SPS260/560 Within the world of cities 

Assignment 4

Mortality Toll of Cities

Emerging Patterns of Disease in Bombay

Radhika Ramasubban
Nigel Crook

Submitted by –
AASTHA GALANI
AU1910330
BBA HONOURS

The article "Mortality Toll of Cities: Emerging Patterns of Disease in Bombay" by Radhika
Ramasubban and Nigel Crook, provides a broad analysis of the health conditions widespread in
urban areas, focusing on the city of Bombay, India. The article analyses qualitative and
quantitative data from numerous sources, including hospital records and death certificates, to
determine why people in the city died. The study was carried out from 1990 to 1995 over six
years.
The distribution of deaths in Bombay from 1990 to 1995 is shown in Graph 1 by age group and
sex. The graph shows that the majority of deaths occurred in the 60 and older age group, with the
biggest number of deaths occurring in males between the ages of 70 and 79. The graph also
demonstrates that while fatalities among males were greater than deaths among females in all
other age categories, deaths among males were higher than deaths among females aged 40 to 59
years.
The data analysis also reflects that Because tuberculosis, respiratory illnesses, and cardiovascular
diseases are common in Bombay, the mortality rate there is greater than the national average.
The fact that some areas of the city had greater fatality rates than others was another finding,
showing that the risk of disease was not distributed uniformly throughout the city.
The authors offer an in-depth analysis of the social and economic aspects of metropolitan areas'
poor health outcomes. For instance, they pointed out that bad housing and poverty were major
factors in Bombay's poor health. Other risk factors mentioned by the authors include poor
sanitation, air pollution, and limited access to medical treatment.
The topic of government policies' contribution to alleviating health disparities in metropolitan
areas is also discussed. According to the authors, actions like bettering housing conditions and
expanding access to healthcare services could aid in lowering the death rate in urban areas. They
also demand more studies on how urbanisation affects health, particularly in underdeveloped
nations.
The article's emphasis on the spatial distribution of health outcomes in Bombay is one of its
unique characteristics. The authors plot the distribution of death rates among several municipal
wards using geographic information systems (GIS). According to this data, there are large
regional differences in mortality rates, with certain wards' rates being more than three times
higher than the citywide average. The authors explain this difference by a confluence of elements
including deprivation, subpar housing, and limited access to healthcare. This conclusion
emphasises how crucial it is to take local conditions into account when developing interventions
to enhance health outcomes in urban settings.
The article's focus on a brief period (1990–1995) and dependence on secondary data sources,
however, pose several limitations. Even though the authors are aware of the limits of their data
sources, it would be interesting to monitor changes in Bombay's health outcomes over time and
determine whether or not efforts to reduce health disparities have been effective.
Overall, this article provides a thorough study of the health issues that are common in urban
environments, particularly in developing nations. The authors' in-depth research of the social and
economic factors that influence poor health outcomes in cities highlights the need for focused
interventions to alleviate health disparities in rapidly urbanising cities. The article's emphasis on
social and economic determinants of health is especially significant in recognising the
complicated relationship between urbanisation and health outcomes.