11

Urban Communities in India

1. INTRODUCTION

The term urban is derived from the Latin word urbanus, which means a city or town. Towns and cities of India make up urban communities with about 30 per cent of the population. Compared with other countries, India has a much higher rural population, but the urban population is increasing rapidly. Towns and cities are getting overcrowded and are expanding. In urban areas, the work of most of the people is related to industry: manufacture, trade, and transport of goods and materials. In urban social life, relations are for a short time and impersonal. There is no feeling of oneness, and it is a case of each person for himself. There is keen competition. The basis of urban social life is class rather than caste, and social class depends on economic status. Some people by working hard, or by other means, may get rich quickly, and move from lower to middle or upper class.

Life is quite different in towns and cities than in villages. Traditions, customs, and mores do not have much influence over those living in urban areas. Family life is less disciplined and there is no community support. There is much more mixing among people of very different backgrounds. This brings about changes in habits and attitudes. In India cities have existed for a long time. Ayodhya and Pataliputra were well-known ancient cities. Rapid urbanization has led to a growth in the number of cities.

2. URBANIZATION

Urbanization is a way of behaviour and thinking. It refers to certain features like transience, superficiality, anonymity, impersonal relations, high mobility, and dynamism. This kind of life pattern is extended to the rural areas because of the vast network of communications.

Urbanization is a process of development. It refers to the movement of population from the rural to the urban areas. It is not merely shifting of people from village to city but also change of work pattern from agriculture to urban type of work, such as industry, trade, service, and so on. According to W.A. Anderson, urbanization is a two-pronged process. It involves not only the movement of people from villages to cities, but also involves change of occupations and basic changes in the thinking and behaviour of people.

3. CLASSIFICATIONS OF CITIES

Cities may be classified in various ways.

• On the basis of functional concepts. Gist and Halbert have given a six-fold classification on the basis of functional concepts:
  1. Production centres such as Jamshedpur for iron and steel, and Ahmedabad for textiles.
  2. Centres for trade and commerce, such as New York, Hamburg, Amsterdam, Mumbai, and Ludhiana.
  3. Political capitals, such as New Delhi, Chandigarh, Washington, and London.
  4. Cultural centres, such as Paris and Varanasi.
  5. Resort cities, such as Bangkok, Srinagar, and Shimla.
  6. Diversified cities, which have a great many varied interests and are not outstanding in any particular activity.

 

TABLE 11.1 Classification of Cities on the Basis of Principal Activity

Type	Description
Defence cities	Which were built for the purpose of defence with walls around them; for example, Quebec, Mexico City, and Manila
Commercial cities	Which are known for trade and commerce; for example, London, New York, and Mumbai
Manufacturing or industrial cities	Which are known for their factories; for example, Massachusetts, Jamshedpur, and Manchester
Political cities	In which governmental activities are centred; for example, New Delhi, Chandigarh, and Washington DC
Religious cities	Which are pilgrimage centres; for example, Jerusalem, Vatican City, and Jeddah
Educational cities	Which are known for their universities; for example, Oxford, Cambridge, and Shantiniketan
Resort cities	Which are places of tourist attraction; for example, Monte Carlo and Srinagar

 

TABLE 11.2 Classification of Cities on the Basis of Size

Type	Description
Town	Consists of 5,000 to 50,000 people
City	Consists of 50,000 people and above
Metropolis	Consists of 100,000 people and above

• On the basis of principal activity: E.E. Muntz has suggested principal activity as the basis for the classification of the cities (see Table 11.1).
• On the basis of size: Urban areas are also classified on the basis of size (see Table 11.2).

4. CHARACTERISTICS OF URBAN COMMUNITIES

4.1. Secondary Control

Primary control is not effective in towns and cities. Social relations are so impersonal and mechanical that family and caste have little control over the conduct and behaviour of the individual. Secondary control like the one exercised by government agencies assumes enormous significance. Laws and the role of the police become crucial. However, dubs and societies in cities also exercise control over the urban people. The intimacy within these societies makes their hold similar to primary control.

4.2. Influence of Materialism

People in cities lack affection and respect for their fellowmen. They are more attached to goods than to human beings. Money has so overwhelming a presence that transactions in cities are viewed in terms of sale and purchase. Every service rendered by someone to someone else has its price. In such a materialistic scenario, impersonality becomes a dominant social aspect of urban life.

4.3. Mechanical Life

Impersonality of relations, industrialization, and the widespread use of gadgets and gizmos have rendered urban life mechanical. Creativity is difficult to find. One comes across such a large number of people every day that close relationships are rarely formed. Most of the times, the ties are temporary, casual, and calculated. Even if there is a longer relationship, utilitarian bias prevails.

4.4. Mobility

The urban people are far more dynamic and mobile than the villagers. There is frequent change of residence in cities as most of the people live in rented houses. One can hardly get attached to people or places in a scenario of constant moving and shifting. We may therefore see impersonality and lack of attachment in social relations. Personal and social disorganization may ensue as a consequence.

4.5. Neighbours Are Alien

It is commonly believed that the larger the city, the lesser the feeling of neighbourliness. Social relations rest on motives and calculations, not on love and sympathy. A big reason behind this lack of neighbourliness is the separation of the residential and the industrial complexes by great distances. On weekdays, people leave their homes early in the morning and return quite late in the evening. The weekends and other holidays are spent in doing household chores. Thus, exhaustion and lack of free time take their toll on neighbourly relations.

4.6. Pomp and Show

In urban life, there is too much emphasis on pomp and show. Attractiveness and packaging are valued more than a person’s real worth. The urban people are ostentatious and like to be respected on the basis of their material possessions. They spend so much time on glitz and glamour that there is little left for introspection. They become what T.S. Eliot calls ‘the hollow men’.

4.7. Fashion

Fashion is a direct outcome of the ostentation discussed earlier. The trends in fashion are set by popular leaders and film actors. The women and the young pay special attention to hairstyle, clothing, ornaments, and mannerisms. Men are no exception either. There were dandies in the past, and there have evolved heterosexuals now. Fashion usually starts in metropolises and travels down to cities and small towns.

Figure 11.1 Characteristics of Urban Communities

4.8. Position of Women

As Maclver observes, the individualization of women has been fostered by urban life, and the resulting free reciprocity of relationship between men and women has a significant influence on the whole structure of society. City women are working in workshop and factory, college, and hospital.

4.9. Formation of Associations

Voluntary associations spring up in city life in large numbers and at quite a rapid pace. These associations meet the diversity of self-interests, aptitudes, aspirations, aims, and purposes that prevails in the cities. Therefore, there are a plethora of voluntary associations in the cities. Some of these associations have usurped the functions of family and neighbourhood.

4.10. Economic Status

Cities provide opportunities for personal development, such as modern businesses, employment opportunities, great achievements, and better living.

4.11. Educational Status

The educational facilities in cities are improved. Elementary schools in a city are better equipped than those in the rural areas. Most training schools, colleges, and technical schools are urban. Many libraries are situated in urban areas.

4.12. Conflict and Competition

Conflict and competition are characteristic of urban life. Leading an artificial and mechanical life leads to mental conflicts. Ambition and materialistic pursuits lead to lives full of discontent and sorrow. The desire to outdo what others have done gives rise to keen competition. At times, these desires assume unrealistic proportions and people fall victim to diseases such as neuroses.

5. FEATURES OF URBAN COMMUNITIES

5.1. Namelessness

The urban groups have, as E.S. Bogardus observes, a reputation for namelessness. By virtue of its size and population, a city cannot be a primary group. The inhabitants of a city do not come into primary contact with each other. They meet and speak without knowing each other’s name. A citizen may live for several years in a city and may not know the names of one-third of the people who live in the same city area. The urban world puts a premium on varied recognition. In short, urban contacts are segmental.

5.2. Homelessness

Homelessness is another disturbing feature of city community. The housing problem in a big city is very acute. Many low-class people pass their nights on pavements. The middle-class people have but insufficient accommodation. They are packed in one- or two-room houses.

5.3. Class Extremes

Class extremes characterize urban community. In a city are found the richest as well as the poorest people—people rolling in luxury and living in grand mansions as well as those living on pavements and hardly getting two square meals a day.

Figure 11.2 Features of Urban Communities

5.4. Social Heterogeneity

Cities are more heterogeneous than villages. They have been the melting pot of races, peoples, and cultures, and are a most favourable breeding ground for new biological and cultural hybrids. They have not only tolerated but also rewarded individual differences. They have brought together people from the ends of the globe because these people are different and thus useful to one another rather than because they are homogeneous and like-minded.

5.5. Social Distance

Social distance is a product of anonymity and heterogeneity. The city-dweller feels lonely. There is masking of one’s true feelings. The routine social contacts are impersonal and segmented.

5.6. Energy and Speed

Energy and speed are the final traits of a city. People with ambition work at a tremendous speed, day and night, and this stimulate others also to work similarly. Stimulation and inter-stimulation are endless. Urban life produces greater emotional tension and insecurity than rural life does.

6. THE REGIONAL COMMUNITY

Another important social unit is the regional area. A region is a large area where there are a good many resemblances among the inhabitants. It may not coincide with state or national boundaries. It usually combines rural and urban communities into one unit. Regional community is marked because one may live one’s entire life with it or one’s social relationships may be found within it. One cannot live a complete life, say, within a church or a business organization. But one can do so in a tribe or a city. The modern civilized communities are much less self-contained. We may live in a metropolis and be a member of a small community, or we may live in a village and be a part of a larger community.

George A. Lundberg defines regional community as an area within which the people and the different constituent communities are conspicuously more interdependent than they are with people of other areas.

6.1. Regionalism

The community feeling within a region is called regionalism. There is a difference between regionalism and sectionalism. The former implies an integral relationship with a larger whole, while the latter suggests segregation, separation, and isolation. Sectionalism is a narrow loyalty to local interests and historic sentiments. Regionalism gives man a feeling of oneness with his fellows and with the earth they share. It involves a cultural wholeness. The people of a region have attitude that looks towards a large unit of stimulation, relationship, and growth. It includes unity in economic and social functioning.

6.2. Special Feature of Regional Community

A special feature of a regional community is that it must occupy a definite territory. A nomadic community like the gypsies has a local, though changing, habitation. At a given time, the gypsies occupy a definite locality, but most of the so-called regional communities are settled.

6.3. Aims of Regionalism

A fundamental aim of regionalism is the development of an integrated large community within which city and country each has its place and makes its contribution. Each region is a locality having a specific geographical character, certain common properties of soil, climate, vegetation, agriculture, and technical exploitation. This is the geographical requirement of a region. Besides, a region. in so far as it is an integrated area of social life, exhibits a balanced state of dynamic equilibrium between its various parts. A region is a community large enough to encompass a variety of interests and activities—urban and rural, industrial and agricultural—to ensure balance. It must be a balanced and integrated community.

6.4. Types of Region

Odum and Moore have distinguished between five kinds of region:

1. A physical region is one which is demarcated by geographical factors. A large river valley surrounded by mountains is a well-known type of physical region.
2. A metropolitan region is a large city with its suburbs and all the surrounding areas whose trading activities are carried on in the city.
3. A sectional region is one in which a particular set of folkways prevails.
4. An administrative region is governed by political boundaries determined by convenience, by accident or by political planning.
5. A group-of-states region is one which usually possesses physical similarity, homogeneity and cultural uniformities.

6.5. Regions in India

Under the States Reorganization Act, 1956, India was divided into four different zones:

1. Northern Zone, including Jammu and Kashmir, Punjab, Rajasthan, Uttar Pradesh, and Delhi.
2. Western Zone, including Maharashtra and Gujarat.
3. Southern Zone, including Madras, Mysore, and Kerala.
4. Eastern Zone, including Assam, Bihar, Orissa, and West Bengal.

Each state within a zone has its own language, its own traditions, and its own special problems. In this country there are variations of geographical factors, industrial and agricultural techniques, consumption habits and standards, and nationality differences, which pose great difficulties in furthering the development of integrated regions, which demand a more complete unification of interests.

7. CITIES AND THEIR GROWTH

An understanding of the origin of the cities is a simpler problem. Cities came into existence many thousand years ago. Ancient cities arose in the Nile, the Tigris–Euphrates, and the Indus river valleys. Great cities like Harappa and Mohenjodaro in India, Memphis and Thebes in Egypt and Rome, and Athens in Italy are ancient cities. During the medieval period, commercial activities, political factors, and religions were chiefly responsible for the growth of cities. Urbanization became a worldwide phenomenon after the 18th century. Some of the factors that gave impetus to the development of cities are discussed in the following:

7.1. Industrial Revolution

• The advent of mechanical power gave a boost to textile and metal industries.
• New sources of power like steam, electricity, and oil led to the establishment of large factories.
• The development of urban market, trade, and commerce.
• Progress in science and technology; countless inventions and discoveries.
• Development of modern means of transport and communication, such as railway, automobile, aeroplane, telephone, telegraph, radio, TV, and computer.
• Migration of rural people in search of jobs to cities: Due to increased birth rates, a significant proportion of the population shifted to urban centres.
• Educational and recreational facilities.
• Political centres or capital cities, military centres, industrial centres, religious centres (places such as Haridwar, Tirupathi, and Varanasi), and educational centres have developed as cities.

The urban population has gradually increased. The decline in the percentage of rural population and the rise in urban population indicate the growth of cities. In India, the urban population was 109.11 million in 1971, which increased to 160.1 million in 1991 and to 291 million by 2001.

New towns came into existence and the old towns grew as cities. Cities such as Kolkata, Mumbai, Chennai, Delhi, Bangalore, and Hyderabad developed as metropolitan cities with more than 50,00,000 population.

7.1.1. Metropolis

The term metropolis means mother city in ancient period, the Greeks established their colonies in foreign countries. Such cities were dependent culturally, politically, and economically on their mother cities. In recent times, the term metropolis has been used to refer to such cities that grew in large proportions, and gained supernational importance. London was considered as a metropolis in 1820 itself because its population exceeded 10,00,000. A century later, 50 cities had a population of more than 10,00,000. Such cities were called giant cities.

8. URBAN SOCIAL PROBLEMS

The rapid urbanization and industrialization processes are responsible for certain social problems. It is said that the city is a centre of attraction but at the same time it is pathological. The common social problems are as follows:

• Overcrowding
• Road accidents
• Growth of slums
• Poverty
• Anti-social activities
• Political unrest
• Prostitution
• Crime and delinquency
• Begging
• Mental illness/conflicts/disease
• Alcoholism
• Drug addiction
• Gambling
• Smoking

8.1. Common Problems in India

8.1.1. Death and Diseases

In earlier days, the cities suffered from different kinds of epidemics. Medical knowledge was meagre and health-care services were not developed. Hygienic measures were primitive and poor. Consequently, the death rates and incidence of diseases were higher in cities.

Nowadays, more and more hospitals have been established in modern cities. They have highly qualified and super-specialty doctors and well-trained para-medical health teams involved in super-specialized medical, surgical, and rehabilitative care. Still, occurrences of death and diseases are present due to new and existing social and man-made troubles.

Figure 11.3 Common Problems in India

8.1.2. Pollution

Pollution occurs because of big factories, traffic congestion, smoke, excessive dirt, dust, and other types of air contamination. Many diseases, such as respiratory problems, asthma, and tuberculosis spread at higher rates, and there is higher mortality rate. Pollution is increasing day by day in spite of implementation of controlling measures.

8.1.3. Mental Disease

City life is very busy, full of excessive noise, glaring lights of automobiles, and economic pressures. All of these create stress and strain. These cause mental tensions and serious problems, and lead to mental illnesses. Isolation is another cause of emotional disturbance. Such a situation in extreme cases of individuals also leads to suicide.

8.1.4. Slum and Housing Problems

Since the dawn of industrial revolution, man has gravitated to cities in search of economic opportunities. In cities, he can seek remunerative jobs. Cities have made the greatest progress in education, trade, and commerce. The new migrants may occupy an area near the place of their work, construct temporary huts or sheds, and begin to live in such residential areas. The overcrowding of such areas without having any basic amenities turns them into slums.

8.1.5. Traffic Congestion

Transport facility in big cities is a major problem. School children find it difficult to go to their schools because of rush. The increasing use of automobiles leads to traffic congestion. The vehicles pollute the environment with heavy smoke.

8.1.6. Sanitation

Cities and towns in India have failed to provide good sanitation facility. Municipalities and corporations have failed to remove the garbage and clean the drains. The sweepers do not perform their duties sincerely. The spread of slum adds to the filth and dirt. Because of unhealthy sanitation diseases like diarrhoea, diphtheria, malaria, and so on, spread among citizens.

8.1.7. Corruption

The city-dwellers are so obsessed with their ambitions that they are ready to adopt unfair means to get things done. The officials too compromise on their ethics.

8.1.8. Inadequate Water Supply and Drainage System

Water management is a serious problem in cities. Most of the cities face the problem of water supply. No city has the facility of supplying water round the clock. Many small towns depend upon tube wells or tanks. Although the aim of the government is to provide clean water to all the city-dwellers, it has failed to formulate a national policy. Drainage system is equally bad. Stagnant water can be seen in every city due to lack of proper drainage and the overcrowding of houses. Consequently, the cities become the breeding places of mosquitoes and cause diseases, such as malaria, dengue fever, and chikungunya.

8.1.9. Poverty

Poverty is a major social problem in most of the underdeveloped and developing countries. It implies less purchasing capacity or poor economy. It is the most important social problem along with health. Some of the causes of poverty are personal, whereas others are geographical, economic, and social. It results from the incapacity of the individual to earn due to faulty heredity, environment, and unfavourable physical conditions, such as poor natural resources and misdistribution of the available resources.

8.1.10. Unemployment

Unemployment among youth, both educated and uneducated, is a major social problem in India. Most of the unemployed are educated youth. The present system of education is responsible for their unemployment.

8.1.11. Crime

Crime is an act forbidden by law, and every crime has a penalty prescribed by law. It is always an anti-social act and thus a social problem. Some people commit crime out of frustration that may have been caused by poverty, unemployment, and coercion by superiors and powerful men. Others like businessmen, professionals, and politicians indulge in criminal acts because of a craving for riches, fame, and power.

8.2. Measures to Solve Urban Problems

In order to solve the problems of the city, effective measures must be taken. The following measures are suggested:

• prevention of migration.
• arresting the individual growth in a particular place; decentralization of industries.
• systematic urban planning and development.
• effective and corruption-free local self-governance.
• improving the infrastructure and providing better healthy civic amenities.
• decentralized administration in which local people must participate.
• organization of free health check-up camps and supply of free medicines to die poor.
• establishment of health centres in all thickly populated mohallas; health education must be given about the use of drinking water and nutrition; community health services must be provided by trained health personnel.

9. SOCIAL EFFECTS OF URBANIZATION

Urbanization and industrialization have brought many changes in the society. The family structure, the status of man, caste and class, values of society, social relationships, and so on, have undergone quite a lot of change.

Urbanization has affected the family structure, functions, and relations. In India the traditional joint family is being replaced by the nuclear family. The trend is towards fragmentation of the joint family. The urban family is based on egalitarian principles. Both husband and wife share their views in decision-making. In many urban families, both the partners are employed.

Urbanization has caused enormous change in caste and family. The three basic features of caste that are affected by urbanization and education are heredity, hierarchy, and endogamy. The urbanites are educated and their relationships are not governed strictly by caste norms. We find change in commensality and material, social, and occupational relations. Another important tendency one can find is the formation of caste associations and the struggle for getting more and more governmental concessions in an organized manner.

The status of women in ancient India was high. But her position declined during the later periods. Women began to be considered inferior and were denied several rights. They were suppressed, secluded, and subjected to harassment. But after the 19th century, the efforts of the reformists’ new legislative measures, the national movement, the establishment of educational institutions, and processes like industrialization and urbanization led to the emancipation of the Indian women.

10. SLUMS

A slum is an overcrowded locality with poor housing conditions, dirty and dark streets, unsanitary conditions, and a lack of civic amenities where the poverty-stricken, the diseased, addicts, beggars, criminals, delinquents, prostitutes, and other people dwell. These are generally called blighted areas. Even middle-class people are forced to live in such places. People living in the slums are poor wage earners, sweepers, casual labourers, hawkers, salesmen, beedi-making labourers, handcart pullers, rickshaw pullers, auto drivers, construction workers, and so on. The habitual criminals and the homeless also reside in such sub-standard areas.

10.1. Features of Slum

• Overcrowding and poor environmental conditions.
• Scarcity of health and family welfare services.
• Absence of minimum level of residential accommodation.

10.2. Major Reasons for Slum

• Poor socioeconomic status is the major reason for the development of slums.
• Industrialization: Very few industries are making sufficient provision for housing of workers.
• Rapid raise and poor status rise in the urban population contributes for the slums.
• Migration is the major reasons for the expansion of growth.
• High house rents in the cities force people to lead their life in slums.
• Poor city planning: Slums are the outcome of poor planning of cities.
• Government negligence: It is a major reason for the expansion of slums.

10.3. Effects of Slum

• An individual who is leading a life in a slum easily gets addicted to all social evils. The social evils are criminal activities, juvenile delinquency, prostration, indecency, gambling, alcoholism, and prostitution.
• The standard of living of families is very poor; conflicts among the family members are very common. In most of the families, the children are rebellious, habitually disobedient, and take up the delinquencies early in their life.
• Anti-social factors disturb the equilibrium of the society and social disorganization may occur.
• The moral standards of slum-dwellers are very poor; there is no moral obligation for the family or community in a slum setup. Sexual immorality is a widespread problem among the slum-dwellers.
• The slum environment is very filthy and unhygienic. The slum environment is always in a risk of developing and spreading of communicable diseases. They are also prone to develop diarrhoea, tuberculosis, skin infections, respiratory diseases, ear infections, eye infections, and lice infestations.

10.4. Suggestions to Alleviate Slum Problems

• The growth and expansion of slum should be limited.
• Proper planning of cities can help minimize the slums.
• Industries should be shifted to outskirts of cities.
• The existing living conditions of slum-dwellers should be improved.
• Adequate medical attention should be provided to prevent spread of communicable diseases.
• Schools should be established near to the slums.
• Migration of villagers to the cities should be prevented.
• Voluntary organizations can be motivated to work for the improvement or the betterment of slums.

11. IMPACT OF URBANIZATION ON HEALTH

Nearly 50% of the world population today lives only in urban area, and by 2050, around 70% of the population will be in towns and cities. Today’s world has been rapidly urbanized with lots of changes such as in standards of daily living, modern lifestyle, and social behaviours.

Health problems are more evident in the urban areas due to polluted water supply to cities; land pollution due to improper sewage disposal; increased violence; prevalence of noncommunicable diseases, for example, cardiovascular illness, cancer, diabetes, chronic respiratory diseases, and constipation; unhealthy diet; no physical activity due to sedentary lifestyle; and more prevalence of epidemiological diseases. The urban life has become harmful to humans nowadays due to the availability of unhealthy food; increased pressure of mass marketing has direct effect on health of people in urban areas. Even the World Health Organization had chosen the theme as Urbanization and Health for World Health Day on 7 April 2010 for identifying the serious effects of urbanization with an impact to improve the health quality of each and every individual. Through this theme, the main goal was to seek worldwide attention and help of governments to improve urban health. WHO report regarding urban health problem mentions the following:

• More than 50–60% (half) of world’s population now resides in cities.
• By the year 2030, it is estimated that 5 out of every 10 people will be living in cities which will increase to 7 out of every 10 people by 2050. This increase is due to rapid urbanization where people migrate from villages to cities to earn their livelihood.
• From the year 1995 till 2005, there was an increase in the urban population of average 1.2 million people per week, that is, 1,65,000 people every day.
• Worldwide census reports that one in every three urban dwellers reside in slums amounting to 1 billion people.
• Global statistics report depicts that road accident injury is the ninth leading cause of death. Pedestrians, cyclists, and two-wheeler riders are the most affected by road accidents.
• About 1.2 million people are affected by respiratory tract diseases and die every year due to urban air pollution caused by motor vehicles, industries, electricity generation, and so on.
• Tuberculosis is the topmost prevalent communicable disease in urban areas. WHO Report says that death rate due to tuberculosis is four times the national average. About 83% of people is affected by tuberculosis infection.

11.1. Global Urbanization Impact on Health

Almost half of the world’s population lives in the urban cities. As cities offer better employment opportunities, education, health care, and culture, there is always a disproportion in contribution of national economics. Because of the global urbanization there is rapid unplanned urban growth that ultimately leads to poverty, environmental degeneration, and population demands that outstrip panic capacity, and thus there is full risk for human health. There is no reliable health statistics available about urban health statistics throughout the world.

The available data about intra-urban health data is alarming about health hazards due to population explosion because of migration to urban areas; substandard housing; overcrowding; air pollution; contaminated drinking water; inadequate sanitation; improper sewage disposal; increase prevalence of vector and waterborne diseases; air pollution due to increase motor vehicle traffic; and overall stress-associated illness due to poverty, unemployment.

Although there are health-care services provided by local and national governments, local organizations take up the challenge to control illnesses in urban areas and improve urban health care. Care is taken to concentrate on health risk areas in urban community on health services availability, good environment, better housing availability of safe drinking water, better sanitation, adopting better methods of safe sewage disposal, and better urban planning. Governance adopting best practice models, benchmarking systems, selecting leadership to lead sectors across disciplines and communities will be good elements for better way of proving good urban health care.

12. NATIONAL URBAN HEALTH MISSION IN INDIA (NUHM)

In India, around 31% of population forms the urban population, and reports estimate that urban centres grow at the rate of 5 per cent every year. According to Mr. Chandrakant Pandar (Professor and HOD for Community Medicine at All India Institute of Health Sciences, New Delhi), if urbanization is unplanned, it always brings out whole set of new health problems; poor urban people are three times more prone to death below 5 years; while considering antenatal care, the availability is 20 times less; and the primary immunization is three times stunted and simply wasted from urban fiches. NUHM will be formed to improve the health-care delivery and public health systems. City-specific planning will be done about slum habitations including the existing health facilities, available manpower, and resources. Collaboration with private providers and non-governmental organizations will be done for filling gaps and covering the slum areas, improving accessibility and quality of health services, and strengthening the referral services.

12.1. Objectives of NUHM

• Main attention given to infrastructural services through integrated department to be covered.
• To provide secured link between asset creation and management for cities by strengthening the infrastructural services which increase the efficiency and self-sustaining capabilities.
• Adequate investment for funds allocated to fulfil the deficiencies in the urban areas.
• In dispersed manner urbanization has taken place with a planned development for identified cities even in peri-urban areas.
• To provide adequate provision for urban poor to scale up delivery of civic amenities and provision of utilities with emphasis mainly on poor people in urban areas.
• To implement the urban renewal programme in order to reduce the congestion.

12.2. Strategies of NUHM

• Improving and strengthening the existing primary health system.
• Implementing private–public partnership.
• Provision of IT enablement benefits through the insurance mechanism.
• Monitoring health status and celebrating nutrition day monthly.
• Improving the capacity of key stakeholder.
• Providing special provisions to improve the health of people in vulnerable areas of illnesses.
• Including monitoring process to evaluate the quality of services.
• Involving the community participation in all types of urban planning and management.
• Providing more focus and concentration on targeted groups vulnerable for illnesses.

12.3. Need of NUHM

NUHM researched about the growth of urban poor areas especially those living in slums. There is always pressure on existing infrastructure, which is deficient. There is inaccessibility of health-care facilities in urban areas due to the following reasons:

• There is overcrowding of patients.
• It is impossible at times of emergency to reach the referral system, with lack of standard and pure norms for urban health care delivery system.
• There is lack of awareness about health-care facilities available. There are poor care facilities and poor economic resources for affording such health-care facilities. There are poor environmental conditions that double the vulnerability of diarrhoea, malaria, and lung disease like asthma and tuberculosis.

12.4. Model

There is a three-tier system of health care:

1. Community level: These provide community outreach services like Mahila Arogya Community Outreach Samities (MAS) and Urban Social Activist (USHA).
2. Urban health centre level: This forms a sound level of health care, which include strengthening of existing public health facility, thereby inculcating the providers.

• The city or the urban community came into being after the development of villages.
• There were cities in ancient times also, but most of them were of importance due to religion, politics, or trade and commerce.
• The urban man is engaged in a large number of diverse occupations, such as industry, trade, commerce, education, government, and recreation.
• Urban society shows serious problems of social disorganization.
• Urbanization and industrialization produce a changed physical environment and economic organization. They change the social, economic, and political institutions.

I. LONG ESSAY

• Define urbanization. Explain the characteristic of urban community.
• Define NUHM. Explain the various goals and objectives of NUHM in detail.

II. SHORT ESSAY

• Explain classifications of cities.
• Discuss regional community.
• Explain urban social problems.
• Explain Social effects on urbanization.
• Explain the features and reasons of slum.
• Explain impact of urbanization on health.

III. SHORT ANSWERS

• Explain regionalism.
• Explain metropolis.
• Explain NUHM model.
• Discuss suggestions to alleviate slum problems.

IV. MULTIPLE CHOICE QUESTIONS

1. The village life differs from city life in that
   1. the city encourages impersonal rather than personal relationship.
   2. there is more cooperation in the city than in village.
   3. the village people are polite, whereas the city people are not.
   4. the village life is peaceful, whereas city life is not.
2. Which of the following features is not common in a town and city?
   1. multiplicity of functions
   2. quick means of transport
   3. uniformity all over the country
   4. majority of occupants are engaged in non-agricultural activities
3. Mark out metropolis from the following:
   1. Ghaziabad
   2. Kanpur
   3. Shimla
   4. Mumbai
4. In ancient period cities were
   1. industrial centres
   2. commercial centres
   3. religious centres
   4. political centres
5. Regional community aims at
   1. economic cooperation
   2. balanced development
   3. cultural development
   4. all of the above
6. Urbanization is a stage of civilization because
   1. only the city provides opportunity for growth of civilization
   2. upper classes live in the city
   3. cities are political centres
   4. cities are economical centres
7. How did development of transport and communication help in growth of cities?
   1. The local transport added to the population of the city.
   2. It connects the different parts of the city.
   3. It connects the city with the different parts.
   4. All of the above.
8. What differentiates an agricultural society from an individual society?
   1. the environment
   2. mode of occupation
   3. social mobility
   4. all of the above
9. Cities came into existence due to
   1. movement of population
   2. growth of agriculture
   3. development of commerce
   4. industrialization
10. In cities the people in the midst of multitude feel
    1. lonely
    2. happy
    3. insecure
    4. secure
11. The main problem in the city is
    1. to find a house to live in comfortably
    2. to develop close personal relations
    3. to get children educated
    4. to have recreational facilities
12. The word urban is described as
    1. a community enjoying modern facilities
    2. a class of people characterized by higher education
    3. a class of people living with modern facilities
    4. all of the above
13. The normal areas surrounded by the city are known as
    1. suburbs
    2. hinterland
    3. urban village
    4. slum

ANSWERS

1. a 2. c 3. d 4. b 5. d 6. a 7. d 8. d 9. d 10. a 11. b 12. a 13. c

1. Bhushan, V. (1995). An Introduction to Sociology (Allahabad: Kitab Mahal).
2. Caroline (2006). Sociology for Nurses (Hyderabad: Frontline Publications).
3. Clement, I. (2007). Basic Concepts of Community Health Nursing (Bangalore: IC Publications).
4. Ganesh, P. (2007). The Textbook of Sociology for Nurses (Bangalore: EMMESS Publications).
5. Gowda, K. (2005). Sociology for Nurses (Bangalore: Shreyas Publications).
6. Krishnamurthy, K.V. (2007). Introductory Sociology (Tumkur: Viswasree Publishers).
7. Lin, J. and Christopher M. (eds) (2005). The Urban Sociology Reader (Oxford: Routledge).
8. Regu, M. (2005). Manual of Sociology (Mumbai: Vora Publications).
9. Resalakshy, M. (2002). Textbook of Sociology for Nurses (Mumbai: Vora Medical Publications).
10. Shankar Rao, C.N. (2000). Fundamentals of Sociology (Mangalore: Jai Bharath Prakashana).