Global Forces of Urbanization: Slums and Urban Health

Favela in Curitiba, Brazi.

The global scale of slums is astounding. According to UN-HABITAT, one billion people currently reside in slums. That number may to grow to three billion by 2050.   People who live in slums lead less healthy lives than their more wealthy urban counterparts or even than rural folks in many places. (Friel et al, 2011, p. 862) The Global Research Network on Urban Health Equity (GRNUHE) researchers wrote, “there is something about urban living – urban physical and social environments and living conditions, and the ways of life they encourage – that cause these inequities in health.” (p. 863) But urban living is not the root cause of health inequities.


Arline T. Geronimus (2000) writes that we must consider “the historical and structural factors that have produced modern ghettos” in order to reverse health inequities in US cities. (p. 867) Similarly we must examine the historic and ongoing global forces that are driving the rapid urbanization of the world if we hope to understand the root causes of health inequities in cities worldwide. Lucky for you, dear reader, I recently read Planet of Slums by Mike Davis and a handful of other texts about the economic drivers of unplanned urbanization and deagrarianization.

Cities, from small to mega, around the world are expanding outward, often without any kind of planning and without a comparable growth in the economy. Urbanization has become disconnected from industrialization and occurs without additional jobs. For example, Africa is urbanizing at 3.5% to 4% per year but has stagnant job growth and agricultural yields. Davis clarifies, “‘Overurbanization,’ in other words, is driven by the reproduction of poverty, not by the supply of jobs.” (Davis, 2006, p. 16)

What drives this type of urbanization without growth? Davis writes that it is “the legacy of a global political conjuncture - the worldwide debt crisis of the late 1970s and the subsequent IMF-led restructuring of the Third World economies in the 1980s.” (Davis, p.14) In the 1970s, a combination of oil price shocks and an economic recession in the Global North led to northern banks raising interest rates and demanding loan repayments. This created an economic crisis in the South, with economic declines and mounting foreign debt. (Holt-Gimenez and Patel, 2009, p. 36)

As nations of the Global South accumulated debts they were unable to pay off, they were obliged to submit to Structural Adjustment Programs (SAP). The financial disciplinary measures imposed by the International Monetary Fund and the World Bank eroded social safety nets and stymied state-led development plans. “Everywhere the IMF and World Bank...offered poor countries the same poisoned chalice of devaluation, privatization, removal of import control and food subsidies, enforced cost-recovery in health and education, and the ruthless downsizing of the public sector.” (Davis, p.153) These programs simultaneously deregulated agricultural markets, forcing peasant farmers to compete on the global market. Small farmers from the Global South could not compete against the subsidized agribusinesses of the developed world. Many of these growers lost their land, their means of production, and moved from rural areas to new settlements on the edge of cities. (Davis, p.153)

The push from the rural and pull to the urban must be seen within the context of the global economy in a globalized world. People are driven to live in these peripheral slums through evictions from rural and inner city areas, loss of farmland, famine, war, and debt. People are also attracted to the city by the hope of finding work. Industries, often polluting, exploitative, or toxic, are located on the urban fringe as well. This location obscures them from official scrutiny and allows them to take advantage of a reserve army of labor, the constant flow of migrants to the urban periphery. (Parker, p. 163, Davis, p. 46) “The urban edge is a societal impact zone where the centrifugal forces of the city collide with the implosion of the countryside.” (Davis, p. 46)

Urban planning to address health inequities could have a positive impact the ‘societal impact zones’ of unplanned urbanizations. Finding the political will to carry out such a project is another matter. Further complicating the issue is the need to reduce health disparity and develop without increasing land values and displacing people from slums. Planners in Curitiba, Brazil have attempted to become a sustainable city and improve the neighborhoods of the ten percent of the population that lives in favelas (slums). Though their projects have displaced people, they have also tried out creative solutions to avoid displacement. For example, planners wanted to run sewer and water lines into a favela but knew that paving streets would escalate land prices. Instead of placing the pipes along new roads, they installed them along footpaths. Land values did not increase rapidly and the favela became a healthier place to live.  (Moore, 2007, pp. 86 - 112) The GRNUHE researchers suggest several research areas to help resolve health inequities in cities, including the impacts of globalization on urban form and how to translate knowledge into action. Hopefully such research will bear fruit for the billion people who live in slums worldwide.


By Emily Becker


References
Davis, M. (2007). Planet of Slums. London: Verso.   

Friel, S., Akerman, M., Hancock, T., Kumaresan, J., Marmot, M., Melin, T., et al. (2011). Addressing the Social and Environmental Determinants of Urban Health Equity: Evidence for Action and a Research Agenda. Journal of Urban Health, 88(5), 860–874.

Geronimus, A. T. (2000). To mitigate, resist, or undo: addressing structural influences on the health of urban populations. American Journal of Public Health, 90(6), 867.

Holt-Giménez, E., & Patel, R. (Eds.). (2012). Food rebellions: Crisis and the hunger for justice. Oakland, CA: Food First 
         Books.

Moore, S. (2007) Alternative Routes to the Sustainable City: Austin, Curitiba, and Frankfurt. Lanham, MD: Lexington Books.