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      Slum Health: From Understanding to Action

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      Author(s): * ,
      Publication date (Electronic):
      Journal: PLoS Medicine
      Publisher: Public Library of Science

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          Abstract

          The defining physical and legal characteristics of slums profoundly affect the health of these communities and may also serve as potential targets for immediate intervention.

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          Most cited references34

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          Urban as a Determinant of Health

          David Vlahov, Nicholas Freudenberg, Fernando Proietti … (2007)
          Cities are the predominant mode of living, and the growth in cities is related to the expansion of areas that have concentrated disadvantage. The foreseeable trend is for rising inequities across a wide range of social and health dimensions. Although qualitatively different, this trend exists in both the developed and developing worlds. Improving the health of people in slums will require new analytic frameworks. The social-determinants approach emphasizes the role of factors that operate at multiple levels, including global, national, municipal, and neighborhood levels, in shaping health. This approach suggests that improving living conditions in such arenas as housing, employment, education, equality, quality of living environment, social support, and health services is central to improving the health of urban populations. While social determinant and multilevel perspectives are not uniquely urban, they are transformed when viewed through the characteristics of cities such as size, density, diversity, and complexity. Ameliorating the immediate living conditions in the cities in which people live offers the greatest promise for reducing morbidity, mortality, and disparities in health and for improving quality of life and well being.
          Article 0 comments Cited 148 times – based on 0 reviews     Review now
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            Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group.

            A I Ko, M Galvão Reis, C M Ribeiro Dourado … (1999)
            Leptospirosis has, traditionally, been considered a sporadic rural disease. We describe a large urban outbreak of leptospirosis. Active surveillance for leptospirosis was established in an infectious-disease referral hospital in Salvador, Brazil, between March 10 and Nov 2, 1996. Patients meeting case criteria for severe manifestations of leptospirosis were recruited into the study. The diagnosis was confirmed in the laboratory with the microagglutination test and identification of leptospires in blood or urine. Risk factors for death were examined by multivariate analyses. Surveillance identified 326 cases of which 193 (59%) were laboratory-confirmed (133) or probable (60) cases. Leptospira interrogans serovar copenhageni was isolated from 87% of the cases with positive blood cultures. Most of the cases were adult (mean age 35.9 years [SD 15.9]), and 80% were male. Complications included jaundice (91%), oliguria (35%), and severe anaemia (26%). 50 cases died (case-fatality rate 15%) despite aggressive supportive care including dialysis (in 23%). Altered mental status was the strongest independent predictor of death (odds ratio 9.12 [95% CI 4.28-20.3]), age over 37 years, renal insufficiency, and respiratory insufficiency were also significant predictors of death. Before admission to hospital, 42% were misdiagnosed as having dengue fever in the outpatient clinic; an outbreak of dengue fever was taking place concurrently. An epidemic of leptospirosis has become a major urban health problem, associated with high mortality. Diagnostic confusion with dengue fever, another emerging infectious disease with a similar geographic distribution, prevents timely intervention that could minimise mortality.
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              Road-traffic injuries: confronting disparities to address a global-health problem.

              Martha Híjar, Shanthi Ameratunga, Robyn Norton (2006)
              Evidence suggests that the present and projected global burden of road-traffic injuries is disproportionately borne by countries that can least afford to meet the health service, economic, and societal challenges posed. Although the evidence base on which these estimates are made remains somewhat precarious in view of the limited data systems in most low-income and middle-income countries (as per the classification on the World Bank website), these projections highlight the essential need to address road-traffic injuries as a public-health priority. Most well-evaluated effective interventions do not directly focus on efforts to protect vulnerable road users, such as motorcyclists and pedestrians. Yet, these groups comprise the majority of road-traffic victims in low-income and middle-income countries, and consequently, the majority of the road-traffic victims globally. Appropriately responding to these disparities in available evidence and prevention efforts is necessary if we are to comprehensively address this global-health dilemma.
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                Author and article information

                Journal
                Journal ID (nlm-ta): PLoS Med
                Journal ID (publisher-id): pmed
                Title: PLoS Medicine
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Print): 1549-1277
                ISSN (Electronic): 1549-1676
                Publication date (Print): October 2007
                Publication date (Electronic): 23 October 2007
                Volume: 4
                Issue: 10
                Electronic Location Identifier: e295
                Author notes
                * To whom correspondence should be addressed. E-mail: aunger@ 123456mednet.ucla.edu
                Article
                Publisher ID: 07-PLME-ES-0619R1
                DOI: 10.1371/journal.pmed.0040295
                PMC ID: 2039756
                PubMed ID: 17958462
                SO-VID: 3df82521-a8b0-401e-b9ce-fc3443f9fe66
                Copyright © Copyright: © 2007 Unger and Riley. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Page count
                Pages: 6
                Categories
                Subject: Essay
                Subject: Infectious Diseases
                Subject: Public Health and Epidemiology
                Subject: Socioeconomic Determinants of Health
                Subject: Public Health
                Subject: Environmental Health
                Subject: Epidemiology
                Subject: Health Policy
                Custom metadata
                citation Unger A, Riley LW, et al. (2007) Slum health: From understanding to action. PLoS Med 4(10): e295. doi: 10.1371/journal.pmed.0040295
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                ScienceOpen disciplines: Medicine
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                ScienceOpen disciplines: Medicine

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