People that live in a poor neighbourhood face a higher risk of ill health and early death, scientists say.
And the longer the person stays stuck in a deprived area, the more likely they are to suffer the health consequences.
Researchers analysed a host of studies for the first systematic review of the evidence between deprivation and poor health. They found the most common poor health outcome for people in poor regions was a premature death, followed by obesity, excess drinking and suicide.
The findings come just days after Jaywick, a town in Essex, was named as the most deprived neighbourhood in England for the third time.
The study, led by University College London, is the first to collect data on the effects of the neighbourhood over the course of a lifetime.
Poor mental health was found to affect those in deprived neighbourhoods in 10 per cent of studies, according to the findings published in the European Journal of Public Health.
Lead author Dr Stephen Jivraj said: “The link between where you live and your health and well-being has been one of the most widely tested hypotheses in the field of health geography for 20 years.
“Our study reviews data collected over time and shows the negative health effects of living in a deprived area increase as people get older. We suspect this cumulative effect occurs because it gets harder to move to a less deprived neighbourhood, the older you get.”
The review of 53 studies includes data from countries including the US, UK, Finland, Japan, Sweden and New Zealand.
People who live in the most deprived areas in England can expect to have two or more health conditions at 61 years, which is 10 years earlier than people in the least deprived areas, according to research carried out by the Health Foundation in 2018.
They found almost a third (30 per cent) of people with four or more conditions are under 65 and this percentage is higher for people living in socioeconomically deprived areas.
It suggests that living with multiple conditions affects a broad range of people and is not always related to old age.
The analysis found approximately 14.2million people have two or more conditions, costing the NHS a staggering amount of money.
The figure represents nearly a quarter (24 per cent) of all adults living in England. Over half (55 per cent) of hospital admissions and outpatient visits and three quarters (75 per cent) of primary care prescriptions are for people living with two or more conditions.
The number of people living with multiple conditions is expected to continue to grow.
Sarah Deeny, assistant director of Data Analytics at the Health Foundation said: “People’s health is a result of a wide range of social determinants including their quality of housing and education, where they live, access to good quality work and affordable food.”
Of those studies, 18 per cent found that premature death was the most common poor health outcome recorded for those living in a deprived neighbourhood.
Some 16 per cent of the studies found participants in deprived areas were more likely to be obese or have a high body mass index, followed by the 15 per cent, which found increased rates of smoking, drinking alcohol and eating unhealthily.
Some of the studies looked at the relationship between neighbourhood and health over a period of time of at least 15 years. They found cumulative exposure to neighbourhood deprivation predicts the onset and deterioration of poor health.
The authors wrote: “The weight of evidence suggests neighbourhood effects accumulate over the life course when exposure to a poor socioeconomic context is sustained. This is the case for outcomes of adolescent parenthood, chronic conditions, disability, smoking, BMI, mortality and physical function.”
The researchers believe the effects can be reversed if a person moves away from a deprived neighbourhood as a child. There is a small amount of evidence that suggests the neighbourhood you live in at the age of 30 will impact life in middle age.
The Health Foundation said there is a multitude of factors that link deprived neighbourhoods and poor health, but these were not investigated in the research.
Kazuyoshi Otsuka didn’t talk to his neighbours much. They knew he worked for the Shochiku movie studio, where the directors Akira Kurosawa and Yasujiro Ozu achieved global renown. They knew he was a costumer, because he used to complain to them about having to argue with famous Japanese actresses over whether their outfits clashed.
They also knew he moved into the Atago apartment blocks, a huge housing complex in the suburbs of Tokyo, in 1971, the year after they were built, with his wife and two sons. The Japanese economy was officially booming, and Otsuka was a fashionable man about town, partial to wearing a neck scarf and buying his coffee beans from a specialty store, even if he otherwise kept to himself.
In 1989, he was struck by a subarachnoid haemorrhage that left him paralysed in his left hand and leg. Some time after he was discharged from hospital and returned home, his wife and children left. Alone, he took to sitting on a bench outside the apartment building. Though he didn’t much discuss it with the neighbours, he once admitted he regretted how life had turned out. “I’m sorry,” he said.
Unable to walk far, Otsuka relied on a meal service. One day, two years ago, his regular delivery man recalls Otsuka being in worse shape than usual. Three days later, there was no answer at the door.
The delivery man informed the police, who arrived at Atago with the fire department, climbed a ladder to the third floor and broke through the window into the room. Otsuka had been spitting blood, and died alone.
No family members came, and nobody claimed his body. The municipality cremated him and placed his remains with a local temple. Otsuka’s nameplate is still on the metal door of his apartment, above a mailbox slot now sealed with tape.
Toei Atago Complex is a sprawling set of five-storey apartment blocks in Tama City in the Tokyo suburbs, about 30 minutes on the express Keio line from Shinjuku station. The complex rings a hillside and and contains 1,894 units across five blocks – one of hundreds of similar social housing developments that dot the seemingly endless Tokyo outskirts.
Many Japanese know the Atago complex as the setting for Whisper of the Heart, an animated film from Studio Ghibli written by the legendary Hayao Miyazaki that topped the domestic box office in 1995.The romantic film depicts the lives of junior high school students whose imaginations are transported through writing stories to each other.
The real Atago complex, however, is home to almost no young people. Japan’s population is ageing rapidly, though not so much in Tokyo, where just under a quarter of residents are older than 65. But in the Tama City suburb the proportion is 29.6%, and is expected to rise to 32.6% over the next decade – increasing more than twice as fast as the Tokyo average.
The number who live in social housing, meanwhile, is higher still by far: approximately two-thirds of the residents of blocks like Atago are over 65. Tokyo’s social housing blocks are becoming de facto retirement homes.
That is a problem for a number of reasons, not least that they weren’t designed for this purpose. The Atago complex was built on a hill, and is accessed by sloping ramps. It has five floors, but there are no lifts, only stairs. Many weaker residents find navigating this terrain very difficult. There are no nearby supermarkets to buy food and newspapers, just a Seven Eleven convenience store, and no clinics or pharmacies within easy access, though the local hospital is well-equipped to handle older patients.
Nor are there enough children, teenagers or young couples to keep the atmosphere lively and to drive demand for services and commerce. The last supermarket serving Atago closed in 2001. The nearby elementary school, Tama City Nishi Atago, which opened in 1976 and hit peak attendance of 714 children in 1982, saw its intake fall to 64 students before it finally closed its doors for good in March 2016.
Toshio Matsumoto, 70, an officer of the Atago housing committee, says it isn’t just death that dampens the mood at Atago: “The people who come after the deceased are also grey, and the elderly will not be rosy in the future unless they get young people into the complex.”
“The only thing I enjoy every day is to drink and smoke,” one 73-year-old man says. He worked in a fresh fish store when he was young, and has lived alone in Atago since he lost his mother 18 years ago. “My feet are lame and I have a cane. Three years from now, I’ll be dead.” He turns and walks away, slowly climbing with his cane up the inclined path towards the buildings.
“I guess I’m not alone after all,” jokes Kaichiro Tanaka, 73, who also lives by himself at Atago. He drops by the community centre, Atago Kaede Kan, every day to chat and smoke cigarettes. Once a week he and his friends gather to sing their favourite songs at karaoke.
He makes the best of what is a difficult life: Tanaka relies on his pension, which specifies less than 1,000 yen per day for food. “You can’t live like that,” he says. In 2007, his wife’s kidneys began to fail her, and for three years he tended to her bodily needs while she was confined to bed. After her death, the only relative he now sees is his daughter, who meets him once a year at his wife’s grave. She has never visited his apartment at Atago.
“Hey, look over there,” Tanaka says, gesturing with his eyes at the lounge in the community centre. “If you think, ‘Hmm, that person hasn’t been here lately,’ it’s commonly the case that they’re dead.” Last summer, residents on his wing reported a strange smell to police. Tanaka attended the scene. The woman had died in bed. Tanaka can’t remember her name. He only knew she was about 80.
Social housing was built across Japan from the 1950s onwards in an effort to give families high-quality homes after the devastation of the second world war. The Public Housing Act of 1951 made nearly 80% of households eligible for some form of subsidised home.
In the mid-1990s, however, a shift in housing policy had major and perhaps unintended consequences. In an attempt to stimulate the housing market, the government tried to guide the young generation of workers away from public housing and into private housing. It revised the Public Housing Act, making public housing more accessible for elderly or disabled people. But it also set strict requirements for younger people who lived there: if your income exceeded a certain threshold, you would be evicted. If you refused, you were charged rent – at potentially up to twice the market rate, depending on your income.
The goal was to make public housing a safety net for elderly, low-income and socially vulnerable people. The effect, however, has been to drive up the cost of private rentals, while making social housing off-limits for most people: eligibility fell from 80% of households in 1951 to 25% after 1996.
And it has turned public housing into a kind of ghetto for poor and elderly people who rely on pensions and can’t afford private rents.
It also forces young adults to leave home once they get a job. A four-person family cannot stay in public housing if they earn more than 4.47m yen (about £32,000), which means that even a part-time job sometimes means moving away from home. The parents stay behind, and the demographics tick another notch older.
Yet another unintended consequence is that Tokyo’s social housing blocks have become the focal point for a phenomenon that has obsessed the national media: kodokushi, or “solitary deaths”. According to Matsumoto, about 20 people died alone at Atago in 2018.
While the Tokyo government does not disclose information on individual cases of solitary death, figures show that 501 people died alone in public housing blocks like Atago last year – more than one a day – and 2,344 over the last five years.
“Solitary deaths are increasing,” confirms Matsumoto. He says the problem started to worsen about 12 years ago. It is almost common now, he says, and residents who live alone are haunted by it.
The Atago community association has taken steps to fight back against loneliness. Its Omushibi Project invites residents to make rice balls together, and every summer there is a dance for the Bon festival.
The Tama municipality, too, is helping. It signed an agreement with 29 local delivery companies that provide services to Atago – such as newspapers or bento lunch boxes – to watch over elderly people. The companies agree to notify the authorities if they don’t receive a response at the door.
In response to requests from Atago residents, there is also now a “mobile supermarket” that sells food from a car, coming three times a week at 10.30am for 40 minutes.
The moves are arguably more than token, but with so few young people living in the units there is a limit to the social and commercial activity that can be sustained. When younger generations do move in, the income restrictions mean they are often low-income single mothers – whose childcare and work commitments mean they rarely have time to join in community activities.
“I have a sense of crisis,” says Takamoto Komachi, director of the Tokyo Metropolitan Housing Management Division. “I want to prevent solitary death as much as possible.”
Komachi says the Tokyo government is starting to consider efforts to reduce loneliness, such as improved patrol systems and collaboration with the welfare department. In 2002, staff began making regular visits to social housing complexes, with the ability to enter the room of elderly residents without permission to check on their safety, after the death of an 90-year-old mother and her sixtysomething daughter were blamed on a multi-day delay in accessing the flat.
“In some cases, [the patrols] saved an emergency call and spared an ambulance – I think there is a certain effect. But I don’t think it’s connected to reducing” the problem of solitary deaths, Komachi says.
Mitsunori Ishida, a sociology professor at Waseda University who studies the changing demographics of Tokyo’s social housing blocks, says: “The people who leave are strong, while those who remain, and the new people who move in, are socially vulnerable. There is a contradiction: although elderly people living alone need the mutual support of the local residents, there is a shortage of community.
“It is hard to leave the situation over to the voluntary efforts of the residents. Japan’s housing welfare policy [changes] were not a subsidy for [private] rent – they were a means to consolidate low-income and disabled people into public housing.”
He adds: “If residents of collective housing are diverse, the concentration of welfare problems and creation of community ought to improve. We need a lot of support from the local government and the social welfare council. “
That help may be a while coming, but it is rising up the political agenda. In April this year, the opposition Japanese Communist party voiced its concern in the House of Representatives construction committee. “As a result of this reform, we have no young dual-employed couples” living in public housing, said one member. “Yet even now, public housing is ageing – and it will only get worse.”
As for Tanaka, he is determined to remain cheerful. He used to say hi to his neighbour who died, even though she didn’t respond. “Maybe she didn’t care about socialising with her neighbours as she got older,” he says. “Nobody can imagine themselves in 20 years. So it is important to enjoy oneself at least in this moment, right now. People ask, ‘Are you worried about lonely death?’ I am prepared.
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Finding the Missing People with TB in the slums of Nigeria:
Nigeria ranks 7th globally amongst the 30 high TB burden countries, and 2nd in the African region. Nigeria is also among one of the strategic initiative countries that makes up the thirteen high burden countries with the most missing people affected by TB1 . In 2017, out of 417, 000 that fell ill, 312 000 (75%) were not notified by the National TB, Leprosy and Control Program (herewith referred to as ‘missed’). This number includes nearly 50% coming from the slum areas in Nigeria2 . Notably, an estimated half of the Nigeria’s population resides in slums; which provide the ideal conditions for transmission and progression of TB infection. Further 71% of TB patients are facing catastrophic costs .
As indicated above, factors that increase people’s vulnerability to tuberculosis (TB) are human rights related; their right to adequate housing, participation in decision making processes and right to sanitation and safe drinking water3 . These interlinked factors spread across and outside the health sector to include the housing and environment sectors. Ending TB therefore requires accountability and obligations from these multisectoral paradigms.
Abuja International Housing Show (AIHS):
The Abuja International Housing Show aims to establish a platform for both public and private sector stakeholders to draw inspiration in addressing sector related problems in Nigeria and even on the continent. The 13th edition of the show holds on July 23 – 26, 2019 in Abuja, Nigeria . The event does not only create awareness on the major challenges in developing or strengthening housing industry and finance markets but also focus extensively on solutions of these challenges by highlighting innovations, new ideas and global experiences in the sector. The Abuja International Housing Show has been the best and most established platform in Africa for such convergence of government officials looking for informed opinion(s) on emerging housing and construction policy dynamics. It also provides the right atmosphere for private sector developers and investors looking for the best clients, partnerships, opportunities for public and private sector collaborations, and customers looking to access the best housing deals. Individual footfalls during the 4-day event is in excess of 25,000 visitors.
As part of the Abuja International Housing Show, the Roland Igbinoba Real Foundation for Housing & Urban Development (RIRFHUD) is organizing an advocacy platform to create the visibility of tuberculosis in the national housing and environment agenda. This platform will be focusing on TB, housing and environment in the context of the right to health. To action this platform, RIRFHUD as part of the organizing committee of AHIS has created a Health, Housing & Environment Track within the AIHS. This will provide an opportunity for TB related discussions and the goal is to hold this partnership platform on annual basis.
Objective of the Platform:
The platform will engage with high level decision makers from the housing, environment as well as the health sector. The engagement/discussions will focus on future collaborations and commitments in realization of the right to adequate housing, participation in decision making processes and right to sanitation and safe drinking water for slum dwellers. Very importantly, the platform will mobilize community leaders from the high TB burden slums to join the discussions. Further, barriers limiting the collaboration between the health, housing and environment sectors; and those that are acting as blockades to improving TB case finding will be identified and a collaborative commitment from the three sectors to remove these barriers will be initiated.
The platform will adopt a multisectoral approach that offers synergistic conversations with five specific objectives:
1. Orientate the housing and environment sector on the link between TB, housing and environment
2. Create an understanding of the United Nations High Level Meeting (UNHLM) on TB commitments and targets among the housing and environment sector
3. Receive inputs towards the creation of a framework/working relationship for accountability and obligations for Ministries of health, housing and environment, Civil society and private sector post the UNHLM on TB commitments and targets
4. Share ideas and experiences on how the health, housing and environment sectors can collaborate to ensure that the commitments made (in 3 above) are being adhered to.
5. Create a platform for slum dwellers, to participate as equal partners, driving TB, housing and environment policy in Nigeria.
Overview of the agenda of the Health, Housing and Environment Track (HHET):
The discussion points will include UNHLM on TB commitment and targets; How housing and environment can influence, and assist health organisations to achieve their outcomes; How adequate housing and clean environment can help prevent people from TB infection; WHO Housing and Health Guidelines; Health and Housing inequalities from the human rights perspective; Economic independence of people affected by TB in the slum community; How can we inspire an effective working relationship between health, housing and environment ministries?
Speakers includes Hon. Minister of Power, Works and Housing, Hon. Minister of Environment, Hon. Minister of Health, International Health Agencies, A Community Leader/TB survivor from a selected slum, A national TB champion (To be provided by International Health Agencies).
There will be screening for latent TB – Over the 4-day period of the event amongst the over 25,000 visitors.
From Athens to Melbourne and Seoul to New York, big cities are increasingly turning to trees to help protect them from heatwaves and floods, and to boost people’s physical and mental health, urban officials and environmental experts say.
South Korea’s capital Seoul recently planted more than 2,000 groves and gardens, and Melbourne in Australia plans to nearly double its canopy cover to 40 percent by 2040.
Athens is looking at planting more trees to lower temperatures and protect the Greek capital from sudden downpours.
“We have real problems with urban heat islands and flash floods. We know we have to take trees very seriously, and we haven’t up to now,” said Eleni Myrivili, deputy mayor of urban nature and Athens’ chief resilience officer.
Athens is still recovering from the 2008 economic crisis and lacks the staff to maintain its trees, which include bitter orange, japonica and Judas trees, she told the World Urban Forestry Forum, taking place in the northern Italian city of Mantua this week.
Milan, which plans to plant 3 million trees and expand its green spaces by 2030, has experienced a 2-degree Celsius temperature rise and increasing heat-related deaths in the past 20 years, as well as worsening floods, said the city’s chief resilience officer, Piero Pelizzaro.
More trees should “reduce air pollution, improve the quality of the urban space … and reduce the impact of climate change”, he told the Thomson Reuters Foundation.
“Nowadays there’s no difference between the city’s energy consumption in the winter and summer” because of the rising demand for air-conditioning, he added.
Cities in Niger and Senegal in Africa are planting trees to create jobs and provide fruit for families to eat, as well as provide much-needed shade.
Trees and green spaces lower stress levels and encourage people to exercise and socialise more, experts at the forum said.
But with urban populations projected to increase by 2.5 billion people by 2050, demand for more housing and transport is putting pressure on green spaces, they said.
And a lack of expertise, data or the ability to attract funds means cities tend to opt for “grey” infrastructure projects over “green” ones to fulfill the same job, according to a report by New York-based 100 Resilient Cities network, published on Wednesday.
That could mean building a concrete wall to protect a coastal city from flooding instead of planting mangroves, which are effective, less costly, more visually pleasing and improve air quality, said 100 Resilient Cities, which produced the report.
“What makes nature-based solutions so appealing is that with one intervention, such as an urban forest, a city can address multiple shocks and stresses at once – from flooding and heat waves to air pollution and public health – which is something that grey infrastructure is rarely able to do,” the report said.
Deprived parts of cities often lack trees and other green spaces.
Residents in almost every city affected by climate change are calling for more equity and fairness, said David Miller, North American director of C40 and a former mayor of Toronto.
“Often that’s about economic goods, but it’s also about social goods like green spaces, and forests and health,” he said.
New York city is planting 1 million trees, and mapping where those are most needed, especially in deprived areas, he added.
It is not just large cities that need to grow more trees, Mantua’s mayor said.
The small north Italian city hosting the international forum is home to 50,000 people and 16,000 trees.
The city council plans to increase this to 25,000 trees by 2020, to help protect it from floods and rising temperatures.
“We believe it’s not about the size of the city – climate change is everywhere,” Mattia Palazzi told the Thomson Reuters Foundation.
Mantua, voted Italy’s greenest city two years in a row, is in one of the most polluted areas in Europe and needs trees to help clean the air, he said.
“Green areas create happiness … and are important for the city’s future sustainability,” he said.
The National Space Research and Development Agency (NASRDA) has identified communities in four states and Abuja as locations where major earthquake may likely occur in the country.
The Director General of NASRDA, Prof. Seidu Mohammed, disclosed this on the sideline of the second Engr. Brig. Gen. M.O Agu (rtd) Annual Distinguished Lecture in Abuja on Thursday.
Prof. Mohammed, who was also the chairman of presidential committee on the Abuja tremor, said Mpape in Abuja, Kwoi in Kaduna, Ijebu-Ode in Ogun, Shaki in Oyo and Igbogene in Bayelsa may likely be the epicentres of major earthquake if precautions were not taken.
The erstwhile inactive faults system in the country are gradually becoming active, he said, ‘’which now make earthquake likely’’ in and around the country.
A number of incidences in these locations, according to him, is also a pointer to the fact that a big disaster may occur there, calling on the Federal Government to do something fast to avert it.
He said analysis of a 100 year-old data done by the members of the presidential committee on Abuja tremor showed that Mpape in Abuja is a hotspot which is highly susceptible to earth tremor and other earth shakeups.
“What it means is that we need a thorough study across the country to identify such hotspots so that we can constantly monitor them from satellite system and from data from outer space’’, he said.
He said the high volume of water being taken out of over 110, 000 boreholes dug in Abuja is further making the situation in the capital city worse.
‘’More than 330 metric tonnes of water being taken out every day in Abuja is causing a vacuum; is straining the earth’’, he said.
He therefore urged the FG to take a look at indiscriminate drilling of boreholes, calling on thorough regulation on earth drilling.
He also said engineers should now take cognizance of likely earth tremor when designing and constructing buildings.
Last week, the Presidential Committee on Abuja Tremor said Nigeria was now prone to seismic hazards, which make earthquake occurrence a potential disaster to the country.
The committee disclosed that when it submitted the report of its findings to the Minister of Science and Technology, Dr Ogbonnaya Onu.
‘’Nigeria is now prone to seismic hazards following recent earthquake occurrences in Kwoi, Kaduna state, Saki, Oyo State and Igbogene in Bayelsa State all in 2016. The latest occurred in September 7, 2018 in Mpape, Abuja’’it said.
It said though ‘’these earthquakes may have been of low-magnitude, it is now certain that earthquake occurrence has become a potential hazards to the nation’’.
The committee alluded to the report conducted by Julius Berger on the geological, hydrological and geotechnical investigation for Abuja which identified Mpape as a Shear zone that is weak with several fractures and faults system.
It added that water extraction and recharge imbalance from aquifer is causing hydrological instability along the fractures.
The existence of 110,000 boreholes within Abuja metropolis with about 330,000 metric tonnes of water drilled daily is not suitable, it added.
In view of the challenges that hinder efficient forecasting, detection and monitoring of earthquakes in Nigeria, the Committee recommended the procurement and installation of more seismometers and GPS sensors/equipment for the enlargement and networking of the Nigeria National Network of Seismographic Stations.
The committee further recommended detailed Seismotectonic study using State-of-the-art equipment in the area and the entire country.
Other recommendations made by the Presidential Committee are:
An integrated study should be carried out to properly delineate the fault systems in the area while ensuring that building should be constructed with the right engineering design and materials on approved sites.
Infrared satellites technology: Space management data for earthquake monitoring are showing more prospect. It is advised that this technology must be adopted and funded adequately.
At present, there is no Nigerian Code of practice that cover Nigerian Seismic building code. There is urgent need to be established the Nigerian Standard for the seismic building code. An agency such as the Nigerian Building and Road Research Institute (NBRRI) should be given the responsibility with budgetary allocations provided.
Earthquakes happen all the time. The key is to monitor, identify and catalog their location so that we can improve on future forecasts in time and space.
To do this we need to upgrade the infrastructure of the current seismic network system to state of the art digital seismic network with real time telemetry capabilities.
Ecological Funds should be released very urgently for Earthquake Monitoring and Hazard Assessment in Nigeria.
Based on the results obtained using the probability of recurrence theory of Abuja via indiscriminate sinking of boreholes because this has been the primary reason for the stress build up leading to the Abuja tremor of 5th-7th September, 2018.
Government should release fund for the training of Geophysicists, Geologists, Engineers, Technologists and Researchers to participate in earth science research, in order to improve poor understanding of Nigerian and West African geophysics and tectonics dynamism. We emphasize that this research has crucial societal value as evident in earthquakes hazards readiness and mitigations.
Federal Government of Nigeria should take proactive and not reactive measures.
The Federal Government should empower relevant research Agencies mandated to carry out studies into the remote causes of the tremor and proffer solutions.
According to a senatorial aspirant Mr. Olanrewaju Lawrence, about 70% of the Federal Capital Territory (FCT) citizens are living in the slumps.
Mr. Lawrence, who is contesting on the platform of Abundant Nigeria Renewal Party (ANRP) for a Senatorial seat in FCT in the 2019 general elections, said the situation was caused by past leaders who refused to plan well for the people.
“FCT ought to be having more than 10 million tourists as a revenue generating area for the government and creating jobs for the citizens duelling in the capital but look around, you will see infrastructure that are not well conceived”, he added.
Affordable housing, it’s a hot-button issue in Rochester and something so many struggles with on a daily basis, medical experts from across the nation were addressing the topic in a way we don’t always think about –from a health perspective.
“When people don’t have housing, when they don’t have a place to call home when they don’t have a place to lay their head, number one, their stress levels go through the roof,” said Dave Dunn, executive director at Olmsted County Housing and Redevelopment Authority.
In the past five years, 5,000 housing units were built in Olmsted County, but only 10 percent are considered “affordable.”
“Having poor quality or unstable housing is one of the most potent forms of toxic stress, so what we’re finding is that it really is directly negatively affecting the well-being of people who are living in low-quality housing or have to move often,” said Dr. Douglas Jutte, who’s been studying health as it relates to housing, for years.
“We’ve seen more and more that your zip code, your health depends on your zip code,” Dunn said.
“There are lots – billions, trillions of dollars being spent on medical care for avoidable, chronic diseases. Some of that money could be spent to help keep people healthy in the first place,” he said.
Many social issues stem from a history of unstable, unaffordable, and poor-quality housing. Research shows that housing is the first rung on the ladder to economic opportunity for individuals and that a person’s access to opportunity is intrinsically linked with that of the community at large. As the gap between rents and incomes widens, it is critical that professionals in fields outside housing—including health, education, and economic development, among others—understand its central importance.
The following research shows how housing can create better educational opportunities for children, contribute to healthier people and neighborhoods, and build stronger economic foundations for families and communities.
Children who live in a crowded household at any time before age 19 are less likely to graduate from high school and tend to have lower educational attainment at age 25. Living in poor-quality housing and disadvantaged neighborhoods is associated with lower kindergarten readiness scores.
Homeless students are less likely to demonstrate proficiency in academic subjects. Passing rates for English language arts, math, and science exams are lower among homeless students than among their housed counterparts.
For typical households in the Fremont Unified School District, the impact of school quality on housing prices is more than three times greater than the impact found in studies in other regions. This impact matches the cost of private education for a child, suggesting that home prices act as tuition for in-demand public schools.
Near a high-scoring public school, housing costs 2.4 times as much, or roughly $11,000 more a year, as housing near a low-scoring public school.
In one study in New York City, improvements in a school’s test scores are associated with higher home values and increased spending on residential investments (whether by owners or developers). Improving a school’s scores by one standard deviation was correlated with a 1.8 percent increase in housing values. Housing and financial instability often lead to children moving to poorer schools.
How housing affects health outcomes
Compared with New York City residents who stay in gentrifying neighborhoods, displaced residents who move to nongentrifying, low-income neighborhoods have significantly higher rates of emergency department visits, hospitalizations, and mental health–related visits for about five years after displacement.
Being behind on rent, moving multiple times, and experiencing homelessness are associated with adverse health outcomes for caregivers and children and with material hardship. Households with poor housing quality had 50 percent higher odds of an asthma-related emergency department visit in the past year.
People with mental illness or an intellectual or developmental disability are less likely to receive responses to inquiries about rental housing and less likely to be invited to inspect available units.
Renter households with children are more likely to have asthma triggers in their homes than owners. They are also more likely to have at least one child with asthma.
In a study of single-parent families living in violent neighborhoods, parents met or exceeded the national average for self-reported physical health but fell below the mental health average. Forty percent reported moderate to severe symptoms of depression and reported higher levels of stress from worrying about financial instability and concern for their children’s well-being. In one study, older homeless adults who obtained housing during the study reported fewer depressive symptoms than those who were still homeless at follow-up.
How housing affects economic outcomes
Black per capita income is lower in regions with higher levels of economic and black-white segregation.There is a positive relationship between high levels of automobile ownership and estimated rates of foreclosure and mortgage default, suggesting that transportation costs affect housing affordability.
In Detroit, strong efforts by residents, coupled with support from community development organizations and external assistance, led to increased neighborhood housing prices in middle- and working-class neighborhoods that lost value in the foreclosure crisis. Residents’ efforts were less effective in higher-poverty neighborhoods with lower rates of owner occupancy.
The need for access to good jobs in central locations that is driving the lack of affordable housing shows that access to housing and access to opportunity are inextricably linked, which affects future intergenerational mobility.
Places with higher job accessibility by public transit are more likely to attract low-income households that do not own cars but have at least one employed worker, demonstrating that job accessibility by transit affects housing location choice.
Economically healthy cities tend to have higher rankings on economic, racial, and overall inclusion than distressed cities.
Federal housing assistance—from housing vouchers, to welfare-to-work programs, to financial coaching and incentives, and more—improves lives. Housing policies can be a tool to fight poverty and create upward mobility, making assistance a worthwhile and imperative investment in America’s future.
I think there are quite a number of factors to consider when analysing things that are responsible for life expectancy. As one is aware, Nigeria is among the countries with the lowest life expectancy in the world. I believe that we need to change so many things to get the desired result. And change begins with us in terms of perception of our environment. How do we treat our environment? We need to have a change of orientation and moral values. Of course, once there is a change in moral value, once there is environmental rethinking, I believe it will have a positive effect on life expectancy.
Improvements in living standards and provision of infrastructure are part of the moral values. Moral value means that will place national interests above personal interests. Corruption is part of the things affecting us. If we know that whatever is entrusted to us, we must use it to deliver the best of care, judicious use of resources will lead to better service delivery, good roads, good housing, and of course, poverty reduction are part of determinants of life expectancy. If the average Nigerian enjoys good health or have access to good health care, then his/her life expectancy will increase. Once we know that we are our brothers’ keepers, we love one another, then that will have a multiplier effect and life expectancy will improve. It is not only by building hospitals, because even if you build hospitals, not everybody will have access to them. There is also the aspect of ignorance. There are people who do not believe in going to hospitals because there is an herbalist that can attend to them. They will say their problem cannot be handled by western medicine, so, they prefer native medicine. That has its impact but what is killing people is attitude. Thirty to 40 years ago, we did not have so many hospitals but our life expectancy was higher than what we have now. So what has changed? It us the moral value.
There is no single measure for the standard or quality of living of human beings. There are composite measures. The per capita income is often taken simplistically. But most of the measures are tied to PCI which is the average income earned by the citizens of any country.The United Nations Development Programme came up with the Human Capacity Index which is derived from the analysis of over 100 parameters including variables such as access to health care, education and other things necessary for the longevity of life.
Since 1998 that the UNDP started reporting on Nigeria, unfortunately, our score has always been in the last quarter; it is very poor.The first way the Federal Government can improve on the life expectancy of Nigerians is to give them employment. A person who is not employed is as good as dead. In a family where both parents are not working and poor, the children will be miserable and they cannot live up to their normal years.So, the first thing is that the government should take employment creation for citizens as the most serious business.
Look at highly industrialised countries such as the United States and the United Kingdom; you will see their politicians still harping on employment, job creation and so on. They are not foolish. They know that this is the first thing an individual and a government must take care of.Let your people be employed. When the people are not employed, it is as if the government has confined them to a lifestyle of misery.
A study done by one of the leading American universities said that people who are retire but still do one work or the other live longer than those who retired and do nothing. This is the way God has designed human beings.So, if the government is going to be sincere, it will not play with employment generation for our millions of unemployed citizens.I have said it before that this government is not sincere in this area. We need a minimum of two million jobs per year in this country if we are going to come out of the poverty trap that we are in. We are still going to require more than that later.
If there are no good jobs, people cannot have access to good health and good nutrition. If the people have sufficient income to live a decent life, they will live longer naturally.There are still other areas that enhance life expectancy; but they are all dependent on a good income.
The issue of the improvement of life expectancy of Nigerians, whether directly or indirectly, can be tied to a number of factors. First, there has to be a structure that supports the general well-being and dignity of the human person as well as a holistic approach to health care delivery. In Cuba, which is not richly endowed in terms of natural resources for example, there is an efficient health care delivery system. This is so because it invested heavily in education. It is a communist society where there is a limit to how much an individual can acquire in terms of personal wealth at the state’s expense; but since the revolution in 1957, Cuba has been able to manage the life expectancy of its population in a way that is comparable to high flyers like the United States and Scandinavian countries, such as Norway, Sweden and Denmark, which are richer financially. What this shows is that, life expectancy is not a function of how materially rich a country is. We must get our governance issues right by changing our orientation to public service. We must invest massively in education and the provision of health facilities from the primary up to the tertiary level. Most importantly, provide Nigerians access to the basic necessities of life. This, more than anything else; will boost the desire to live and live well.
I think the first thing is for us to improve the economy. The more people are unemployed, the more frustrated they become. You know that Nigeria is now the poverty capital of the world. More than 80 per cent of the population live below the benchmark of one dollar per day. When you look at things critically, once people cannot meet basic needs, be it food or shelter, the propensity to fall sick and die is high. It is a leadership issue; if the quality of leadership and governance is improved, the life expectancy of Nigerians will improve. If we also have infrastructure like basic health care, even primary health care, it would impact life expectancy. In most communities, you don’t have hospitals, so before you transport the sick to a hospital, he would have died. Many lacked access to potable water; how many cities can boast of potable water? In the urban areas, how many homes can boast of tap water supply? How many people can boast of 24 hours power supply? So, the little things of life that make people live longer like food, shelter, health care are lacking in the country and that is why people die needlessly. Provision of these things would increase life expectancy and this is only possible through quality governance and good leadership.
The first area to look at in increasing the life expectancy of Nigerians is the aspect of public health. The government must work with experts in the field of public health to manage the well-being of its citizens. When there is a breakdown in public health, the effects are always devastating on the society. In the past, the life expectancy rate of our people was affected by communicable diseases such as Cholera and Tetanus. Today, we have non-communicable and lifestyle diseases such as diabetes, hypertension and arthritis affecting the quality of living of the people. So, we are watching the trend and we believe that no government must fold its arms in advancing the public health which is one key index of the quality of life the people are going to live. The government needs to do more on public health enlightenment and work with professionals to sensitise the people to better ways of improving their health. There are so many areas that still need improvement in the country and we have to intensify our efforts.
Prof. Abdulwaheed Olatinwo (A former Chief Medical Director, University of Ilorin Teaching Hospital)
Bisi Sanda (An economist/retired Senior Partner, Ernst and Young),
More than 40 percent of extremely poor people in the world will be living in Nigeria and DR Congo by 2050, a report by Bill and Melinda Gates Foundation has revealed. Poor nutrition, high maternal and infant mortality are major contributors to relatively low average life expectancy in Nigeria In the 2018 goalkeepers report released, yesterday, the foundation said by 2050, Nigeria will have 152 million people in extreme poverty, out of a projected population of 429 million.
It blamed this on the lack of investment in human capital to correspond with the increasing population growth. Nigeria is currently the seventh most populous country in the world with an estimated population of 198 million.
The annual report, produced in partnership with Institute for Health Metrics and Evaluation, IHME, at University of Washington, tracks progress being made on the United Nations sustainable development goals, SDGs. In June, Brookings Institution reported that Nigeria had overtaken India as the nation with the highest number of poor people, with 87 million of its citizens in extreme poverty. International Monetary Fund, IMF, had also said in March that Nigerians are getting poorer due to the lack of coherent and comprehensive economic reforms.
The goalkeepers report said while more than a billion in the world have lifted themselves out of extreme poverty since 2000, “extreme poverty is becoming heavily concentrated in sub-Sahara African countries.” “By 2050, that’s where 86 per cent of the extremely poor people in the world are projected to live. The challenge is that within Africa, poverty is concentrating in just a handful of very fast-growing countries. “By 2050, for example, more than 40 percent of the extremely poor people in the world will live in just two countries: Democratic Republic of Congo and Nigeria.
Even within these countries, poverty is still concentrating in certain areas.” The foundation said to address the poverty crisis, adequate investment would need to be made in young people, especially in areas of education, health and human capital development. “Investing in young people’s health and education is the best way for a country to unlock productivity and innovation; cut poverty, create opportunities and generate prosperity,” the report added.