The Invisible Poor

Agarwal, Siddharth. The Invisible Poor. 2011. World Health Design, Volume 4: Number 3, pg 20-26; The International Academy for Design and Health; ISSN 1654-9654. DOI: 10.13140/RG.2.1.1485.3529

7 Pages Posted: 27 May 2016

See all articles by Siddharth Agarwal

Siddharth Agarwal

Urban Health Resource Centre; Dept. of International Health, JHBSPH

Date Written: July 2011


The global population landscape has been changing very fast over the last century. Lesser-developed countries in Asia, Latin America and the Caribbean have witnessed large growth in their urban population, projected to increase from 2.4 billion in 2007 to 5.3 billion in 2050. The urban environment can have a significant impact on health and wellbeing, particularly among the poorest of city dwellers. Slum environments present a unique set of challenges for urban planners and designers which include: i) poor roads, drainage and lack of playing spaces for children; ii) lack of safe water supply and sanitation facilities, iii) a large proportion of urban poor reside in unrecognised slums, iv) in terms of housing and land tenancy. unrecognised slums, as informal settlements have no formalised place to live, they are often located on marginal land (along river banks, railway lines, steep slopes and on or near garbage dumps), unseen by most, v) health inequities in urban areas, vi) undernutrition among children is also significantly greater in slums than in non-slum residential areas in most developing countries, vii) low access of urban vulnerable to health services, viii) cramped housing and risk of communicable diseases, ix) uncertain livelihoods.

This article discusses how urban planning and design can help improve their situation by positively impacting the urban physical environment in various ways, such as through the determination of the nature of residential units and infrastructure, the regulation of land use and density and the location of facilities and open space.

The paper suggests approaches that urban planners, socially scientists, and civic authorities can adopt to make cities safer and healthier: i) mapping of urban poor habitations and resources, ii) social mobilisation, organising and strengthening slum community associations can help addressing health and habitat related concerns, iii) lead programmes in selected countries linking urban design and health can serve as learning sites for planners, implementers, iv) equitable access to the benefits of urban life and improved livelihood opportunities through an efficient and affordable public transport system, v) government agencies facilitate access to adequate shelter with humane and basic living conditions through support from NGOs and other civil society organisations in planning houses for the poor in terms of design and facilities, vi) provision of a safer living environment with low risk of injuries to vulnerable segments of the city’s populace who are more at risk of traffic-related deaths, vii) addressing food and nutrition security so that today's children can develop into well-nourished adults over the next 15 years and contribute with more energy to an increasingly urbanising economy, in the world’s developing countries, viii) equitable availability of space, physical activity and play avenues for children and adults for playing, cycling, walking and social interaction need to be adapted to suit the urban contexts of low- and middle income countries, ix) access to a healthy natural environment, utilising local solutions to overcome local problems with active involvement of urban vulnerable communities to identify needs and contribute to planning basic facilities such as health, transport and education.

Keywords: Urbanization, urban poor, slums, health and environmental challenges, developing countries, Asia, Africa

JEL Classification: D10, D19, D33, D39, D60, D63, D69, D70, D71, I1, I10, I12, I18, I30, I31, I38, I39, L3,L30, L31, L39

Suggested Citation

Agarwal, Siddharth, The Invisible Poor (July 2011). Agarwal, Siddharth. The Invisible Poor. 2011. World Health Design, Volume 4: Number 3, pg 20-26; The International Academy for Design and Health; ISSN 1654-9654. DOI: 10.13140/RG.2.1.1485.3529, Available at SSRN: or

Siddharth Agarwal (Contact Author)

Urban Health Resource Centre ( email )

136, Humayunpur, First Floor
Safdarjung Enclave
New Delhi, Delhi 110029
911126199771 (Phone)


Dept. of International Health, JHBSPH ( email )

Wolfe Street
Baltimore, MD 21205
United States

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