Slum Definitions in Urban India: Implications for the Measurement of Health Inequalities

Half the population of low- and middle-income countries will live in urban areas by 2030, and poverty and inequality in these contexts is rising. Slum dwelling is one way in which to conceptualize and characterize urban deprivation but there are many definitions of what constitutes a slum. This paper presents four different slum definitions used in India alone, demonstrating that assessments of both the distribution and extent of urban deprivation depends on the way in which it is characterized, as does slum dwelling’s association with common child health indicators. Using data from India’s National Family and Health Survey from 2005–2006, two indicators of slum dwelling embedded in the survey and two constructed from the household questionnaire are compared using descriptive statistics and linear regression models of height- and weight-for-age z-scores. The results highlight a tension between international and local slum definitions, and underscore the importance of improving empirical representations of the dynamism of slum and city residents.

Condition of people living in Slums!

The parts of the cities, where these slums are located, are quite congested, as they are over populated. The conditions of the slum areas in metropolitan cities have deteriorated to such an extent due to the high density of population that the people there hardly enjoy even the basic amenities. The lanes are narrow and the houses are nothing but a single room tenement without the facilities of an open courtyard or an enclosure, thus depriving the people of natural gifts like sunshine and air.

In such areas, people use common latrines and water taps. Some of the slum areas do not even have single rooms, they are thick clusters of small, dilapidated mud huts, the roofs and ceilings of which are made of scraps of wood, gunny sacks, metal or some sort of waste material. Sometimes, 10 to 12 people live, eat and sleep in the same room. The streets are narrow and the sewage water stagnates in open surface drains, which emit bad smell. The children often play in places where the drains are used as open latrines.

Living conditions in many urban slums are worse than those in the poorest rural areas of the country. This can be attributed pardy to the slum’s exceptionally unhealthy environment. Many of the most serious diseases in cities are ‘environmental’ because they are transmitted through air, water, soil and food or through insect or animal vectors.

The concentration of people in areas where the provision of water, sanitation, garbage collec­tion and health care is inadequate creates the conditions where infectious and parasitic diseases thrive and spread. Around half the slum population is suffering from one or more of the diseases associated with inadequate provision of water and sanitation.

Despite the exterior appearance of chaos, slum life is highly structured, with many economic, religious, caste and political interests expressed in the daily activity. Living conditions are extremely difficult, and slum dwellers fear the constant threat of having their homes bulldozed in municipal ‘slum clearance’ efforts.


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