed

Verma, A

1994-01-01

Although all individuals and couples want high quality services, many dimensions of such services are impractical or even unfeasible in poor settings. The author considers the situation in the majority of South Asian countries where 75-80% of the population lives in rural areas or urban slums on the periphery of large metropolitan cities. Typically poorly trained community health workers live and work in cramped, unhygienic, poorly equipped service delivery centers often with neither electricity nor safe drinking water. Supplies of essential drugs, contraceptives, and equipment are extremely limited. When the workers do not live in the small facilities, they often commute by bus from a neighboring village or walk 5-6 kilometers to work. The number of males or females available and willing to be trained for services is often insufficient. The author explains that good quality is all relative. Such impoverished contexts demand that standards be situation-specific, dependent upon resource availability, and fitted to local circumstances and the social milieu. Moreover, efforts must be made to focus upon the needs of women and undertake low-cost improvements where possible. The Mini Welfare Center Scheme of the Indian Ministry of Health and Family Welfare to help voluntary organizations promote health and family welfare activities is described.

Spatiotemporal trends of urban heat island effect along the urban development intensity gradient in China

Treesearch

Decheng Zhou; Liangxia Zhang; Lu Hao; Ge Sun; Yongqiang Liu; Chao Zhu

2016-01-01

Urban heat island (UHI) represents a major anthropogenic modification to the Earth system and its relationshipwith urban development is poorly understood at a regional scale. Using AquaMODIS data and LandsatTM/ETM+images, we examined the spatiotemporal trends of the UHI effect (ΔT, relative to the rural reference) along theurban...

Quality-of life of the elderly in urban and rural areas in Serbia.

PubMed

Urosević, Jadranka; Odović, Gordana; Rapaić, Dragan; Davidović, Mladen; Trgovcević, Sanja; Milovanović, Verica

2015-11-01

The number of elderly people in the world is growing, in Serbia as well. Serbia is already among the top ten countries with the oldest population, it is the fact. Aging influences the quality of life in different ways. The aim of this study was to assess the health-related quality of life of the elderly in urban and rural areas in Serbia. The study included 100 elderly people aged 65 years and above in urban and rural areas in Serbia. The next questionnaires were used: a socio-demographic questionnaire and a Serbian version of standardized European Euro-QoL questionnaire (EQ-5D-3L), as a basic index for the assessment and description of the quality of life. In the structure of the respondents, according to the achieved social contacts (p = 0.012), the life of those with family members (p = 0.009), and health status (p = 0.000), in relation to the place of residence there was a statistically significant difference. There was a significant difference (p = 0.040), predominantly poor score for anxiety/depression within the rural population. The average value of quality of life in urban and rural areas was not statistically significant (p = 0.720). For those living in rural areas there was a statistically significant positive correlation between anxiety/depression and age, wealth status, marital status, living with family members and achieving social contacts, while a negative correlation was observed between anxiety/depression and education. On the basis of the data of our study, we can say that the presence of anxiety/depression among older people is greater in rural than in urban areas. The results of this study show that the perception of anxiety/depression among older in rural areas is bigger with the age and poverty increasing, the loss of a spouse, life without family members, lack of achievement of social contacts and lower education.

Urban-rural differences in social capital in relation to self-rated health and subjective well-being in older residents of six regions in Poland.

PubMed

Tobiasz-Adamczyk, Beata; Zawisza, Katarzyna

2017-06-12

The aim of the study was to assess the differences between rural and urban areas as regards the role of social capital and its effect on self-rated health and subjective well-being among older people in Poland. The sample was selected on the basis of multi-stage clustered design from the non-institutionalized adult population. Analysis was based on 1,299 elderly people aged 65 and over from the general Polish population who participated in the COURAGE in Europe project. Six regions of Poland were distinguished according to first level of Nomenclature of Units for Territorial Statistics (NUTS) classification . As an indicator of social capital, the COURAGE Social Network Index, the OSLO-3 Social Support Scale, and the three item UCLA Loneliness scale were used, as well as social participation and trust was assessed. Self-rated health (SRH) was measured by WHO-Europe recommended version (ranging from 'very good' to 'very bad'). Well-being was assessed by the Day Reconstruction Method. Results: The results showed that in urban areas, social network and social participation supported positive self-rated health; in rural, older residents the number of years of education and social support played the same role, while self-rated health decreased with an increasing level of loneliness. Self-rated health decreased in both groups of older people with a growing number of diseases. The multivariate linear regression model of predictors of well-being in older age also confirmed differences between urban and rural elderly residents. In rural residents, subjective well-being significantly increased with the positive effect of the social network. In both urban and rural areas, poor assessment of subjective well-being in older age increased with a higher level of loneliness and growing number of chronic diseases.

Signatures of positive selection and local adaptation to urbanization in white-footed mice (Peromyscus leucopus).

PubMed

Harris, Stephen E; Munshi-South, Jason

2017-11-01

Urbanization significantly alters natural ecosystems and has accelerated globally. Urban wildlife populations are often highly fragmented by human infrastructure, and isolated populations may adapt in response to local urban pressures. However, relatively few studies have identified genomic signatures of adaptation in urban animals. We used a landscape genomic approach to examine signatures of selection in urban populations of white-footed mice (Peromyscus leucopus) in New York City. We analysed 154,770 SNPs identified from transcriptome data from 48 P. leucopus individuals from three urban and three rural populations and used outlier tests to identify evidence of urban adaptation. We accounted for demography by simulating a neutral SNP data set under an inferred demographic history as a null model for outlier analysis. We also tested whether candidate genes were associated with environmental variables related to urbanization. In total, we detected 381 outlier loci and after stringent filtering, identified and annotated 19 candidate loci. Many of the candidate genes were involved in metabolic processes and have well-established roles in metabolizing lipids and carbohydrates. Our results indicate that white-footed mice in New York City are adapting at the biomolecular level to local selective pressures in urban habitats. Annotation of outlier loci suggests selection is acting on metabolic pathways in urban populations, likely related to novel diets in cities that differ from diets in less disturbed areas. © 2017 John Wiley & Sons Ltd.

Urbanization in sub-saharan Africa and implication for malaria control.

PubMed

Keiser, Jennifer; Utzinger, Jurg; Caldas de Castro, Marcia; Smith, Thomas A; Tanner, Marcel; Singer, Burton H

2004-08-01

Malaria not only remains a leading cause of morbidity and mortality, but it also impedes socioeconomic development, particularly in sub-Saharan Africa. Rapid and unprecedented urbanization, going hand-in-hand with often declining economies, might have profound implications for the epidemiology and control of malaria, as the relative disease burden increases among urban dwellers. Reviewing the literature and using a modeling approach, we find that entomologic inoculation rates in cities range from 0 to 54 per year, depending on the degree of urbanization, the spatial location within a city, and overall living conditions. Using the latest United Nations figures on urbanization prospects, nighttime light remotely sensed images, and the "Mapping Malaria Risk in Africa" results on climate suitability for stable malaria transmission, we estimate that 200 million people (24.6% of the total African population) currently live in urban settings where they are at risk of contracting the disease. Importantly, the estimated total surface area covered by these urban settings is only approximately 1.1-1.6% of the total African surface. Considering different plausible scenarios, we estimate an annual incidence of 24.8-103.2 million cases of clinical malaria attacks among urban dwellers in Africa. These figures translate to 6-28% of the estimated global annual disease incidence. Against this background, basic health care delivery systems providing early diagnosis and early treatment and preventive actions through mother and child health programs and the promotion of insecticide-treated bed nets for the rapidly growing numbers of the urban poor must be improved alongside well-tailored and integrated malaria control strategies. We propose environmental management and larviciding within well-specified productive sites as a main feature for such an integrated control approach. Mitigation of the current burden of malaria in urban African settings, in turn, is a necessity for stimulating environmentally and socially sustainable development. Copyright 2004 The American Society of Tropical Medicine and Hygiene

Urban residence, neighborhood poverty, race/ethnicity, and asthma morbidity among children on Medicaid.

PubMed

Keet, Corinne A; Matsui, Elizabeth C; McCormack, Meredith C; Peng, Roger D

2017-09-01

Although poor-urban (inner-city) areas are thought to have high asthma prevalence and morbidity, we recently found that inner cities do not have higher prevalent pediatric asthma. Whether asthma morbidity is higher in inner-city areas across the United States is not known. This study sought to examine relationships between residence in poor and urban areas, race/ethnicity, and asthma morbidity among children with asthma who are enrolled in Medicaid. Children aged 5 to 19 enrolled in Medicaid in 2009 to 2010 were included. Asthma was defined by at least 1 outpatient or emergency department (ED) visit with a primary diagnosis code of asthma over the 2-year period. Urbanization status was defined at the county level and neighborhood poverty at the zip-code level. Among children with asthma, logistic models were created to examine the effects of urbanization, neighborhood poverty, and race/ethnicity on rates of asthma outpatient visits, ED visits, and hospitalizations. This study included 16,860,716 children (1,534,820 with asthma). Among children enrolled in Medicaid, residence in inner-city areas did not confer increased risk of prevalent asthma in either crude or adjusted analyses, but it was associated with significantly more asthma-related ED visits and hospitalizations among those with asthma in crude analyses (risk ratio, 1.48; 95% CI, 1.24-1.36; and 1.97; 95% CI, 1.50-1.72, respectively) and when adjusted for race/ethnicity, age, and sex (adjusted risk ratio, 1.23; 95% CI, 1.08-1.15; and 1.62; 95% CI, 1.26-1.43). Residence in urban or poor areas and non-Hispanic black race/ethnicity were all independently associated with increased risk of asthma-related ED visits and hospitalizations. Residence in poor and urban areas is an important risk factor for asthma morbidity, but not for prevalence, among low-income US children. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Predicting Intra-Urban Population Densities in Africa using SAR and Optical Remote Sensing Data

NASA Astrophysics Data System (ADS)

Linard, C.; Steele, J.; Forget, Y.; Lopez, J.; Shimoni, M.

2017-12-01

The population of Africa is predicted to double over the next 40 years, driving profound social, environmental and epidemiological changes within rapidly growing cities. Estimations of within-city variations in population density must be improved in order to take urban heterogeneities into account and better help urban research and decision making, especially for vulnerability and health assessments. Satellite remote sensing offers an effective solution for mapping settlements and monitoring urbanization at different spatial and temporal scales. In Africa, the urban landscape is covered by slums and small houses, where the heterogeneity is high and where the man-made materials are natural. Innovative methods that combine optical and SAR data are therefore necessary for improving settlement mapping and population density predictions. An automatic method was developed to estimate built-up densities using recent and archived optical and SAR data and a multi-temporal database of built-up densities was produced for 48 African cities. Geo-statistical methods were then used to study the relationships between census-derived population densities and satellite-derived built-up attributes. Best predictors were combined in a Random Forest framework in order to predict intra-urban variations in population density in any large African city. Models show significant improvement of our spatial understanding of urbanization and urban population distribution in Africa in comparison to the state of the art.

Urban growth in Korea, 1970-1980: an application of the human ecological perspective.

PubMed

Ko, S H

1994-07-01

This study supports the ecological perspective proposed by Duncan (population, environment, organization, and technology) explaining urban population growth. Data were obtained from the 1970 and 1980 Korean Population Census and Korean Municipal Yearbook on cities with a minimum size of 20,000-50,000 people (108 cities and towns). Urban growth is most strongly influenced by indigenous labor surplus and the population potential of the city to be in contact with another city. Nine multiple regression variables explained just under 66% of the variance in urban growth. Net migration was influential among those aged 15-24 years. The extent of differentiation of industry affected net migration only among those aged 15-24 years and those aged 35-44 years. Population redistribution was more affected directly by changes in industrial organization, and migration was affected indirectly by environmental and technological effects on organization. Urban growth through migration of older age groups was affected by government expenditure on public works. Urban growth was not much affected by transportation/communication concentration, manufacturing concentration, urban labor surplus, population size, and site. Urban growth was viewed as the interaction between the unemployment rate and the urban wage, following Todaro's equilibrium models. In Korea, larger cities only grew faster during the 1960s. By the 1970s, upper middle-sized cities grew faster. Location was not a significant factor in explaining urban growth, but growth was rapid along a corridor within 100 km from Seoul and 50 km from Pusan, the second largest city in Korea. Caution was urged in interpreting Korea's ecological urban growth patterns as indicative of developing countries.

The impact of rapid population growth, expanding urbanisation, and other factors on development in sub-Saharan Africa: the contrasting responses of Tanzania and Kenya.

PubMed

Huth, M J

1984-01-01

This article analyzes the impact of the twin factors of rapid population growth and expanding urbanization on social and economic development in sub-Saharan Africa and compares policies that have been developed in Tanzania and Kenya in response to these factors. The principal consequences of overpopulation and overurbanization have been economic stagnation and physical and cultural malaise in urban population centers. Between 1960-80, per capita incomes in 19 countries of sub-Saharan Africa grew by less than 1%/year and 15 countries recorded a negative rate of growth in per capita income during the 1970s. Urban populations have increased at at overall rate of 6%/year as sub-Saharan Africans have migrated to cities in search of employment. Few national governments in the region have formulated longterm strategies to deal effectively with this double-faceted development constraint or have integrated new urban populations into the national economy. tanzania's development strategy is focused on the goals of socialism, rural development, and self-reliance. Urban development has remained a residual item in Tanzania's national development process, despite the fact that the urban population increased from 5.7% of the total population in 1967 to 12.7% in 1978 and is projected to comprise 24.7% by the year 2000. In contrast, Kenya, whose proportion of urban population increased from 9% to 15% between 1962 and 1979, has pursued an urban-focused development strategy. The strong urban-rural linkages of the economy have focused migration to the secondary towns. The national development plan includes urban spatial, employment, and investment policies. Although this plan constitutes a good basis for future planning, the magnitude of the urban problem is beyond the capabilities of the central government and requires the development of local capabilities.

Measuring progress toward the Millennium Development Goals and the missing millions.

PubMed

Carr-Hill, Roy A

2013-01-01

The 2015 target date for achieving the Millennium Development Goals (MDGs) is fast approaching, but there is very little discussion of the validity of the indicators used to measure progress. In particular, there has been little attention given to the problems that arise when assessments of progress are based on household surveys. These are inappropriate for obtaining information about the poorest of the poor. Typically, they omit by design those not in households because they are homeless; those who are in institutions; and mobile, nomadic or pastoralist populations; and, in practice, household surveys will typically under-represent those in fragile, disjointed or multiple occupancy households; and those in urban slums and insecure areas of a country. Those six subgroups constitute a pretty comprehensive ostensive definition of the "poorest of the poor." Between 300 and 500 million people--mainly in developing countries--will be missed worldwide from the sampling frames of household surveys.

Rural to Urban Population Density Scaling of Crime and Property Transactions in English and Welsh Parliamentary Constituencies.

PubMed

Hanley, Quentin S; Lewis, Dan; Ribeiro, Haroldo V

2016-01-01

Urban population scaling of resource use, creativity metrics, and human behaviors has been widely studied. These studies have not looked in detail at the full range of human environments which represent a continuum from the most rural to heavily urban. We examined monthly police crime reports and property transaction values across all 573 Parliamentary Constituencies in England and Wales, finding that scaling models based on population density provided a far superior framework to traditional population scaling. We found four types of scaling: i) non-urban scaling in which a single power law explained the relationship between the metrics and population density from the most rural to heavily urban environments, ii) accelerated scaling in which high population density was associated with an increase in the power-law exponent, iii) inhibited scaling where the urban environment resulted in a reduction in the power-law exponent but remained positive, and iv) collapsed scaling where transition to the high density environment resulted in a negative scaling exponent. Urban scaling transitions, when observed, took place universally between 10 and 70 people per hectare. This study significantly refines our understanding of urban scaling, making clear that some of what has been previously ascribed to urban environments may simply be the high density portion of non-urban scaling. It also makes clear that some metrics undergo specific transitions in urban environments and these transitions can include negative scaling exponents indicative of collapse. This study gives promise of far more sophisticated scale adjusted metrics and indicates that studies of urban scaling represent a high density subsection of overall scaling relationships which continue into rural environments.

Rural to Urban Population Density Scaling of Crime and Property Transactions in English and Welsh Parliamentary Constituencies

PubMed Central

Hanley, Quentin S.; Lewis, Dan; Ribeiro, Haroldo V.

2016-01-01

Urban population scaling of resource use, creativity metrics, and human behaviors has been widely studied. These studies have not looked in detail at the full range of human environments which represent a continuum from the most rural to heavily urban. We examined monthly police crime reports and property transaction values across all 573 Parliamentary Constituencies in England and Wales, finding that scaling models based on population density provided a far superior framework to traditional population scaling. We found four types of scaling: i) non-urban scaling in which a single power law explained the relationship between the metrics and population density from the most rural to heavily urban environments, ii) accelerated scaling in which high population density was associated with an increase in the power-law exponent, iii) inhibited scaling where the urban environment resulted in a reduction in the power-law exponent but remained positive, and iv) collapsed scaling where transition to the high density environment resulted in a negative scaling exponent. Urban scaling transitions, when observed, took place universally between 10 and 70 people per hectare. This study significantly refines our understanding of urban scaling, making clear that some of what has been previously ascribed to urban environments may simply be the high density portion of non-urban scaling. It also makes clear that some metrics undergo specific transitions in urban environments and these transitions can include negative scaling exponents indicative of collapse. This study gives promise of far more sophisticated scale adjusted metrics and indicates that studies of urban scaling represent a high density subsection of overall scaling relationships which continue into rural environments. PMID:26886219

Kenya's Maternal Child Health Family Planning Program (Family Health).

PubMed

Kiereini, E M

1982-01-01

In an attempt to improve accessibility to health care for the majority of its population, the government of Kenya has, since 1970, undertaken an integration of its dispersed health care system. In 1972 the Ministry of Health carried out a study to identify the problems associated with health care in rural areas. A task force consisting of government and other officials carried out a situation analysis with a view to making specific recommendations for improving community health status. The 4 main health problems identified had to do with family health problems, communicable diseases, diseases related to poor environmental sanitation, and health problems related to poor nutrition. The analysis also revealed the importance of maternal and child health for overall health of the community. A Maternal Child Health Family Planning (MCH/FP) program was then designed to improve services to women aged 15-49 years and children below 5 years, the groups proven to be at greatest risk for ill health. Also integrated into this approach were family planning services. Health workers ranging from enrolled community nurses (equipped with knowledge and skills for diagnosing and treating common conditions) to traditional birth attendants, serve both rural and urban areas. In addition, registered public health nurses, supervising MCH/FP services in district facilities, also operate in urban areas. Rural populations also have the services of a clinical officer who is answerable to the district medical officer, and who has charge of the health center. The Family Health Field Educators Training Program, which was started in 1975 has not yet been evaluated, but it is evident that the efforts of the government to train and equip health workers has greatly improved the quality and availability of health care service to Kenyans.

Maternal short stature does not predict their children's fatness indicators in a nutritional dual-burden sample of urban Mexican Maya.

PubMed

Wilson, Hannah J; Dickinson, Federico; Griffiths, Paula L; Bogin, Barry; Hobbs, Matthew; Varela-Silva, M Inês

2014-04-01

The co-existence of very short stature due to poor chronic environment in early life and obesity is becoming a public health concern in rapidly transitioning populations with high levels of poverty. Individuals who have very short stature seem to be at an increased risk of obesity in times of relative caloric abundance. Increasing evidence shows that an individual is influenced by exposures in previous generations. This study assesses whether maternal poor early life environment predicts her child's adiposity using cross sectional design on Maya schoolchildren aged 7-9 and their mothers (n = 57 pairs). We compared maternal chronic early life environment (stature) with her child's adiposity (body mass index [BMI] z-score, waist circumference z-score, and percentage body fat) using multiple linear regression, controlling for the child's own environmental exposures (household sanitation and maternal parity). The research was performed in the south of Merida, Yucatan, Mexico, a low socioeconomic urban area in an upper middle income country. The Maya mothers were very short, with a mean stature of 147 cm. The children had fairly high adiposity levels, with BMI and waist circumference z-scores above the reference median. Maternal stature did not significantly predict any child adiposity indicator. There does not appear to be an intergenerational component of maternal early life chronic under-nutrition on her child's obesity risk within this free living population living in poverty. These results suggest that the co-existence of very short stature and obesity appears to be primarily due to exposures and experiences within a generation rather than across generations. Copyright © 2013 Wiley Periodicals, Inc.

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana

PubMed Central

Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas. PMID:27807453

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana.

PubMed

Boateng, Simon; Amoako, Prince; Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas.

Rural Education in Mexico: A Gateway to a Better Life

DTIC Science & Technology

2011-10-28

combatting of poverty as a top priority. However, inequities exist within the Mexican education system between those living in urban areas and those living...product-education” to the “target consumer - rural poor” the government must address the inequalities in the system by applying the factors of quality...out of poverty for the rural poor. 15. SUBJECT TERMS Poor Rural Education in Mexico; Educational Inequities Between Urban and Rural Areas

Blaming the helpers: the marginalization of teachers and parents of the urban poor.

PubMed

Farber, B A; Azar, S T

1999-10-01

The nature and origins of the current tendency toward disparaging parents and teachers of the urban poor are examined. It is suggested that the influence of parents and teachers must be understood in the context of multiple intervening variables. Several explanations are offered for the phenomenon of blame, including the fact that women constitute the great majority of teachers and are often the primary agents of parenting.

Social problems and health in urbanization.

PubMed

Talib, R; Agus, M R

1992-01-01

One of the main characteristics of urbanization in Asia is the very rapid increase in population movement from rural to urban centers. This phenomenon has led to changing population structure, its composition and lifestyles in the cities and its fringes. As a consequent of population pressure on urban system and infrastructure, compounded by the nature of the composition of the in-migrant population, the urban concentrates are faced with several social and socio-economic problems. Although there has been a lot of interests among researchers to study the causes and effects or urbanization, there is a vacuum in the area of health implications. Planners and administrators usually give priority to the physical aspects of the urban and urbanities. Social problems and health implications thereof receives very little attention either at the level of administration or research. This paper therefore is a brave attempt to focus and draw some attention to this neglected area by looking at selected social problems and the health consequences.

Poor nutrient intake and high obese rate in an urban African American population with hypertension.

PubMed

Jen, K-L Catherine; Brogan, Kathryn; Washington, Olivia G M; Flack, John M; Artinian, Nancy T

2007-02-01

To describe the nutrient intake patterns and general health conditions in an African American (AA) hypertensive population living in Detroit, MI. Demographic, anthropometric, general health condition and 3-day dietary recalls were collected from 387 AAs in community-based settings. Only data from 342 participants who met the inclusion criteria were reported. The obesity and type 2 diabetes prevalence in this minority population were significantly higher, and both energy and nutrient intakes were significantly lower than the RDAs or those reported in NHANES. Female participants reported their highest weight at an earlier age but their body weight reduced in the older group. No such trend was observed in male participants. Both males and females consumed significantly fewer servings of fruit, vegetable and grains as recommended by USDA. As household income increased, the consumption of fruits and vegetables were also increased. In order to reduce the incidence of obesity and hypertension in this minority population, dietary intervention should begin at adolescence or even earlier. DASH diet would be beneficial for this population.

Deliberate self-harm in rural and urban regions: a comparative study of prevalence and patient characteristics.

PubMed

Harriss, Louise; Hawton, Keith

2011-07-01

In countries like the U.K., people living in urban regions are more likely to suffer poor physical and mental health than rural populations, and to have increased rates of psychiatric disorder. Urban/rural differences in suicidal behaviour have most frequently focussed on variations in the occurrence of suicide. We have investigated rates of deliberate self-harm (DSH) in urban and rural districts of Oxfordshire, England, and compared characteristics of DSH patients resident in these two areas. Information was collected on 6833 DSH episodes by 4054 persons aged 15 years and over presenting to the local general hospital between 2001 and 2005. We found that urban DSH rates were substantially higher than rural rates amongst both males and females aged between 15 and 64 years. This relationship was sustained even when socio-economic deprivation and social fragmentation were taken into account. There was little difference between urban and rural rates for patients aged 65 years and over. Urban DSH patients were more likely to be younger, non-white in ethnic origin, unemployed, living alone, to have a criminal record, to have previously engaged in DSH, and to report problems with housing. Rural DSH patients were more likely to suffer from physical illness, and to have higher suicide intent scores. Results of studies such as this can help identify where resources for preventive initiatives should be primarily directed and also what types of individuals may be at most risk in different areas. However, since variation by area will in part be due to differences at the individual level, further research utilising multi-level modelling techniques would be useful. Copyright © 2011 Elsevier Ltd. All rights reserved.

Growing food in urban areas: Food security, community benefits, any concerns?

USDA-ARS?s Scientific Manuscript database

Over 80% of our nation’s population lives in urban areas, including Minneapolis-Saint Paul, the 16th most populous metropolitan area in the USA, with 3.3 million inhabitants. Trends of growing urban populations and increased desire for locally sourced food have culminated in greater public interest...

Urbanization in 21st century.

PubMed

Altarejos, R G

1990-01-01

Due to a combination of rapid population growth and high levels of rural-urban migration, overcrowding will be common in many cities around the world in the 21st century. Currently at 5.3 billion, the global population is expected to increase to 6 billion by the year 2000, and to 9 billion by 2025. Experts predict that urban centers will bear the brunt of the population growth. Rural areas have seen declines in the standard of living, partly due to natural disasters, civil war, and economic policies favoring urban centers. In search of jobs, better access to education, and health services, rural populations will flock to cities. But the rapid growth of cities will inevitably lead to the creation of slums, which will hamper urban development. Urban demographers predict that by the end of the century, 1/2 of the world's population will be urban, and 1/5 of these people will be concentrated in "mega cities," populations of 4 million or more. International migration will play a significant role, as people cross borders in search of opportunity. But contrary to the traditional model of urban growth, much of it will take place in developing countries. According to a 1985 study, developed nations had an urbanization level of 71%, compared to 31% in developing countries. However, experts calculate that by 2025, these levels will practically even out, with an urbanization level of 74% for developing countries and 77% for developed countries. By 2025, 25 cities will have populations of over 9 million, including Mexico City (25.8), Sao Paulo (24.0), Tokyo (20.2), Calcutta (16.5), Greater Bombay (16.0), and New York (15.8).

Urbanization and Mental Health in China: Linking the 2010 Population Census with a Cross-Sectional Survey.

PubMed

Chen, Juan; Chen, Shuo; Landry, Pierre F

2015-07-31

Along with the rapid urbanization in China, the state of mental health also receives growing attention. Empirical measures, however, have not been developed to assess the impact of urbanization on mental health and the dramatic spatial variations. Innovatively linking the 2010 Chinese Population Census with a 2011 national survey of urban residents, we first assess the impact of urbanization on depressive symptoms measured by the Center of Epidemiological Studies Depression Scale (CES-D) of 1288 survey respondents. We then retrieve county-level characteristics from the 2010 Chinese Population Census that match the individual characteristics in the survey, so as to create a profile of the "average person" for each of the 2869 counties or city districts, and predict a county-specific CES-D score. We use this county-specific CES-D score to compute the CES-D score for the urban population at the prefectural level, and to demonstrate the dramatic spatial variations in urbanization and mental health across China: highly populated cities along the eastern coast such as Shenyang and Shanghai show high CES-D scores, as do cities in western China with high population density and a high proportion of educated ethnic minorities.

Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study.

PubMed

Ghosh-Jerath, Suparna; Devasenapathy, Niveditha; Singh, Archna; Shankar, Anuraj; Zodpey, Sanjay

2015-03-20

Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes. A household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented. Almost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not. Pregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in providing effective nutrition counselling should be explored given the overburdened public health system.

Application of the Water Needs Index: Can Tho City, Mekong Delta, Vietnam

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Neumann, Luis E.; Alexander, Kim S.; Nguyen, Minh N.; Sharma, Ashok K.; Cook, Stephen; Trung, Nguyen H.; Tuan, Dinh D. A.

2012-10-01

SummaryProvision of urban water supplies to rapidly growing cities of South East Asia is difficult because of increasing demand for limited water supplies, periodic droughts, and depletion and contamination of surface and groundwater. In such adverse environments, effective policy and planning processes are required to secure adequate water supplies. Developing a Water Needs Index reveals key elements of the complex urban water supply by means of a participatory approach for rapid and interdisciplinary assessment. The index uses deliberative interactions with stakeholders to create opportunities for mutual understanding, confirmation of constructs and capacity building of all involved. In Can Tho City, located at the heart of the Mekong delta in Vietnam, a Water Needs Index has been developed with local stakeholders. The functional attributes of the Water Needs Index at this urban scale have been critically appraised. Systemic water issues, supply problems, health issues and inadequate, poorly functioning infrastructure requiring attention from local authorities have been identified. Entrenched social and economic inequities in access to water and sanitation, as well as polluting environmental management practices has caused widespread problems for urban populations. The framework provides a common language based on systems thinking, increased cross-sectoral communication, as well as increased recognition of problem issues; this ought to lead to improved urban water management. Importantly, the case study shows that the approach can help to overcome biases of local planners based on their limited experience (information black spots), to allow them to address problems experienced in all areas of the city.

The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India.

PubMed

Gowda, Mrunalini J; Bhojani, Upendra; Devadasan, Narayanan; Beerenahally, Thriveni S

2015-08-15

Chronic conditions are on rise globally and in India. Prevailing intra-urban inequities in access to healthcare services compounds the problems faced by urban poor. This paper reports the trends in self-reported prevalence of chronic conditions and health-seeking pattern among residents of a poor urban neighborhood in south India. A cross sectional survey of 1099 households (5340 individuals) was conducted using a structured questionnaire. The prevalence and health-seeking pattern for chronic conditions in general and for hypertension and diabetes in particular were assessed and compared with a survey conducted in the same community three years ago. The predictors of prevalence and health-seeking pattern were analyzed through a multivariable logistic regression analysis. The overall self-reported prevalence of chronic conditions was 12%, with hypertension (7%) and diabetes (5.8%) being the common conditions. The self-reported prevalence of chronic conditions increased by 3.8 percentage point over a period of three years (OR: 1.5). Older people, women and people living below the poverty line had greater odds of having chronic conditions across the two studies compared. Majority of patients (89.3%) sought care from private health facilities indicating a decrease by 8.7 percentage points in use of government health facility compared to the earlier study (OR: 0.5). Patients seeking care from super specialty hospitals and those living below the poverty line were more likely to seek care from government health facilities. There is need to strengthen health services with a preferential focus on government services to assure affordable care for chronic conditions to urban poor.

Grand Forks - East Grand Forks Urban Water Resources Study. Social and Environmental Inventory.

DTIC Science & Technology

1979-01-01

61 Introduction 57IPrehistoric 58 Historic 58-61 Social Organization 62-72 Introduction 62 Demography 62-63 Population Distribution by Age 64-65 Urban...programs, native timber is decreasing due to agricultural clearing operatings and urban growth. Native tree species are important because of their longevity ... Demography 62-63 Population Distribution by Age 64-65 Urban-Rural Distribution 66 Population Projections 67-68 Racial Distribution 69 Ethnic Groups 70

Influence of landscape mosaic on streamflow of a peri-urban catchment under Mediterranean climate

NASA Astrophysics Data System (ADS)

Ferreira, Carla; Walsh, Rory; Ferreira, António

2017-04-01

Peri-urban areas tend to be characterized by patchy landscape mosaics of different land-uses. Although the impact of land-use changes on catchment hydrology have been widely investigated, the impact of mixed land-use patterns on the streamflow of peri-urban areas is still poorly understood. This study aims to (i) explore and quantify streamflow delivery from sub-catchments characterized by distinct landscape mosaics; (ii) assess the impact of different urbanization styles on hydrograph properties; and (iii) explore the influence of urbanization type on flow connectivity and stream discharge. The study was carried out in Ribeira dos Covões, a small (6.2km2) peri-urban catchment in central Portugal. The climate is Mediterranean, with a mean annual rainfall of 892mm. Catchment geology comprises sandstone (56%), limestone (41%) and alluvial deposits (3%). Soils developed on sandstone are generally deep (>3m) Fluvisols and Podsols, whereas on limestone the Leptic Cambisols are typically shallow (<0.4m). Forest is the dominant land-use (56%), but urban areas cover an extensive area (40%), whereas agricultural land has declined to a very small area (4%). The urban area comprises contrasting urban styles, notably older discontinuous urban areas with buildings separated by gardens of low population density (<25 inhabitants km-2), and recent well-defined continuous urban cores dominated by apartment blocks and of high population density (9900 inhabitants km-2). The study uses hydrological data recorded over three hydrological years, starting in November 2010, in a monitoring network comprising eight streamflow gauging stations (instrumented with water level recorders) and five rainfall gauges. The gauging stations provide information on the discharge response to rainstorms of the catchment outlet and upstream sub-catchments of different size, urban pattern (in terms of percentage urban land-use and impervious area, distance to the stream network, and storm water management), and lithology (either sandstone or limestone). Annual storm runoff coefficients were lowest (13.7%) in catchments dominated by forest (>80%) and greatest (17.3-17.6%) in the most urbanized sub-catchments (49-53% urban). Impervious area seems to control streamflow particularly during dry periods. Winter runoff (streamflow per unit area) was 2-4 times higher than summer runoff in highly urbanized areas, but was 21-fold higher in winter than in summer in the least urbanized sub-catchment, indicating greater flow connectivity in winter, enhanced by increased soil moisture. Lithology also played an important role on hydrology, with sandstone sub-catchments exhibiting greater annual baseflow index values (23-46%) than found in limestone ones (<5%). For sub-catchments underlain by both lithologies, linear relationships were found between storm runoff coefficients and percentage urban and percentage impervious area, but with greater runoff responses in the sandstone ones. Nevertheless, linear regression lines for both lithologies get close to each other when the extent of urban areas reached about 50%. The proximity of urban areas to the stream network and whether urban storm runoff is directly piped to the stream network were important parameters influencing peak flows and response time. Landscape mosaics that include land-use patches of high soil permeability tend to provide locations of surface water retention and enhanced infiltration, thereby breaking flow connectivity between hillslope urban surfaces and the stream network. This kind of spatial pattern should be considered for urban planning, in order to minimize flood hazards.

Healthcare and healthcare systems: inspiring progress and future prospects

PubMed Central

2016-01-01

Background Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. Methods A structured review of both peer-reviewed and gray literature on the topic was carried out. Results On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world’s population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population growth will occur in the urban areas of poor countries. The rapid, unplanned and unsustainable style of urban development will make developing countries cities the key focal points for emerging environmental and health hazards. Changes will be seen in design, culture and practices of hospitals to better meet the needs of patients, families and providers. Top driving factors of global healthcare system for next 30 years will be leading causes of mortalities, non-health factors (impact of nutrition, sanitation and women’s empowerment), investment in health workforce and growth of medical tourism in future healthcare scenario. Conclusions Evaluating the patterns of previous 30 years and predicting the progress and challenges of future health system are no rocket science. Medical care will be more self-directed in a more tech-savvy population as information will be more accessible and user friendly with higher quality. Health driving factors such as clean water, sanitation and food will take the center stage in humanities struggle and even increase population size. PMID:28293581

Healthcare and healthcare systems: inspiring progress and future prospects.

PubMed

Durrani, Hammad

2016-01-01

Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population growth will occur in the urban areas of poor countries. The rapid, unplanned and unsustainable style of urban development will make developing countries cities the key focal points for emerging environmental and health hazards. Changes will be seen in design, culture and practices of hospitals to better meet the needs of patients, families and providers. Top driving factors of global healthcare system for next 30 years will be leading causes of mortalities, non-health factors (impact of nutrition, sanitation and women's empowerment), investment in health workforce and growth of medical tourism in future healthcare scenario. Evaluating the patterns of previous 30 years and predicting the progress and challenges of future health system are no rocket science. Medical care will be more self-directed in a more tech-savvy population as information will be more accessible and user friendly with higher quality. Health driving factors such as clean water, sanitation and food will take the center stage in humanities struggle and even increase population size.

[Rural-urban population redistribution between 1970 and 1980 (a micro-regional analysis)].

PubMed

Costa, M A

1982-01-01

Changes in rural-urban population distribution in Brazil from 1970 to 1980 are analyzed using census data. Trends examined include spatial redistribution throughout the country, rapid urbanization, the decline in the size of the rural population in the state of Parana, agricultural expansion in the northern and central-western regions, and the increase of the rural population within metropolitan areas. (summary in ENG)

Potential for use of environmental factors in urban planning

NASA Astrophysics Data System (ADS)

Teixeira da Silva, Ricardo; van der Ploeg, Martine; van Delden, Hedwig; Fleskens, Luuk

2016-04-01

Projections for population growth estimate, on top of the current 7.4 billion world population, an increase of 2 billion people for the next 40 years. It is also projected that 66 per cent of the world population in 2050 will live in urban areas. To accommodate the urban population growth cities are changing continuously land cover to urban areas. Such changes are a threat for natural resources and food production systems stability and capability to provide food and other functions. However, little has been done concerning a rational soil management for food production in urban and peri-urban areas. This study focuses on the assessment of soil lost due to urban expansion and discusses the potential loss regarding the quality of the soil for food production and environmental functions. It is relevant to increase the knowledge on the role of soils in peri-urban areas and in the interaction of physical, environmental and social factors. The methodology consists of assessing the soil quality in and around urban and peri-urban areas. It focuses particularly on the physical properties and the environmental factors, for two periods of time and account the potential losses due to urban expansion. This project is on-going, therefore current advances will be presented and will look for a discussion on the contribution of soil quality for decision-making and land management in urban and peri-urban areas.

Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya.

PubMed

Magadi, Monica A

2017-09-01

The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Multilevel logistic regression models are applied to nationally-representative samples of 13 094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Projected Regional Climate in 2025 Due to Urban Growth

NASA Technical Reports Server (NTRS)

Shepherd, J. Marshall; Manyin, Michael; Messen, Dmitry

2005-01-01

By 2025, 60 to 80 percent of the world s population will live in urban environments. Additionally, the following facts published by the United Nations further illustrates how cities will evolve in the future. Urban areas in the developing world are growing very rapidly. The urban growth rate will continue to be particularly rapid in the urban areas of less developed regions, averaging 2.4 per cent per year during 2000-2030, consistent with a doubling time of 29 years. The urbanization process will continue worldwide. The concentration of population in cities is expected to continue so that, by 2030, 84 percent of the inhabitants of more developed countries will be urban dwellers. Urbanization impacts the whole hierarchy of human settlements. In 2000,24.8 per cent of the world population lived in urban settlements with fewer than 500,000 inhabitants and by 2015 that proportion will likely rise to 27.1 per cent.

Analysing Surface Exposure to Climate Dynamics in the Himalayas to Adopt a Planning Framework for Landslide Risk Reduction

NASA Astrophysics Data System (ADS)

Tiwari, A.

2017-12-01

Himalayas rank first in the inventory of most densely populated and congested high altitude mountain regions of the planet. The region is mostly characterized by inadequate infrastructure, lack of mitigation tools along with constraints of terrain undermining the carrying capacity and resilience of urban ecosystems. Moreover, climate change has increased vulnerability of poor and marginalized population living in rapidly urbanizing mountain towns to increased frequency and severity of risks from extreme weather events. Such events pose multifold threat by easily translating to hazards, without the ability to respond and mitigate. Additionally, the recent extreme climate dynamics such as rainfall patterns have influenced the natural rate of surface/slope processes in the Himalaya. The aim of the study was to analyze the extent of interaction between climate dynamics and upland surface to develop participatory planning framework for landslide risk reduction using Integral Geographic Information System (integral GIS). At this stage, the study is limited to only rainfall triggered landslides (RTL). The study region lies in the middle Himalayan range (Himachal). Research utilized terrain analysis tools in integral GIS and identified risk susceptible surface without: 1.adding to its (often) complex fragmentation, and 2. Interference in surface/slope processes. Analysis covered most of the relevant surface factors including geology, slope instability, infrastructure development, natural and urban drainage system, land-cover and land-use as well. The outcome included an exposure-reduced model of existing terrain and the surface-process accommodated by it, with the use of local technical tools available among the poor and fragile mountain community. The final participatory planning framework successfully harmonized people's perception and adaptation knowledge, and incorporated priorities of local authorities. This research is significant as it rises above the fundamental challenges arising during management of the (often) conflicting perspectives, interests, and approaches of multiplicity of stakeholders thereby having vast potential to replicate/upscale in mountains beyond the study region as it ensures barrier free risk-communication through the most affordable and innovative tools.

Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space.

PubMed

Knight, Kelly R; Lopez, Andrea M; Comfort, Megan; Shumway, Martha; Cohen, Jennifer; Riley, Elise D

2014-05-01

Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly funded, newly built SROs to privately owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.'s framework of socio-structural vulnerability, we explore how SROs can operate as "mental health risk environments" in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women's mental health. The degree to which SRO built environments were "trauma-sensitive" at the macro level significantly influenced women's mental health at meso- and micro-levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro-level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women. Copyright © 2013 Elsevier B.V. All rights reserved.

Single Room Occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space

PubMed Central

Knight, Knight R.; Lopez, Andrea M.; Comfort, Megan; Shumway, Martha; Cohen, Jennifer; Riley, Elise

2014-01-01

Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly-funded, newly built SROs to privately-owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.’s framework of socio-structural vulnerability, we explore how SROs can operate as “mental health risk environments” in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women’s mental health. The degree to which SRO built environments were “trauma-sensitive” at the macro level significantly influenced women’s mental health at meso- and micro- levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro- level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women. PMID:24411945

Hypertension in Sub-Saharan Africa: A Contextual View of Patterns of Disease, Best Management, and Systems Issues.

PubMed

Nulu, Shanti; Aronow, Wilbert S; Frishman, William H

2016-01-01

Sub-Saharan Africa (SSA) bears the highest burden of both communicable and noncommunicable disease and has the weakest health systems. Much attention is directed toward a rising burden of chronic disease in the setting of epidemiologic transition and urbanization. Indeed, the highest prevalence of hypertension globally is in the World Health Organization's African region at 46% of adults aged 25 and above. And while hypertension in SSA is common, its prevalence varies significantly between urban and rural settings. Although there is evidence for epidemiologic transition in urban areas, there is also evidence of static levels of hypertension within rural areas, which comprise more than 70% of the population of SSA. Furthermore, overall cardiovascular (CV) risk in rural areas remains low. The mean age of hypertensives in SSA is approximately 30s to 40s, burdening those at peak productivity. Complications of hypertension are frequent, given the poor levels of awareness and treatment (<10%) of hypertension on the continent. Such complications include primarily stroke and hypertensive heart disease, as ischemic heart disease is uncommon. Mortality associated with these complications is high, with in-hospital mortality from 2 different sites reported as around 20%. The overall burden of hypertension is likely to be more related to poor access and availability of health systems and is representative of a looming crisis in health care delivery. The best approaches to population-wide treatment are those that utilize CV risk prediction for those with stage 1 hypertension, whereas treatment is generally indicated for all those with stage 2 or greater hypertension, especially in light of the high burden of stroke in SSA. Current guidelines recommend first-line drug therapy with a diuretic or calcium channel blocker. Despite these recommendations, the major obstacles to hypertension treatment are systemic and include the availability and cost of medications, the adequacy of health facilities and systems, and the lack of health insurance to address affordability. New and innovative systems-oriented approaches are needed to address the burden of hypertension on a platform of global equity.

Population genetics of the olive-winged bulbul (Pycnonotus plumosus) in a tropical urban-fragmented landscape.

PubMed

Tang, Grace S Y; Sadanandan, Keren R; Rheindt, Frank E

2016-01-01

With increasing urbanization, urban-fragmented landscapes are becoming more and more prevalent worldwide. Such fragmentation may lead to small, isolated populations that face great threats from genetic factors that affect even avian species with high dispersal propensities. Yet few studies have investigated the population genetics of species living within urban-fragmented landscapes in the Old World tropics, in spite of the high levels of deforestation and fragmentation within this region. We investigated the evolutionary history and population genetics of the olive-winged bulbul (Pycnonotus plumosus) in Singapore, a highly urbanized island which retains <5% of its original forest cover in fragments. Combining our own collected and sequenced samples with those from the literature, we conducted phylogenetic and population genetic analyses. We revealed high genetic diversity, evidence for population expansion, and potential presence of pronounced gene flow across the population in Singapore. This suggests increased chances of long-term persistence for the olive-winged bulbul and the ecosystem services it provides within this landscape.