Urban Health in Peru

As urban populations continue to grow globally, there is an increasing need to focus on urban health. Metropolitan areas generally offer a more prosperous setting with greater health care, education, and economic prospects. Given their size and infrastructure, cities can often deliver better services more efficiently than rural areas. However, population growth and urbanization in many cities have surpassed the local government’s capacity to maintain adequate infrastructure and environmental management. As cities continue to expand, an increasing number of urban residents lack access to basic public services, such as clean water, sanitation, and medical services.

Peru has not remained unaffected by such rapid urbanization. In fact, the percentage of the total Peruvian population living in cities has increased from 47% in 1961 to 77% as of 2010, and the population of the Lima Metropolitan Area stood at about 8.5 million in 2007. With greater access and proximity to heath care services (10 of Peru’s 16 national hospitals are located in Lima), the move from rural to urban regions has generally proven to be promising for the health of migrants. Indeed, MEDLIFE has encountered a number of families who have come to Lima from the Amazonian or Andean regions of Peru in search of better healthcare. Research has shown that heath indicators in Peru are two to four times better in urban regions compared to rural areas (Table 1). Yet, urbanization is by no means a resolution to improve the health profile of Peruvian residents.

Table 1

Though urban residents arguably have access to a greater variety of food, the combination of a more sedentary lifestyle and a less healthy diet have resulted in cardiovascular health concerns in cities. According to Peru’s National Survey of Nutritional, Biochemical, Socioeconomic and Cultural Indicators Related to Chronic Degenerative Diseases, urban regions have a higher prevalence of obesity, hypertension, and diabetes (Table 2).

Table 2

Urbanization produces accompanying health challenges in Peru: the growth of cities is often accompanied by the growth of slums. With the great influx of rural residents into Lima, a number of pueblos jóvenes, or shantytowns, have sprung up on the outskirts of the city. Characterized by high rates of poverty, inadequate and haphazard housing conditions, and a lack of clean water and sewage lines, these slums house at least 30% of the Limean population. This growth results in overcrowding, insufficient resources, and deficient hygiene — often leading to the progression of preventable diseases into chronic illnesses.

MEDLIFE works primarily in the pueblo joven of Pamplona Alta, where over 20,000 Peruvians live in conditions of extreme poverty. Over the past year and a half, we’ve brought Mobile Clinic services to thousands of residents seeking medical care, in addition to completing 20 small infrastructural and developmental projects. While the Peruvian Ministry of Health hasn’t yet been able to extend adequate services to recently populated slums like Pamplona Alta, MEDLIFE hopes to continue to bridge the gap until the local and national governments have sufficient resources to serve their populations, and we look forward to working on shared projects to promote the Ministry of Health’s programs.

With an urbanization rate of 1.6% in Peru and an annual slum population growth rate of 3% in Lima, health effects of urban population growth will only continue to rise if more aid isn’t delivered to the pueblos jóvenes. City governments need to first recognize and then establish and maintain effective programs to improve urban living conditions and cope with the increasing urbanization, especially with the growth of slums. Though Peru’s Ministry of Health established the General Directorate of Environmental Health (DIGESA) in response to Peru’s expanding population and rapid urbanization, environment health problems have exceeded DIGESA’s abilities to successfully respond. While some NGOs, like MEDLIFE, provide aid to assist with the consequences of this rapid urbanization, there remains a great deal of work to be done. It is essential that MEDLIFE continues to work with and support local governmental efforts, in order to help Peru itself deliver a lasting, sustainable solution to its healthcare deficiency.