The COVID-19 pandemic has shed light on the ongoing pandemic of racial injustice. In the context of these twin pandemics, emergency medicine organizations are declaring that “Racism is a Public Health Crisis.” Accordingly, we are challenging emergency clinicians to respond to this emergency and commit to being antiracist. This courageous journey begins with naming racism and continues with actions addressing the intersection of racism and social determinants of health that result in health inequities.
In the first paper in this Series we assessed theoretical and empirical evidence and concluded that the health of people living in slums is a function not only of poverty but of intimately shared physical and social environments. In this paper we extend the theory of so-called neighbourhood effects. Slums offer high returns on investment because beneficial effects are shared across many people in densely populated neighbourhoods. Neighbourhood effects also help explain how and why the benefits of interventions vary between slum and non-slum spaces and between slums.
Access to water in Sub-Saharan Africa (SSA) continues to be a challenge to the extent that there are more people without access to water in 2015 than in 1990. This indicates that current approaches to water provision have been ineffective. Governments have failed to provide a structure, mechanisms or approaches that guarantee water for ALL, resulting in a vacuum which has been ‘filled’ by a number of social actors (NGOs, Faith Based Organisations, Donors).
