Urbanization and Health Issues

Introduction

By the year 2050, approximately 70% of the global population will be residing in cities. In the realm of the UK, more than four in every five persons dwell in urbanised areas. Residing in urbanised areas breeds forth a broad spectrum of health issues, most of which begins early in life and are propelled by wider determinants of health and wellbeing. Andrea (2019) suggests urban health issues are extracted from the intersection between the built environment of an area, and adopted lifestyles. This study intends to understand the intrigue of diabetes in an urbanised setting and how it impacts health and holistic wellbeing, through a systematic review of secondary literature. The context of this study is Sydenham Ward. The study will also harness fieldwork study in selected centres, official documents, meetings and observations, interviews and statistics in developing useful insights towards a logical conclusion on street violence.

Rationale of the Report

Diabetes affects people, communities, cities and countries globally. According to the International Diabetes Federation (IDF), diabetes attack approximately 9% of global adult population, translating to about 420 million people as at 2015. With this number increasing alongside the increase number of urbanisation, scholarly attention has been attracted concerning how urbanisation especially how the influx of people to urban setting triggers the increase in diabetes cases. Atkins (2018) study suggests two-third of the urbanised population is suffering from diabetes.

The urban health penalty approach suggests cities accumulate low income earners and expose residents to unhealthy conditions resulting to disproportionate burden of poor health, more so in ‘inner cities” (Gassasse et al., 2017). As the prospect of population increase ensues in urbanised setting, so does the occupants succumb to laxity and life free from physical exercises. This sort of dormancy accelerates accumulation of blood sugar which consequently motivates the development of diabetes (Cairns, 2019). This systematic study intends to substantiate the relationship between diabetes and urbanised settlement; and underscore the particular characteristics within the urban setting which invokes the development of diabetes, to further offer useful guidance to planners and policy makers for better decision making.

Profiling and Description of the Study Area (Sydenham Ward)

The study ward; Sydenham Ward is situated in the South Eastern part of London, and is comprising of a population of about 28, 500 people based on the 2011 census report (Lenzi, 2019). Initially known as Shippenham, Sydenham Ward began as a small settlement characterised by a few cottages inside the woods whose inhabitants collected firewood and reared animals. Sydenham Ward rapidly grew in the 19th century mainly following the introduction of Croydon Canal which connected Grand Surrey Canal to Croydon. Sydenham Ward is divided into three major localities namely the Sydenham Hill, Upper Sydenham and the lower Sydenham and Dell Green (Lenzi, 2019). The major commercial centre at Sydenham Ward commences at Kirkdale area around Cobbs Corner all the way to Sydenham road. These centres harbour various shops including coffee ships, Sydenham Ward as six main conservation areas namely Dulwich village, Cobbs Corner, Halifax Street, Sydenham Thorpes, Sydenham Park, and Sydenham Kirkdale. Sydenham Ward houses the highest concentration of green spaces in the London Borough of Lewisham. Sydenham Ward is well served with national rail and London buses as means for public transport, and is situated in Travel card Zones 4 and 3. Many people harness public means of transport relative to riding bicycles and walking.

The Observation Data

Diabetes is observed as a characterisation of Sydenham Ward courtesy of the city’s inability to venture into daily exercises helping to burn out excess calories from the body. Based on in-situ interviews, observations and a review of current literature, various factors were recorded as major of diabetes in Sydenham Ward including urbanisation which disorients peoples’ lifestyles including food habits, working patterns, physical activity, smoking, alcohol consumption, travelling patterns, and leisure activities which all have effect on health (Chan et al., 2015)..

Despite the relatively improved living standards in Sydenham Ward, other environmental stressors such as crime, violence and psychosocial elements affects the people of Sydenham Ward which dramatically shapes the health of the residents. Diabetes in the area of study, based on first-hand interviews with the residents portrayed an increasing trend. A critical observation noted the deviation from rural lifestyle to urbanised life characterised by dormancy in physical exercise and eating habits were the biggest contributors to ill-health among the diabetes patients.

In some areas, the emergence of informal settlements, motivated by food insecurity and lifelong conflicts was also observed in Sydenham Ward. The low income earners without access to health cover led to huge discrepancies in health care outcomes. Low income earners equally lacked favourable threshold for obtaining information regarding diabetes and related prevention measures. This made this study come to the realisation that the continued blossoming of urbanisation coupled with the increase in traffic congestion, slums, and stiff competition over social amenities such as hospitals and health care will ignite major concerns about public health.

The study records despite public disorder some Sydenham Ward neighbourhoods; some communities are dealing with mild violence than others, and with various violence patterns. The study observed for distinctive channels through which urbanised setting induces street violence namely insufficient infrastructure inducing less safe space to contain a secure community, inadequate street lighting bearing thresholds for violence and assaults, limited infrastructure and services which induce frustrations, which negatively impacts on wellbeing.

Painter-Davis (2018) positively correlates unemployment with street violence. Existing literature is not conclusive concerning the link between the two. However, the conviction that people perceive unemployment as the chief precursor of violence is fundamental to policy formulation for curtailing street violence.

Analysis, Interpretation and Discussion of Observation Data Analysis

Urbanised environments are highly complex with diverse ranges of cultural, social, environmental and economic factors which affect the health of residents (Diabetes U.K., 2015). Whereas urbanised set ups generally submits better education, improves income per capita; these do not always translate to improved health. Diabetes is a deleterious condition, induced as a result of dormancy and inactivity of the body, triggering high accumulation if blood sugars. The aspect of changing preferential patterns in eating in new urbanised setting is one of the core contributors to the basketry of diabetes. As observed in the area of study, the high tendencies towards street foods with high fat contents, and deviation from traditional foods contribute to obesity which may activate the outbreak of diabetes.

In addition, urbanised setting lacks widespread space and equipment for indulging into recreation and physical exercise to help in burning down excess fats from our bodies.

Sydenham Ward is well connected with roads and railway transport for car travel and public transport; but which inhibit cycling and walking. Reduced levels of exercise are encouraged by use of these means of transport, technologies at home, passive leisure pursuits and sedentary work. All these elements accounts for increased levels of obesity in turn increasing diabetes type 2.

The elements of environmental stressors preceding urbanisation such as crime and violence trigger emotional disturbances that affect wellbeing. In addition, irrespective of the role which genetics play in one’s health profile social aspects and cultural determinants reacts with peoples’ health in life. Social factors entails the social conditions in which people are born, grow, live and work which therefore shapes daily life. On the other realm, cultural factors determining diabetes are geographical, environmental, economic and political in nature and they help in determining how shared understandings, conventions and practices affect wellbeing and health. Cultural factors encompasses common believes of health, body size and illness.

Prevailing circumstance in the city may also promote crime, suggest Ogurtsova et al., (2017) Unequal access to employment and resources for individual empowerment arouses a state of despondency in which victims’ resorts to stress. Besides, rapid influx of people into the city without corresponding improvement in existing quantity and quality of infrastructures bring forth the development of scanty housing, poorly lit streets, creating a civilization organised in crime as a lifestyle.

Recommendations and Conclusion

In conclusion, the prospect of diabetes is a rich reservoir for mental and physical, mental and economic discomforts in most cities. Diabetes affects the economy if a neighbourhood, and may negatively influence economic development. These impacts are cumulative, spreading from individual level to becoming a health issue nationally. Despite diabetes attracting enough scholarly attention in academia and in policy formulation, it has not been eradicated Sydenham Ward and many urbanised settings. This study suggests the following recommendations as key measures for managing the condition.

1. Adopting in-depth community-involvement and community-led participations in understanding diabetes to form a holistic preventive measure. This study maintains community-involved and community led strategies upholds the role of elements such as race, accountability, power and inter-agency priorities and interests as crucial bases from which oppressive gaps emerge which are perceivable to trigger diabetes.

2. Establishment of support structures and interventions to foster economic empowerment of the urbanised population. These interventions should be all-inclusive and responsive to the target audience’s preferences to increase chances of uptake and acceptance.

3. Induction of awareness about diabetes and dietary concerns and encouraging healthy lifestyles including regular physical exercises, traditional foods with low fat contents, and stress management to curb obesity.

4. Provision of social services and improving infrastructural development including increasing health care centres, and deployment of various awareness programmes sensitizing about the role of regular health check-ups. Besides, parents should ensure responsible upbringing of children, to ensure their moral ideals are compatible with the universally acceptable ethics, but also to expose them to proper cooking and eating habits.

References

Andrea, L., 2019. Why urbanisation and health?. Acta Bio Medica: Atenei Parmensis, 90(2), p.181.

Atkins, K., 2018. The cottage hospital movement in England & Wales 1850–1914: origins, growth and contribution to the healthcare of the poor (Doctoral dissertation, Kingston University).

Cairns, G., 2019. Designing for Health & Wellbeing: Home, City, Society. Vernon Press.

Chan, J., DeMelo, M., Gingras, J. and Gucciardi, E., 2015. Challenges of diabetes self-management in adults affected by food insecurity in a large urban centre of Ontario, Canada. International journal of endocrinology, 2015.

Gassasse, Z., Smith, D., Finer, S. and Gallo, V., 2017. Association between urbanisation and type 2 diabetes: an ecological study. BMJ global health, 2(4), p.e000473.

Lenzi, A., 2019. Why urbanisation and health?. Acta Bio Medica Atenei Parmensis, 90(2), pp.181-183.

Ogurtsova, K., da Rocha Fernandes, J.D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N.H., Cavan, D., Shaw, J.E. and Makaroff, L.E., 2017. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes research and clinical practice, 128, pp.40-50.