Abstract

PIP: This article draws attention to the health implications of poverty in urban areas of developing countries. Migrants in Africa are depicted as bringing poverty with them and, in turn, being exposed to urban problems of access to water, sanitation, and shelter. Urban populations in low-income countries are viewed as carrying a double burden of health problems from communicable diseases and health problems typically associated with economically advanced societies, such as chronic diseases, accidents, and violence. Disease rates among children in urban slums from infectious diseases are reported to be sometimes higher than in rural areas. The rates of heart diseases and neoplasms are higher among the urban poor, even in Southern countries. The double burden is not shared equally by cities. The European experience is described as one where health professionals were instrumental in shifting policies to alleviating poor health conditions by changing physical conditions and socioeconomic conditions and improving the adjustment to the stresses of urban living. The European experience needs to be applied and is being applied by health professionals working in African cities. Urbanization is expected to increase by 40-66% by the year 2010. Shifts will occur due to the desire for better jobs and better lives and due to displacement from war and civil conflict. 30-60% of urban population already live in slums, which may have a lack of access to basic needs such water, sanitation, and adequate housing, or inadequate food supplies and expensive and scarce fuel. Slums are characterized by high population densities and location on hazardous sites. Children are at high risk.