Urbanization and workers’ health
Cities themselves are built by workers, particularly (but not only) those in the
construction industries. But in most cases neither industry nor the city authorities
provide the infrastructure and the services necessary for workers to live decent,
healthy lives. Health should be a right for workers—Health for All being a conerstone
of healthy public policy—but workers who move into cities for economic reasons and
to purchase better services, education and ultimately good health are confronted by a
number of conditions that instead create ill health, both for them and their families.
According to UN Habitat, over 40% of the urban population of South Asia live
in slums. Workers often live near or even in their workplaces, such as roadsides
and building sites. Lack of safe drinking water and access to sanitation services,
and pollution from nearby transportation, factories and industrial complexes can
harm workers’ health, partly due
to the degraded quality of basic
environmental services such as clean
air, water and soil. Although in rare
cases slum dwellers have managed
to improve their housing and living
conditions, such as getting access
to water, most face a number of
environmental risk factors that give
rise to ill health. Diseases with the
largest environmental contributions
(diarrhoea, respiratory infections,
and injuries, including road traffic
injuries) are the most prevalent
environmental conditions that affect urban workers and the most vulnerable members
of their families, such as children.
Photo: Akshat Jain
Urban environments
Urbanization is defined by the United Nations as the movement of people from rural
to urban areas. People move into cities to seek economic opportunities. Living in rural
areas, often on small family farms, it is difficult to improve one’s standard of living
beyond basic sustenance. By contrast, cities are known to be places where money,
services and wealth are centralized. Living in cities permits individuals and families to
take advantage of the opportunities of proximity, diversity and marketplace competition.
Cities are where fortunes are made and where social mobility is possible. Businesses
that generate jobs and capital are usually located in urban areas. As a result, most
of the people who move to cities and stay in cities are workers.
Impact of environment on workers’ health
Globally, an estimated 24% of the disease burden (healthy life years lost) and an
estimated 23% of all deaths are attributable to environmental factors. The three most
predominant diseases in urban areas affecting migrant workers in cities—diarrhoea,
respiratory infections and injuries—can be attributed to the modifiable environment.
In addition, large numbers of workers are being inadvertently exposed to chemicals
and hazardous substances that cause irreversible damage to human health.
Diarrhoea: An estimated 94% of the diarrhoeal burden of disease is attributable
to the environment and is associated with risk factors such as unsafe drinking water
and poor sanitation and hygiene. Diarrhoea among children who are often already
malnourished leads to chronic malnourishment and higher levels of illnesses.
Respiratory diseases: These diseases are associated with air pollution due to traffic
and industrial emissions, dust containing particles hazardous to health, and indoor air
pollution related largely to household solid fuel use. An estimated 42% of respiratory
infections are attributable to environmental factors.
Increased burning of fossil fuels and the swelling numbers of motor vehicles on city
streets are polluting the environment at a pace that will be difficult to reverse unless
major concerted actions are taken. But the example of the Delhi government’s success
in reducing air pollution through a number of measures, particularly the conversion
of buses from diesel to compressed natural gas, has demonstrated that pollution can
be combated even in the context of rapid urbanization.
Injuries: These include injuries arising from workplace hazards, radiation and
industrial accidents; 44% of such injuries are attributable to environmental factors.
Workers are not aware of the conditions that expose them to injuries nor do they
have the means to prevent these injuries.
Chemicals have contributed to the improvement of living conditions and are on a
daily basis handled by workers in the chemical industry, as well as other industries.
It is estimated that 20% of all work-related fatalities involve chemicals. Workers and
other urban dwellers are often also exposed to dust that contains asbestos, mercury
or lead, all of which are highly damaging to human health.
The hazards that workers face in the cities are created by different sectors
of the government, community and industry. Any efforts to minimize these
hazards and promote the health of urban workers should therefore involve
all these sectors of the city.
Many measures can be taken to reduce the environmental disease burden
amongst workers in cities.
Different sectors of the city such as transport, energy, infrastructure and
industry must work with the health sector to address the root environmental
causes of ill health.
All sectors of the city should focus on improving the health of workers by
promoting safe water, better hygiene measures, use of cleaner fuels and
more judicious use and management of toxic substances in the home and
workplace.
Coordinated action by city authorities, sectors and civil society can lead to “human
resources” who can build healthier cities.