Measuring the Local Burden of Diarrhoeal Disease Among Slum Dwellers in the Megacity Chennai, South India

Abstract

India is one of the focal points of the global megapolisation process. The country is facing urban poverty and the urban poor bear a large disease burden. In the South Indian metropolis of Chennai, one of India’s seven megacities, an estimated 18.9% (Census of India 2001) to 40.9% (NFHS-3 in Gupta et al. 2009: 74) of the population lives in areas categorised as slums. Slums are characterised as areas with lack of access to basic services, substandard housing, overcrowding, insecure tenure, poverty as well as unhealthy living conditions (UN-Habitat 2003: 11). Consequently slum dwellers are not only more exposed to social and environmental health risks (e.g. lack of sanitation facilities), but also have less capacities to cope with them. The health status of slum dwellers is poor in comparison to other residents. The results of the third National Family Health Survey (NFHS-3, 2005-06) (Gupta et al. 2009) clearly indicates this intra-urban health inequality. The South Indian megacity Chennai is a case in point (NFHS-3, 2005-06): while the infant mortality rate for Chennai as a whole was 27.6, the rate in non-slum areas was 24.2 as compared to 38 in slum areas. A look at the disease-specific health burden shows that slum dwellers are suffering a higher burden of infectious diseases: tuberculosis, a widespread infectious disease in India, has a prevalence of 863 per 100,000 among male slum dwellers in Chennai. The prevalence in nonslum areas in contrast is 437 per 100,000. In addition, slum dwellers have, in certain areas, a higher burden of non-infectious diseases as well: the prevalence of diabetes among female slum dwellers was 3,901 per 100,000 in Chennai. It was slightly higher than the prevalence among non-slum female residents, which was 3,867 per 100,000.