Health in Human Settlements

Integrating data on health and human settlements to inform intersectoral action for health.

Health is influenced by the environments where we live such as the quality of housing, the availability of water and sanitation, and the presence of parks for physical activity. Obtaining and integrating data from multiple sectors such as health, urban planning, human settlements and education is needed to explore associations between these environmental features and health, Such efforts can help to develop appropriate built environment interventions to improve health and to measure how such interventions impact health profiles over time.

We explored factors that can either facilitate or impede the integration of data across several health and non-health government sectors. As proof-of-concept, we also merged administrative health data (health sector) and human settlements enumeration survey data (human settlements sector) for a selected informal settlement in Cape Town, South Africa. The aim was to assess whether such data integration could help to identify which areas should be prioritised for intervention based on the health profiles of the population and to explore whether this could also inform the choice of informal settlement upgrading intervention implemented in order to improve both human and environmental health.

Image from https://www.pri.org/stories/2013-04-04/school-year-blog-khayelitshas-code-vigilante-justice
Methods

Using a transdisciplinary research approach, we collaborated with key government stakeholders from the health and human settlements sectors in Cape Town to explore specific urban health challenges occurring in informal settlements. 

The stakeholders contributed to our study design,  the process of integrating health and housing data, and ideas for disseminating research findings. 

The study was conducted in two parts. 

  1. Using the integrated data to explore the health profiles for an informal settlement in Cape Townand to highlight features of the living environment that may influence health.
  2. Exploring the practicalities of merging two datasets across sectors, including the factors that facilitate or impede integration, and the opportunities to improve the data merging process in future. 

Key findings / Progress

We found that merging health and human settlements data allowed for important baseline urban health evidence to be developed for a local informal settlement.

The analysis highlighted a high level of diarrhoea cases presenting at clinics surrounding the informal settlement.

Of the available environmental data, water and sanitation were identified as most linked to diarrhoea and infectious diseases, according to the available literature. We found inequality across the informal settlement in households’ self-reported utilisation of water and sanitation services. For example, not every household within 50 metres from a communal toilet made use of it, with some households instead using bucket toilets or the bush, both of which are defined as inadequate forms of sanitation. Utilisation is often used as a proxy indicator for “access”. Yet, the concept of “access” to services is more than just the physical presence or use of a service. It is also about the acceptability, affordability, and physical access to services especially for the elderly, children, and vulnerable groups including those with disabilities.

We found that qualitative information enhanced the interpretation of quantitative data for the local community setting. For example, available media reports suggested that some households claim basic services for private use, forcing others to pay out of their pocket to use what should be a public service. Additional reports highlighted crime and vandalism as other barriers to service access. These findings highlight the need to involve the community in the development of data collection tools and to include the community voice in healthy urban planning interventions.

The integration of data from more than one sector was important for informing intersectoral action for health. The use of a transdisciplinary research approach, which included government department champions in the study design process, proved to be incredibly valuable. Government department champions and designated point-persons who were familiar with the availability and validity of data, variables, data collection methods, and consolidation processes, were able to provide guidance on the selection of indicators for this study and contributed to the development of our data merging strategy that complied with data governance procedures. This study thus presents a model for data integration applying a transdisciplinary approach that may be useful for government sectors and academics seeking to improve collaboration.

Project outputs
Other UrbanBetter projects you might be interested in…

Global Diet and Activity Research (GDAR)

The Global Diet and Activity Research Group and Network (GDAR) is funded through the NIHR Global Health Research initiative. The goal is to help prevent non-communicable diseases (NCDs), such as type 2 diabetes, heart disease, and cancers, in low and middle income countries (LMICs). 

Our work involves finding solutions that are affordable and created in partnership with local communities. GDAR builds on the expertise and knowledge of research in Cameroon, the Caribbean, Kenya, South Africa and the UK.

Integrating health into human settlements policy (LIRA study)

The LIRA study explores the knowledge, attitudes and practices of intersectoral collaboration between health and human settlements sectors among policymakers in Cape Town and Douala.

Using Cape Town, South Africa, and Douala, Cameroon, as case studies, this LIRA project (2018–2020), led by Tolullah Oni, seeks to develop a practical health and housing-integrated collaboration model that will improve urban policymaking and governance for the planning of African cities. 

UrbanBetter project outputs

Empowering Words for Cleaner Skies from the CLEAN-Air Africa Network

The fourth annual International Day of Clean Air for Blue Skies (07 September 2023) focusses on the theme, ‘Together for Clean Air’. The theme aims to highlight the urgent need for stronger partnerships, increased investment, and shared responsibility for overcoming air pollution.  The CLEAN-Air Africa

air pollution

Citizen science insights on air quality in 3 cities

The Cityzens for Clean Air campaign, part of the UrbanBetter Cityzens initiative, aims to amplify youth voices with advocacy on air pollution, climate and health using citizen scientist data generated by young people. The report is based on PM2.5 and NO2 air quality data collected

Air Of Excitement 

In this blog #UrbanBetter Disruptor, Waziri Mainasara Abubakar writes about his recent visit to a park in Lagos and what he discovered about the air quality at the park. “We spoke and he’ll be more than delighted to host you guys. He said to me that he

An Activist Architect Advocating for Healthy Public Spaces

On the 25th of September 2022, Lagos held its first ever Car-Free day. To commemorate this event, Cityzens4CleanAir Run Leaders organised and led a run through the streets of Lagos, using the opportunity to advocate for clean air and healthy public spaces. We asked #UrbanBetter Disruptor, Olasumbo Olaniyi,

Urban Health Governance -ISUH Africa Community of Practice webinar

Hosted by the Africa Community of Practice of the International Society for Urban Health, the webinar, centred around “Urban Health Governance”, is part of the Urban Health in Africa Webinar Series and will be held on 28th April 2022. The speakers will include actors from

urban planning & development

Integrating health in human settlements

Health through human settlements: Investigating policymakers’ perceptions of human settlement action for population health improvement in urban South Africa.

air pollution

The urban environment and leisure physical activity during the COVID-19 pandemic: a view from Lagos

In this commentary, we highlight five aspects of the ordinary – known interactions between urban environments and physical activity – that are amplified by the extraordinary – an unprecedented societal response to the ongoing COVID-19 pandemic. Using Lagos, Nigeria as a case study, we illustrate the possibility of re-thinking urban development and the potential for urban (re)form to address health inequalities in African megacities in the context of post-COVID-19 pandemic.

RICHE | Africa Workshop On Healthy Cities: Intersectoral Approaches To Non-Communicable Disease Prevention In Africa

The “Healthy Cities: Intersectoral approaches to non-communicable disease prevention in Africa” workshop presented the opportunity to collaboratively identify opportunities to promote health and wellbeing and prevent non-communicable diseases in African cities through investments that support active living and healthy diets.  Workshop participants were policy, civil

The LIRA project (2018–2020) team, led by Tolullah Oni
urban planning & development

Integrating health into human settlements policy (LIRA study)

Using Cape Town, South Africa, and Douala, Cameroon, as case studies, this LIRA project (2018–2020), led by Tolullah Oni, seeks to develop a practical health and housing-integrated collaboration model that will improve urban policymaking and governance for the planning of African cities. The project brings together academic and non-academic stakeholders representing a range of expertise: public health, health geography, urban planning, and demography. The project contributes to SDG 3 and SDG 11.

urban planning & development

A Systematised Review of the Health Impact of Urban Informal Settlements and Implications for Upgrading Interventions in South Africa, a Rapidly Urbanising Middle-Income Country

Informal settlements are becoming more entrenched within African cities as the urban population continues to grow. Characterised by poor housing conditions and inadequate services, informal settlements are associated with an increased risk of disease and ill-health. However, little is known about how informal settlement upgrading impacts health over time. A systematised literature review was conducted to explore existing evidence and knowledge gaps on the association between informal settlement characteristics and health and the impact of informal settlement upgrading on health, within South Africa, an upper-middle-income African country.