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Poverty, housing and health in Johannesburg: exploring intra-urban inequalities   22 nd  August 2011 Liz Thomas, PhD – Wits/MRC Jo Vearey, PhD - Wits
Four aims for today ,[object Object],[object Object],[object Object],[object Object]
Developmental local government “ local government committed to working with citizens and groups within the community to  find sustainable ways to meet their social, economic and material needs  and  improve the quality of their lives ”  (RSA, 1998: 23)
Defining health ,[object Object],[object Object],[object Object]
Measuring health ,[object Object],[object Object],[object Object],[object Object]
WHO Commission on the Social Determinants of Health (2008)
Gini coefficient in selected South African cities   (Figure adapted from UN-HABITAT, 2008: 72)
A quadruple burden of disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
National YLL leading cause of Premature Mortality  DB 2006 using 2000 data pg 6 Differentiation between urban formal, urban informal and rural  1 HIV/AIDS Higher in urban areas, especially in informal housing areas with dense social networks. In  2 Homicide and violence Urban areas, especially young men associated with alcohol use 3 TB Overcrowded areas, closer proximity of people, poor ventilation, low immunity due to poor nutrition, HIV etc  4 Diarrhoeal diseases  Poor sanitation urban informal, higher chance of transmission due to density of people, and rural poor sanitation 5 Lower respiratory Exposure to indoor air pollution, elderly and under 5s, poor immunity, higher ambient air pollution where biomass fuels used for cooking and heating 6 Road traffic accidents Urban pedestrians especially with high alcohol levels 7 Stroke Disease of lifestyle  8 Ischaemic heart disease High stress, poor diet, low exercise, smoking and alcohol 9 Low birth weight Under 5’s – born to poor urban and rural woman, esp with low education levels, limited access to health facilities  10 Protein energy malnutrition Under 5’s - poor urban and rural contexts esp with low education levels of mothers
Urban informal settlements are associated with urbanisation.  ,[object Object],[object Object],[object Object]
So what do we know? ,[object Object],[object Object],wealthiest -----------------------------------middle --------------------------------------poorest  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIV  2x HIV in informal .
HIV prevalence in adults aged 15 – 49 years by locality type, South Africa, 2005 (HSRC, 2005)
Urban informal settlements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
24 hours Dietary Diversity Score: respondents residing informally are more likely to have a deficient dietary score Chi-square 89.880;  p =  <0.0001 Score 0 - 3 Score 4 - 6 Score 7 - 9 24 hour Dietary Diversity Score In a context of high HIV prevalence, urban informal settlements have poor food security.
Perception of risk of HIV Chi-square = 14.221; p = 0.0002 In a context of high HIV prevalence, urban informal settlement residents perceive themselves at risk of HIV
Inadequate access to basic services ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Housing
[object Object],[object Object]
Schooling
Transit camps
Development…..
Key messages ,[object Object],[object Object],[object Object],[object Object]

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Poverty, housing and health in Johannesburg

  • 1. Poverty, housing and health in Johannesburg: exploring intra-urban inequalities 22 nd August 2011 Liz Thomas, PhD – Wits/MRC Jo Vearey, PhD - Wits
  • 2.
  • 3. Developmental local government “ local government committed to working with citizens and groups within the community to find sustainable ways to meet their social, economic and material needs and improve the quality of their lives ” (RSA, 1998: 23)
  • 4.
  • 5.
  • 6. WHO Commission on the Social Determinants of Health (2008)
  • 7. Gini coefficient in selected South African cities (Figure adapted from UN-HABITAT, 2008: 72)
  • 8.
  • 9. National YLL leading cause of Premature Mortality DB 2006 using 2000 data pg 6 Differentiation between urban formal, urban informal and rural 1 HIV/AIDS Higher in urban areas, especially in informal housing areas with dense social networks. In 2 Homicide and violence Urban areas, especially young men associated with alcohol use 3 TB Overcrowded areas, closer proximity of people, poor ventilation, low immunity due to poor nutrition, HIV etc 4 Diarrhoeal diseases Poor sanitation urban informal, higher chance of transmission due to density of people, and rural poor sanitation 5 Lower respiratory Exposure to indoor air pollution, elderly and under 5s, poor immunity, higher ambient air pollution where biomass fuels used for cooking and heating 6 Road traffic accidents Urban pedestrians especially with high alcohol levels 7 Stroke Disease of lifestyle 8 Ischaemic heart disease High stress, poor diet, low exercise, smoking and alcohol 9 Low birth weight Under 5’s – born to poor urban and rural woman, esp with low education levels, limited access to health facilities 10 Protein energy malnutrition Under 5’s - poor urban and rural contexts esp with low education levels of mothers
  • 10.
  • 11.
  • 12. HIV prevalence in adults aged 15 – 49 years by locality type, South Africa, 2005 (HSRC, 2005)
  • 13.
  • 14. 24 hours Dietary Diversity Score: respondents residing informally are more likely to have a deficient dietary score Chi-square 89.880; p = <0.0001 Score 0 - 3 Score 4 - 6 Score 7 - 9 24 hour Dietary Diversity Score In a context of high HIV prevalence, urban informal settlements have poor food security.
  • 15. Perception of risk of HIV Chi-square = 14.221; p = 0.0002 In a context of high HIV prevalence, urban informal settlement residents perceive themselves at risk of HIV
  • 16.
  • 17.
  • 19.
  • 23.

Hinweis der Redaktion

  1. Add photos to illustrate Start with showing the different types of housing Diseases of lifestyle go across
  2. Not sure that we need this slide as the data/findings are presented over the next few slides….
  3. There are several ways of viewing food security: dietary diversity is one. Also access to food…. But I’m trying to keep it simple. I can ‘talk to it’ if needed (i.e. about other ways we measured food security).
  4. I can talk to this (I’ve not put numbers).