Close proximity of slum dwellers could be answer to health problems
A new study suggests that the 'neighbourhood effect' of slums could help to alleviate some of their associated health problems.
A team of academics led by Warwick Medical School, University of Warwick have conducted a review of international slum research, which is being published in The Lancet.
They concluded that the one issue associated with the problems caused by living in a slum – people living in very close proximity to one another – could be the answer to some of their problems.
The study coincides with the UN's conference Habitat III to be held in Quito, Ecuador (17-20th Oct).
According to Improving the Health and Welfare of People who Live in Slums residents are exposed to what the authors call the neighbourhood effect – that is many people are affected by one factor because they live in close proximity to one another. However the authors argue that this can be a benefit because a single intervention can simultaneously improve many lives in one densely packed community.
Massive slums have become major features of cities in many low- and middle-income countries. The nearly one billion people who live in slums are a marginalised group facing unique health issues. The study was led by Professor Richard Lilford who along with colleague, Oyinlola Oyebode, is supported by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) West Midlands initiative. He said: "The neighbourhood effect in slums is both a problem and an opportunity. It is a problem because it is likely to amplify health hazards. However this effect is likely to offer economies of scale and increasing returns on investments to create a healthy environment. A historical example of this can be found in Victorian London when a water pump was shut down which averted a cholera epidemic.
"In addition our research highlighted that higher population density allows more people to be treated by clinic staff in less time; another potential example of increased economies to scale when intervening at the neighbourhood level in slums."
The academics argue that all slums should be included in censuses. Although slums are easily identifiable physically in many cities, statistics about them are often non-existent. Slums are rarely identified in national censuses, which form the sampling frames for national surveys. The team recommend that all censuses include identification for slum and non-slum clusters for all urban areas. They believe this will encourage better recording of information about health indicators for slum and non-slum areas both for research purposes and to identify local priorities for action for instance determining where disease outbreaks are most prevalent.
The report's authors argue that the topic of slum health should become a standalone academic disciple to help understand and improve conditions in slums. Fellow author, Dr Oyinlola Oyebode, Associate Professor, Warwick Medical School said: "To tackle the issue of slums we need to start looking at them in a different way. After all not all people living in slums fall below the poverty line, with anecdotal reports that there are even millionaires living in some slums. Poverty isn't the only cause of ill health in slums, the neighbourhoods themselves as 'spaces' need attention."
The paper Improving the Health and Welfare of People who Live in Slums is the second of a two part series of papers by the team called 'The health of people who live in slums' to be published in The Lancet on Sunday 16 October 11.30pm (BST)
Notes to editors
The health of people who live in slums 2; Improving the health and welfare of people who live in slums, The Lancet published 16 October 2016
Published Online October 16, 2016 http://dx.doi.org/10.1016/PII
List of authors
Prof Richard J Lilford, DSc (Hons) Warwick Centre for Applied Health Research and Delivery, University of Warwick;
Dr Oyinlola Oyebode, PhD Warwick Centre for Applied Health Research and Delivery,
Dr David Satterthwaite, PhD International Institute for Environment and Development, London;
Dr GJ Melendez-Torres, PhD Warwick Centre for Applied Health Research and Delivery, University of Warwick; School of Medicine,
Dr Yen-Fu Chen, PhD Warwick Centre for Applied Health Research and Delivery, University of Warwick;
Dr Blessing Mberu, PhD African Population and Health Research Centre, Manga Cl, Nairobi, Kenya;
Dr Samuel I Watson, PhD Warwick Centre for Applied Health Research and Delivery, University of Warwick
Jo Sartori, BA (Hons) Warwick Centre for Applied Health Research and Delivery, University of Warwick
Dr Robert Ndugwa, PhD Global Urban Observatory, Research and Capacity Development Branch United 24 Nations Human Settlements Programme
Prof Waleska Caiaffa, PhD School of Medicine, Federal University of Minas Gerais, Brazil
Dr Tilahun Haregu, PhD African Population and Health Research Centre, Manga Cl, Nairobi, Kenya
Prof Anthony Capon, PhD United Nations University, Kuala Lumpur
Dr Ruhi Saith, Oxford Policy Management, New Delhi
Dr Alex Ezeh, PhD , African Population and Health Research Centre, Manga Cl, Nairobi, Kenya; School of Public Health, University of Witwatersrand, Johannesburg, South Africa
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www.nihr.ac.uk).
NIHR CLAHRC West Midlands is a five-year initiative funded by the National Institute of Health Research (NIHR) and matched funds provided by local health and social services. The initiative builds on the successful CLAHRC for Birmingham and Black Country pilot with a mission to create lasting and effective partnerships across health and social care organisations, universities (Birmingham, Keele and Warwick) to improve the services we can deliver for patient benefit.
Richard Lilford and Oyinlola Oyebode are supported by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) West Midlands initiative. Waleska Caiaffa is supported by the Brazilian National Council for Scientific and Technological Development (CNPq). The African Population and Health Research Centre (APHRC) team are supported in part from core support grants from the Hewlett Foundation, the Swedish International Development Cooperation Agency (Sida), and an anonymous funder. The paper presents independent research and the views expressed are those of the authors and not necessarily those of the funding sources, the National Health Service (NHS), or the UK Department of Health.