Exploring the social and physical determinants of urban health: constructing a health profile of the Kaula Bandar slum community

Overview

This ground-breaking project is a collaboration among PUKAR, the Harvard School of Public Health (HSPH), and New York University (NYU).  The agenda of this project is to perform a series of studies that will help to define the critical health issues in Kaula Bandar, a marginalized slum community located on the eastern docks of Mumbai.  The Rockefeller Foundation has generously provided funding for this endeavor.

Context

The year 2008 marked a demographic watershed as, for the first time, more than half of the world’s population was residing in urban areas.  Due to the intersection of rapid urbanization and poverty in developing countries, one-sixth of the world’s population now lives in urban slums — low-income, incredibly high-density settlements that often lack access to proper sanitation facilities or clean water.  Despite the obvious looming public health crisis in these communities, there is a remarkable paucity of medical or epidemiological research from urban informal settlements.

Addressing gaps in knowledge

The unique PUKAR-HSPH-NYU collaboration is using an interdisciplinary approach to address these gaps in knowledge.  We are exploring slum health using diverse research methods, including epidemiology, economics, anthropology, laboratory testing, and geographic information system (GIS) mapping.  HSPH and NYU contribute researchers trained in an array of these health and social science methodologies.  The research agenda has ranged from “core” public health questions (malnutrition rates, immunization rates, maternal health) to less commonly studied issues in poor communities (disasters and calamities, mental health, and occupational health).  This series of studies will highlight previously unexplored issues in urban health while also paving the way for new, evidence-based interventions addressing health in Kaula Bandar.

Building local capacity

In line with PUKAR’s larger mission of democratizing the research process, we also hope to foster new levels of community engagement with public health research.  PUKAR has cultivated a team of “barefoot researchers” — youth fellows, some of whom are from the Kaula Bandar community, who are receiving exposure to public health research methods.  The long-term goal is to facilitate the capacity of barefoot researchers to use these tools for alternative pedagogy, advocacy, intervention, and transformation, both of themselves and their community.  For more information about PUKAR’s larger philosophy regarding the right to research, please see the following.

The engagement of the barefoot researchers also facilitates acquisition of high-quality data on sensitive issues related to the physical, social, and financial well-being of the community.  Working with the community (and not on it) heightens understanding of the unique and important health needs in urban slums.  Findings from this joint investigation will help to position the public health field for novel interventions in slums across India, South Asia, and beyond.

 Project Leadership

The principal investigators for this project are Anita Patil-Deshmukh (Executive Director of PUKAR), David Bloom (Chair, Department of Global Health and Population and Clarence James Gamble Professor of Economics and Demography at HSPH), and Arjun Appadurai (Goddard Professor of Media, Culture, and Communication at NYU and  President of the PUKAR Board of Trustees).  For related queries, please contact Ramnath Subbaraman at ramnath.sub@gmail.com.