Children's health in slum settings

Alon Unger

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Urban and Rural Development Challenges Child Nutrition and Water Access Child and Adolescent Health

Abstract

Rapid urbanisation in the 20th century has been accompanied by the development of slums. Nearly one-third of the world's population and more than 60% of urban populations in the least developed countries live in slums, including hundreds of millions of children. Slums are areas of broad social and health disadvantage to children and their families due to extreme poverty, overcrowding, poor water and sanitation, substandard housing, limited access to basic health and education services, and other hardships (eg, high unemployment, violence). Despite the magnitude of this problem, very little is known about the potential impact of slum life on the health of children and adolescents. Statistics that show improved mortality and health outcomes in cities are based on aggregated data and may miss important intraurban disparities. Limited but consistent evidence suggests higher infant and under-five years mortality for children residing in slums compared with non-slum areas. Children suffer from higher rates of diarrhoeal and respiratory illness, malnutrition and have lower vaccination rates. Mothers residing in slums are more poorly educated and less likely to receive antenatal care and skilled birth assistance. Adolescents have earlier sexual debut and higher rates of HIV, and adopt risky behaviours influenced by their social environment. We also know little about the consequences of this form of early childhood on long-term health-related behaviour (eg, diet and exercise) and non-communicable disease outcomes, such as obesity, heart disease and mental illness. Further attention to understanding and addressing child health in slum settings is an important priority for paediatricians and those committed to child health worldwide.

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2005Social determinants of health inequalities 2001Investigating Neighborhood and Area Effects on Health 2005World Urbanization Prospects 2005Social determinants of health inequalities 2014World urbanization prospects 2003The measurement of SES in health research: current practice and steps toward a new approach 2009Built Environments and Obesity in Disadvantaged Populations 2004The Challenge of slums: global report on human settlements, 2003

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2021The Most Important Social Determinants of Slum Dwellers’ Health: A Scoping Review 2022Effects of social determinants on children’s health in informal settlements in Bangladesh and Kenya through an intersectionality lens: a study protocol

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