Give me shelter: the global housing crisis

Give me shelter: the global housing crisis

The problem of inadequate or nonexistent housing has reached crisis proportions globally. The world population passed 6.1 billion in 2001 and is expected to reach 7.9-10.9 billion by 2050, according to the United Nations (UN) Population Fund. This sheer volume alone exerts enormous pressure to improve existing housing and create new homes. As the global population grows, rural areas around the world are emptying and megacities springing up, usually as unregulated districts circling an older, more organized core. According to the Washington, D.C.-based advocacy group Population Action International, as of 1996 (the latest figures available), approximately 52% of the total housing in Caracas, Venezuela, consisted of squatter settlements; in Dar es Salaam, Tanzania, the figure was 49%, and in Karachi, Pakistan, 40%.

Housing affects health in many different ways. Deficient housing can compromise the most basic needs of water, sanitation, and safe food preparation and storage, allowing the rapid spread of communicable and foodborne diseases. Other problems, such as poor temperature and humidity regulation, can lead to respiratory disease. Overcrowding brings both physical and psychological dangers. And living in nonresidential settings such as factory grounds often exposes people to toxic chemicals that can cause both acute and chronic health effects.

A Multifactorial Epidemic

The UN Human Settlements Programme (UN-HABITAT) estimates that 600 million urban residents and 1 billion rural dwellers in developing countries live in overcrowded housing with poor water quality, lack of sanitation, and no garbage collection. People live in old buses, shipping containers, cardboard boxes, and aluminum shacks, and under staircases and plastic sheeting, among other forms of inadequate housing. In both the developed and developing worlds, industrial sites have become attractive settlements for displaced populations, partly because settlers can sometimes appropriate building materials and tap into water and electricity systems.

Inadequate housing can be considered a multifactorial epidemic--rapid urbanization, economic restructuring, natural disasters, and political events such as regime changes and wars all have contributed to the crisis. In China, where the economy is modernizing rapidly, increasing urbanization in the next few decades will create a need for more than 200 million new housing units, almost twice the total number of existing housing units in the United States, says John Spengler, a professor of environmental health at the Harvard School of Public Health. According to A Report on Worst Case Housing Needs in 1999: New Opportunity Amid Continuing Challenges, published in January 2001 by the U.S. Department of Housing and Urban Development (HUD), more than 5 million American families live in housing that is substandard, yet barely affordable.

A 2000 report by the Special Rapporteur to the UN Commission on Human Rights, The Realization of Economic, Social and Cultural Rights, noted that regional housing crises are increasingly being triggered by forced evictions stemming from ethnic cleansing and civil wars. For example, as many as 1.5 million people may have been displaced in southeast Turkey during a civil conflict from 1984 to 1999 between the government and the Kurdish Workers' Party, according to Displaced and Disregarded: Turkey's Failing Village Return Program, an October 2002 report published by the nonprofit Human Rights Watch. This report also says many villagers are still waiting in cities for the chance to reclaim their lands. In the city of Van, one refugee reported his family living in stables, 13 to a room, with 100 people sharing one water tap and one toilet.

Consequences of the Crisis

Not surprisingly, such conditions of overcrowding have fostered physical health problems such as typhoid fever and bronchitis, as well as post-traumatic stress disorder and depression, according to the Human Rights Watch report. In developing countries, overcrowding and poor ventilation can encourage the growth of disease vectors such as mosquitoes, parasites, bacteria, and viruses. Noise and sheer physical safety, including vulnerability to violent crime, contribute to anxiety and depression in both developed and developing countries. Some of the worst environmental health problems associated with housing, especially in developing countries, are unsafe water supplies, lead exposure, and poor indoor air quality (along with related dust and moisture problems).

Unsafe water. The developing world suffers 98% of the deaths resulting from unsafe water, sanitation, and hygiene facilities, according to the World Health Organization's (WHO) World Health Report 2002. The report identifies infectious diarrhea as the largest single contributor to ill health associated with water, sanitation, and hygiene inadequacies. In some countries schistosomiasis, trachoma, and other parasitic diseases arise from contaminated water systems. Schistosomiasis is caused by a blood fluke and causes fever, diarrhea, and enlargement of the liver and spleen. Trachoma is caused by a Chlamydia parasite and causes inflamed eyelids, corneal abrasion, and eventually blindness. According to the WHO, 6 million people worldwide are blind due to trachoma, and more than 150 million are threatened with blindness because of trachoma infection.