Factors determining the heterogeneity of disease burden in relation to urban disparities for Rawalpindi city slum area dwellers

Urban infectious diseases presents an appealing focus for control interventions due to rising global burden of diseases in urban dwellers. Urbanization in developing countries is mostly haphazard, ill-planned resulting in slum... [ view full abstract ]

Urban infectious diseases presents an appealing focus for control interventions due to rising global burden of diseases in urban dwellers. Urbanization in developing countries is mostly haphazard, ill-planned resulting in slum area where dwellers confront with health inequalities and are vulnerable to infectious diseases. The current study was conducted in urban-slum areas of Rawalpindi to investigate (i) incidence of infectious diseases in poor communities, (ii) factors associated with disease prevalence in urban settings and (iii) how equitable resource allocation can reduce the health risks of vulnerable population. Using self structured questionnaire, based on information gathered after extensive field surveys, data of 944 persons were collected out of which 585 (62 %) were females while 359 (38 %) were males with an average family income less than Rs. 15,000 (US$ 150) per month. Based on odds ratio statistics, significant increase in flu and gastrointestinal infections were observed. Age group between 6–12 years was most affected by flu while females appeared highly vulnerable to both flu (OR=1.39; 95% CI=1.07–1.80) and gastro problems (OR=1.51; 95% CI=1.16–1.95). Results of univariate logistic regression revealed that room sharing (OR=2.11; 95% CI=1.62–2.74) and 1-2 bed houses (OR=1.58; 95% CI=1.21–2.06) has significant effect on household flu vulnerability apart from other characteristics of slum areas such as open wastewater channels and exposure to cold. Inappropriate heating and inaccessibility to clean drinking water has forced people to indulge in risky behavior that has reduced their quality of life and increased their susceptibility to infectious diseases. We conclude that equitable allocation of financial resources can uplift the health of urban poor community investigated here. Better housing, safe infrastructure for extreme cold and heat exposure prevention, improved sanitation and access to safe drinking water are highlighted as intervention priorities.