Urban Health and Well-being

Semester and Year Offered: Monsoon semester, 2nd Year

Course Coordinator and Team: Samik Chowdhury

Email of course coordinator: samik[at]aud[dot]ac[dot]in

Pre-requisites: None

Aim: The aim of this course is to introduce students to urban health and well-being as an outcome of the complexities of the urban way of life. It deals with the historical, demographic, physical, social, economic and institutional attributes of urbanization which along with innate biological and behavioural characteristics, constitute the multi-sectoral and multi-level determinants of urban health and well-being.

Course Outcomes:

Gain understanding of some of the historical, demographic, physical, social, economic, ecological and institutional factors determining urban health and well-being in a global context.

1. To understand urban disease burden vis-à-vis the non-urban, and acknowledge and observe its heterogeneity even within cities.
2. To develop a practical understanding of urban health in India
3. Gain familiarity with health statistics in India and develop the ability to perform basic data analysis to highlight urban health issues.

Brief description of modules/ Main modules:

1. Urban way of life – An overview: An introductory module that provides an overview of status and prospects of global urbanization and urban facts of life viz. importance of cash income, markets, informality, safety nets, women’s work, lifestyle, access to public services, environmental contamination and governance, migration, urban slums and their characteristics.
2. Disease burden and well-being in urban settings: This module discusses key characateristics of disease burden in urban like double burden of disease, re-emergence of vector borne diseases etc. The module shall particularly focus diseases like tuberculosis, dengue, malaria, diabetes, cardio-vascular diseases, accidents, occupational injuries, mental health etc.
3. Inequity in urban health and well-being: This module deals with inequities in urban health and well-being. Inequities in health outcome and determinants will be examined across population groups defined by socioeconomic status, race or ethnicity, gender, migration status or location.
4. Health and the urban physical environment: This module captures the urban physical environment and its impact on urban health and well-being. Out of issues like housing, drinking water, sanitation; air and noise pollution, food and nutrition, transport, culture of physical activity, substance abuse etc. three to four key issues would be covered depending on the time at disposal.
5. Urban health in India: This module will discuss some of these unique features of an urban health system with particular reference to India and its impact on health outcomes of the different segments of urban populace. The module also aims at providing hands on experience of reading, interpreting and analysing data related to urban physical environment, health outcomes and their distribution across urban socio-economic categories.

Assessment Details with weights:

1. Term paper (30%).
2. The mid semester assessment will consist of a group work leading to (1) a complete mapping of health service providers in one's neighbourhood OR (2) a report based on a survey (heterogeneous sample with a maximum size of 20) of health provider preference with reasons (30%).
3. The end semester assessment will consist of a final examination (40%).

Reading List:

• World Urbanization Prospects 2018, United Nations Population Division, https://population.un.org/wup/
• The challenge of slums : global report on human settlements, 2003 / United Nations Human Settlements Programme https://www.un.org/ruleoflaw/files/Challenge%20of%20Slums.pdf
• Chapters 3, 4 & 5 of Global report on urban health: equitable, healthier cities for sustainable development. World Health Organization 2016.
• Amartya Sen. Why health equity? Health Economics. 11: 659-666 (2002)
• Sandro Galea, David Vlahov (eds). Handbook of Urban Health-Populations, Methods, and Practice (Part-I, Chapters 2-12). Springer, 2005.
• Hidden cities: unmasking and overcoming health inequities in urban settings. WHO & UNHABITAT (2010). https://apps.who.int/iris/bitstream/handle/10665/44439/9789241548038_eng.pdf?sequence=1&isAllowed=y
• Climate Change and Urban Health. https://alumni.northeastern.edu/wp-content/uploads/2017/02/Climate-Change-Principles-and-History-of-Urban-Health.pdf
• Jishnu Das and Jeffrey Hammer. Location, Location, Location: Residence, Wealth, And The Quality Of Medical Care In Delhi, India. Health Affairs. 27 March 2007.
• Siddharth Agarwal. The state of urban health in India; comparing the poorest quartile to the rest of the urban population in selected states and cities. Environment & Urbanization 2011. Vol 23(1): 13-28.
• NUHM Implementation framework, http://www.nhm.gov.in/images/pdf/NUHM/Implementation_Framework_NUHM.pdf

ADDITIONAL REFERENCE:

• Sharan, Awadhendra. In the City, Out of Place: nuisance, pollution and dwelling in Delhi, c. 1850-2000. New Delhi Oxford University Press 2014.
• Das Veena. Affliction: Health, Disease, Poverty. Orient Blackswan New Delhi; 2015.