Poverty triggers poor urban health in Pakistan

It is widely recognised that about 3.5 billon human are urban settlers. One third these 3.5 billons are categorised as urban poor dwellers. This phenomenon of urban poverty is widely observed in developing and under developed nations especially, in Asia and Africa where poverty is thought to be one of the major reasons behind the catastrophic increase in these slum areas. Each year around 11 million refugees as well as 25 million persons migrate internally and externally, according to UNHCR, which is one of the most prominent factors playing its part in increasing the number of urban settlers and poverty chart. Pakistan is also facing this momentous challenge of rural-urban shifts an internal migration.

Various prediction models and reports indicate clearly that till 2050 the number of urban settlers will reach to almost 6.2 billion. Poverty in urban regions is a prominent shareholder of global poverty. It is mostly thought that urban residents are far better than rural ones in terms of food, education, health care as well as various other opportunities leading towards a better successful life. For some people it may be true but keeping in mind the vast increase in number of residents along with increasing poverty level this so called “Urban benefit” is just a myth.

Colossal disease burden among urban poor is an imminent challenge for governments all over the world. Surprisingly, top indicator of human well being the ‘mental health’ is observed negatively associated with urban poverty by epidemiologists in developing countries. Unfortunately, in Pakistan limited research on urban health issues has attributed for scanty data regarding big cities. Consequently, unaccounted cases of poverty–health are raising but growing population effects on poverty in urban areas, have certainly noticed. The most devastating effects, mostly ignored by our governments include poor living standards, food scarcity, unhygienic neighbourhood and bad health conditions due to increase in the poverty in urban areas. Many health problems and fatal diseases are the hallmark of poverty dominant spots in big cities primarily due to unsafe housing and poor sanitation.

In this regard, it has been observed that tuberculosis is the most commonly emerging disease in poor nations. Although it is curable and the treatment is cost effective but still high prevalence of tuberculosis is accounted for over population, poor diet and lower socio-economic status. An important intervention to prevent tuberculosis is to provide better living conditions and ultimately by decreasing poverty.

Undoubtedly, urban areas offer better employment opportunities owing to that rural population tend to migrate towards urban areas. Therefore rural to urban migration increases poverty and causes more air pollution affecting health of inhabitants. According to WHO, the overcrowded areas of developing countries have more chances of disease prevalence such as malaria, polio, diphtheria and tetanus. In urban environment, air pollution and poverty are affecting the cognitive functions both directly by the exposure of air pollutants to brain, immune dysregulation, neuroinflamation, oxidative stress and indirectly through overcrowding and loud noise. It is quite unfortunate that large cities in Pakistan have rarely been screened for poor areas of where public health risks are high and expected prevalence of asthma, malaria, dengue and other water-borne or air-borne disease is high. Many developed countries still face the problem of poverty. Few studies conducted by EcoHealth Research Group, working in the Department of Environmental Sciences, PMAS Arid Agriculture University, Rawalpindi has explicitly identified poor urban neighbourhoods in Rawalpindi city with high prevalence of water-borne diseases. Apart from that findings further reveal considerable level of heterogeneity of disease burden in relation to urban disparities among surveyed population. Some immediate intervention measures are required to improve urban health. The reason poverty became such an important topic in recent years is that more and more people now realise how important it is for peace, stability and healthy society.

Ongoing instability of Pakistan is thought to be directly linked with prevailing poverty in both the rural and urban areas. Poverty, fast growing population, and economic instability are key determinants of poor urban health. Newspapers and media have repeatedly presented pictures of deteriorating livelihood conditions in different cities. However, in-depth research has not yet being conducted on urbanisation and health effects especially in Pothowar region. Health-related awareness programmes and research should be conducted to address cultural, economic and social dynamics of urban health.

This year, International Society for Urban Health has organised its annual conference in San Francisco, USA from April 1 to 4 where researchers from EcoHealth group Arid Agriculture University, Rawalpindi are presenting their findings to share knowledge and gain from the experiences of leading urban health researchers. It is assumed that urban health scientists from Pakistan will gain enormous benefits from the conference platform and enable them to evolve appropriate intervention strategies to address the urbanisation and health challenges.

Eco Health Research Group, Department of Environmental Sciences, PMAS Arid Agriculture University, Rawalpindi

Email: razia.sultana@zoho.com