Urban transformation and public health in future cities
Michael Keith and Andreza Aruska de Souza Santos
Social scientists, data scientists, epidemiologists, zoologists and other scholars have delved into the co-variables of class, transport patterns, housing conditions, age, migration, nutrition, climate change and sanitation as well as access to health centres to determine the probability, duration and extent of disease outbreaks. Such studies have shown that the separation of the body from what surrounds it, ‘the flesh’ from ‘the stone’, is of little help if one shapes the other. With most of the world’s population now living in cities, this chapter discusses healthy living in changing metropolises. We consider in this chapter how cities may circumscribe access to health centres, the factors that determine housing choices and how these in turn may determine health outcomes. We also consider how individuals and communities may reshape cities recursively, all too often meaning that urban health is not only a study that intertwines people and space, but also does so under a temporal matrix. Historical legacies and path dependencies, migration, adaptation and change are thus conceptualised and discussed when the ethics, the access, the definitions and the transformations of public health initiatives and the demands of the twenty-first century are examined.
The introduction outlines the aim of the study, the source material is
described, and previous research on the subject is presented. The source
material consists of judgement-book material on the court-of-appeal and
hundred-court levels as well as of marriage applications and political and
legislative material. The author also discusses the theory of symbolic
interaction, explaining what guided her choices of source materials as well
as their limitations. The origins of incest taboos are discussed from the
standpoint of scientific research. Furthermore, the complicated subdivisions
of the different incest prohibitions are carefully presented with regard to
both consanguinity and affinity relationships.
Epidemiological research has repeatedly pointed to the increased prevalence of both ‘common’ and ‘severe’ mental disorders in cities, and proposed a range of competing hypotheses to account for this relationship. Recent research on the social determinants of mental ill health has identified correlations between social disadvantage and mental disorder, but attempts to identify the pertinent dimensions of adversity have proved inconclusive. Many contemporary researchers suggest that the disadvantages experienced and the adversities undergone must in some way be instantiated neurologically, and returned to an old idea that ‘stress’ is the mediating mechanism. Recently, in the face of arguments about the prevalence of mental ill health in their own cities, urban policy makers have attempted to make their city a place where individuals and communities can ‘thrive’. This chapter brings together research on urban mental health and emerging programmes for healthy cities, and examines the extent to which we are seeing ‘evidence-based’ programmes and policies for mental health in urban settings.
This summary is divided into thematic subsections that define the results of
the study. A brief review of the outlines of the study is supplied, as well
as an overview of the European context. The long timeline has proved vital
to the ability to perceive cultural changes, which are often subtle and
slow. It is clear that criminal cases and marriage applications involving
incest have been assessed not only according to the official laws but also
in accordance with cultural values. The view of incestuous relations at any
one time has, for instance, been affected by economic conditions at a
structural as well as an individual level. Furthermore, notions regarding
marriage, sexuality, love, and passion have influenced the assessments of
different cases in various ways. The prevailing view regarding the relevant
persons’ respective ages has also been important to assessments of
incestuous relationships at different points in time.
The case of community initiatives promoting cycling and walking in São Paulo and London
Tim Schwanen and Denver V. Nixon
Recent years have seen extensive interest in the relationships between urbanisation and city living and wellbeing as a subjectively experienced state. This chapter proposes firstly that for cities characterised by trenchant socio-spatial inequalities, wellbeing is best conceptualised in terms of capabilities, and secondly that capabilities need to be understood in a more dynamic and process-oriented manner and with greater consideration for experience than is common in most research on capabilities. The arguments are first elaborated in conceptual terms for the case of people’s everyday mobility in the city and then illustrated empirically, using a study about how community-led initiatives to support walking and cycling contribute to the wellbeing of marginalised social groups in São Paulo and London. The findings show the importance of focusing attention on the ongoing and dynamic interweaving of capabilities, practices and experiences in research that seeks to understand the relationships between wellbeing and mobility in highly unequal cities.
Reinventing depression among Rio de Janeiro urban dwellers
Leandro David Wenceslau and Francisco Ortega
Recent epidemiological surveys have shown an important prevalence of depressive and anxious symptoms in the Brazilian population, especially in its urban metropolises. In the past two decades, primary health care in Brazil has increased its coverage, becoming the main reference in public mental health care. Social determinants of mental suffering represent a challenge for patients and professionals in search of more comprehensive approaches to mental health. This chapter presents an ethnographic study conducted in the city of Rio de Janeiro with twenty-two patients who presented depressive symptoms and were treated in primary health care. Primary care physicians used the native categories of ‘hill’ and ‘asphalt’ to typify the patients´ depressive presentations. This categorisation has important consequences for the diagnosis and treatment of these symptoms. ‘Hill’ and ‘asphalt’ are analysed as ‘moral economies’ (Didier Fassin), and their meanings are contrasted with the individual therapeutic experiences of two patients. The singularities of these experiences evince that even approaches based on a broader understanding of these problems may hinder a comprehensive approach to the patients' suffering experiences in those expanding therapeutic scenarios.
A Toilet Revolution and its socio-eco-technical entanglements
This chapter examines the role of sanitation in China’s urban transformation and how the recently announced Toilet Revolution is linked with largely unsustainable ideas of progress. The Toilet Revolution is designed as a new driver for economic growth and linked with strategies for the development of the country’s tourism industry. China is now well on the way to complete the transition from largely closed-loop, service-based sanitation to resource-intensive sewage-based sanitation across urban and rural settings. However, the implications of rapid sanitation transitions for human health, social relations and environmental sustainability are largely unclear. Research is urgently needed to inform policy and praxis across all levels of governance, planning and implementation. The theoretical and practical assumptions embedded in the study, design, planning, implementation and use of ‘sanitation’ must be challenged from the ground up in order to develop a rich understanding of sanitation needs, challenges and the possibility for future alternatives to standard sanitation interventions. A systems approach drawing on complexity theory and practice theory is a plausible starting point for the unravelling of sanitation and its socio-eco-technical entanglements.
Urban transformations and public health in the emergent city examines how urban health and wellbeing are shaped by migration, mobility, racism, sanitation and gender. Adopting a global focus, spanning Africa, Asia, Europe and Latin America, the essays in this volume bring together a wide selection of voices that explore the interface between social, medical and natural sciences. This interdisciplinary approach, moving beyond traditional approaches to urban research, offers a unique perspective on today’s cities and the challenges they face. Edited by Professor Michael Keith and Dr Andreza Aruska de Souza Santos, this volume also features contributions from leading thinkers on cities in Brazil, China, South Africa and the United Kingdom. This geographic diversity is matched by the breadth of their different fields, from mental health and gendered violence to sanitation and food systems. Together, they present a complex yet connected vision of a ‘new biopolitics’ in today’s metropolis, one that requires an innovative approach to urban scholarship regardless of geography or discipline. This volume, featuring chapters from a number of renowned authors including the former deputy mayor of Rio de Janeiro Luiz Eduardo Soares, is an important resource for anyone seeking to better understand the dynamics of urban change. With its focus on the everyday realities of urban living, from health services to public transport, it contains valuable lessons for academics, policy makers and practitioners alike.
More than three centuries of slavery have left a painful and visible scar on Brazilian society, and racism continues to shape the deep social and economic inequalities that Brazilians experience to this day. Even after the institution of slavery was abolished, by the end of the nineteenth century class exploitation and rapid urbanisation meant that racism was a structural and permanent feature of Brazil’s cities. Every dimension of society reveals this fracture. Ongoing lethal police brutality and the process of mass incarceration have to be understood within this historic frame.
This chapter begins by showing how the First World War improved the technology used in amplified telephony while simultaneously creating the conditions of mass deafening that made such technology necessary. It then argues that the telephone was used as an arbitrator of normal hearing and that the data used to create apparently normal hearing levels in the British interwar telephone system featured a ‘disability data gap’. This disability data gap was embedded in the British Post Office’s ‘artificial ear’, which represented ideal hearing (eight normal men with good hearing) as normal, to the detriment of those at the outer edges of a more representative average curve. Subsequently, those with less than perfect hearing agitated to demand the Post Office supply telephones that could be used by the majority of the population. The Post Office responded by creating its ‘telephone service for the deaf’, and the subsequent user appropriation and modification of this service vividly demonstrates the fluid categorisation of deafness that the telephone enabled. This history reveals how aspirational users employed a variety of strategies to ensure equitable access to telephony and how users with hearing loss created modified devices so that they could access telephony.