CVGZ 2OTB HC2: EFFECTS OF POVERTY ON HEALTH

CHARACTERISTICS OF THE POOR IN THE PHILIPPINES (ADB) COASTAL POVERTY

- The majority lives in rural areas and work in the agriculture sector, mostly as farmers and - BASECO sits on a delta created by deposits from the Pasig River
fishers. - It covers an area approximately 56 hectares considering of 4 main blocks:
- In the urban areas, such as Metro Manila, they are found in slums and the informal sector. o Big island 11.7 has
- They have large families (six members or more). o Dumping site 5.4 has
- In 2/3 of poor families, the head of household has only an elementary education or below. o Small island 15.1 has
- They have no or few assets and minimal access to credit. o Swampy area 23.7 has
- Environmental concerns:
RURAL POVERTY o Flooding (9)
o Sanitation (9)
- In impoverished rural areas, there is less sophisticated o Congestion (7)
medical care, the towns are spread out, further away o Water Pollution (7)
from intervention services and often there is little to no
public transportation. ALONG ROADS OR HIGHWAY
- People living in these areas are less likely to have strong
academic backgrounds- they may not have graduated - The centre has a land area of 184 hectares
from high school. - The houses are situated along the highway of Commonwealth
- According to the government definition, all areas that are Avenue
not urban, suburban or metropolitan are by default Urban population (2010 & 1990)
- Major environmental problem:
classified as rural. o Air pollution
o Noise pollution
RURAL VS URBAN o Congestion

RURAL URBAN URBANIZATION DUE TO MIGRATION

- Poorer - Wealthier
- Lower literacy - Higher literacy - Is a reality 12

- Lower health care
- Little infrastructure available
- Poor standard of housing
- Only primary employment (farming)
- Overall rural areas have lower standard
of living
- Better health care
- More developed infrastructure
- Better housing conditions
- More tertiary/secondary employment
- Overall urban centres give people higher
standard of living
- Has reached to considerable proportions
- Leading to increased growth of slums
- Will increase further to greater proportions in the foreseeable future
- Slums lack infrastructure in basic amenities like safe drinking water, sanitation, housing etc
- At increased risk of both communicable and non-communicable diseases

DUMPSITE POVERTY MIGRATION

- The settlement was started by previous residents of Smokey Mountain in 2000 CAUSES CONSEQUENCES
- The dump covers an area of at least 10 hectares - Increased family size - Overcrowding
o Limited agricultural property - Mushrooming of slums
- Major environmental problems:
o Land use Pattern - Unemployment
o Congestion o Irrigation facilities
o Air pollution - Poverty
- Better income prospects
o Sanitation - Physical & mental stress
- Better educational facilities
o Flooding/mud - Family structure
- Better “Life style”
o Nuclear
12 families
- Basic amenities – health, transport, water, o Single males
FLOODWAY POVERTY electricity
- Victims of natural/manmade calamities
- Thickly populated and houses are separated by thin walls, especially - Refugees
now that the Manggahan East and West Floodway is full of Settlers
- Environmental concerns:
o Flooding
o Congestion
 CVGZ 2OTB HC2: EFFECTS OF POVERTY ON HEALTH
MIGRATION: COB-WEB NOTES

- In Manila, more than 35 diseases have been identified in scavenger communities and in areas
that lack garbage collection and sanitation
- . They include diarrhea, typhoid fever, cholera, dysentery, tuberculosis, anthrax, poliomyelitis,
skin disorders, pneumonia, and malaria
- Respiratory ailments such as tuberculosis, bronchitis and asthma are common complaints of
households in dumpsite communities and those along roads and highways.
- Mental stress and sleepless nights affects the residents specially children and the elderly.
- Diarrhea and skin ailments are common ailments in all slum communities especially those
residing near rivers.

Table 1: Top Morbidity and Mortality Diseases, Manila City (Rate per 100,000 population)

HEALTH PROBLEMS DUE TO URBANIZATION

URBAN VS RURAL HEALTH

Is urban health better than rural health? → Almost all health indicators are better for urban when
compared to rural → When the urban slums are taken many are worse than rural !!!

DOUBLE BURDEN OF DISEASES

- Overcrowding and related health issues

o Rapid growth of urban centers has led to substandard housing on marginal land and
overcrowding
o Outbreaks of diseases transmitted through respiratory and faeco-oral route due to
increased population density
o It exacerbates health risks related to insufficient and poor water supply and poor
sanitation systems Table 2: Top Morbidity and Mortality Diseases, Municipality of Cainta (Rate per 100,000 population
o Lack of privacy leading to depression, anxiety, stress etc

- Air pollution and its consequences

o Due to increase in the numbers of motorized vehicles and industries in the cities of the
developing world
o Problems of noise and air pollution
o Air pollution can affect our health in many ways with both short-term and long-term
effects
o Short-term air pollution can aggravate medical conditions like asthma and emphysema
o Long-term health effects can include chronic respiratory disease, lung cancer, heart
disease, and even damage to other vital organs

- Upsurge of Non-communicable diseases

o The rising trends of non-communicable diseases are a consequence of the demographic
and dietary transition
o Decreases in activity combined with access to processed food high in calories and low in
nutrition have played a key role
o Urbanization is an example of social change that has a remarkable effect on diet in the
developing world
 CVGZ 2OTB HC2: EFFECTS OF POVERTY ON HEALTH
- The urban poor do not “wait” for governments or organizations to act on their behalf. They
have the desire and resourcefulness to find ways to improve their shelters, access running
water, produce food, organize child care, educate themselves and their children, and protect
each other amid extreme poverty

- Uncontrolled, rapid urbanization and the unraveling of the traditional social fabric deepen
inequity and give rise to alternative governance structures such as gangs (which target
impoverished youth) and paramilitary organizations (known to recruit children for warfare).
- People who live in informal settlements are at higher risk of exposure to crime and violence.
- Since 2000, the world’s fastest growing urban areas are also those where there are increasing
concentrations of informal settlements.
- This has profound consequences for public health strategies to control communicable (HIV-
AIDS, TB, H5N1 virus, dengue, and other vector-borne diseases), as well as noncommunicable
(obesity, diabetes, cancer, chronic heart disease, stroke, hypertension) diseases, mental health
and conditions that are associated with urban life (road traffic injuries, urban violence,
obesity, and unsafe settlements).
- Given the high concentration of national resources in cities, it is often assumed that city
dwellers have better access to services including health care, and that poor people in urban
settings are therefore better off than their rural counterparts
- Despite the obvious linkage between urban poverty and ill health and the potential impact on
the rest of the population, the health sector in many countries continues to narrowly define its
role as that of finding ways to improve access to services and improve the financing of health
care services for the poor.