Nowhere are social disparities more marked than within India’s most glittering cities. Take the case of India’s three most prosperous states, Punjab, Haryana and Maharashtra. While bustling economic activity seems to be offering jobs to migrants flocking to the cities in these states, the urban infrastructure has not coped with this growth of population. Cities have not been able to offer decent housing, water, sanitation and other essential services to all their citizens.According to the 2001 Census, 33.3 per cent of Maharashtra’s urban population, 20.5 per cent of Punjab’s and 33.1 per cent of Haryana’s, live in slums. In fact slums in the 61 towns of Maharashtra account for 11.2 million inhabitants, who constitute more than one-fourth of India’s total slum population. Greater Mumbai has the highest proportion of slum population in the country. Around 64 lakh people, or 54.1 per cent of the total population in Greater Mumbai, live in slums.Faridabad (Haryana), with 46.5 per cent of its population residing in slums, has the distinction of having the second highest proportion of slum population among the 35 million-plus cities, after Mumbai. Most cities of Haryana around the NCR, such as Rewari, Rohtak, Hisar, Sonepat, Panipat, Karnal and Bhiwani, have over 30 per cent of their population residing in slums. Cities like Jalandhar, Ludhiana and Amritsar in Punjab have slum population ranging from 20-25 per cent. Note that these estimates do not include unlisted settlements, which are often home to a large proportion of the urban poor. So the actual extent of urban poverty is much more than what appears on paper.The consequence of overcrowded living, poor environmental conditions and lack of access to services is the poor health status of these people. Re-analysis of NFHS-3 data according to the Standard of Living Index has revealed that only 56.9 per cent of children among Maharashtra’s urban poor receive complete immunisation, more than 52.5 per cent of urban poor women were anaemic and 45.2 per cent children are underweight. Similarly, an analysis of the District Level Health Survey conducted by the health ministry between 2002 and 2004 found that 75 per cent of child births among the urban poor in Punjab and Haryana take place at home, putting the life of both the mother and the newborn at great risk. Less than one-third of children among Punjab’s urban poor and less than one-fourth of Haryana’s urban poor children received the recommended vaccinations by one year of age. This leads to high infant/child mortality in the region. Such inequitable access to health care is unacceptable in a country with a GDP growth rate of 9 per cent. The urban poor contribute significantly to the country’s economy. It is in India’s interest therefore to focus on this section.The writer is executive director, Urban Health Resource Centre, New Delhi
