Abstract

PIP: Urbanization in Mexico has given rise to creation of unauthorized squatter settlements on the peripheries of large cities. Such settlements are estimated to house about 1/2 of the urban population of Mexico. These settlers share a low standard of housing resulting from lack of employment and low income. Very often large households are crowded into poor quality structures with no running water or sewage disposal. Health consequences are serious. Although precise data are lacking in Mexico, residents of squatter settlements generally fall below the rest of the urban population in health indicators. Settlers in these makeshift communities all tend to be disadvantaged, but there are significant differences in the health and living conditions of different low income zones on the urban periphery. The relationship between the physical and social environments of squatter settlements and the health of the residents should be analyzed by urban administrators and public health officials as well as by demographers and social scientists, in order that solutions be found to existing problems. An integrated focus on the problem will be necessary. A working hypothesis to guide research is that habitat is a principal factor influencing the health o the population, and it affects health through a series of processes that can be analytically decomposed. In this multicausal approach, health status is the final result of a complex process in which many different factors intervene. A fundamental determinant is that of factors in the general social context, including public policy regarding low income housing, basic services, and health. A 2nd level of determinants is that of underlying factors in the physical and social environment. In squatter settlements, housing and services are central elements of the physical environment in which the life of the inhabitants unfolds. The current cholera epidemic in Latin American demonstrates the importance of housing and related variables for health. Social variables affecting health include demographic and socioeconomic characteristics of families. It must also be remembered that conditions of the physical and social habitat are mediated by social practices such as hygienic habits, diet, use of medications, and reproductive patterns.