MINI RESEARCH PROJECT

Group E
Mentor: Dr. Niraj
Group E
Shrestha
Overcrowding in relation to socio-
economic status of the families in a
ward of Gokarneshwor
Municipality.

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Members:
Roll no. Name: Roll no. Name:

2161 Rasu Singh 2173 Sanjay Upreti

2162 Sangeet Singh 2174 Sulav Waglay

2163 Aayusha Sthapit 2175 Nikesh Kumar Yadav

2164 Bonish Raj Subedi 2176 Raj Nandan Yadav

2166 Anu Thakali 2177 Rajeev Kumar Yadav

2167 Madhu Kumari Thakur 2178 Sonu Yadav

2168 Awesh Thapa 2179 Sushmitakumari Yadav

2169 Prashant Thapa 2180 Nabin Yogi

2171 Roshna Timilsina 1939 Ravi Prakash Bansal

2172 Manisha Tiwari 1968 Susmita Gurung

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Abstract:
• As Nepal is a developing country many households fall under lower socio-economic class.
• As many families have limited access to proper housing facilities, overcrowding has evolved as a major threat
to the health of the family members.
• This study was aimed to determine the prevalence of overcrowding and its association with socioeconomic
class of the families in a ward of Gokarneshwor municipality.
• It was a descriptive, cross sectional and community based study.
• Data was collected from 165 families of Ward 2 of the municipality over a 6 week period.
• Overcrowding and socio-economic status of the family was calculated using total floor area per unit person
and modified Kuppuswamy’s scale in context to Nepal respectively.
• Data was entered in SPSS, descriptive statistics was applied and chi square test was used to find association
between overcrowding and socio-economic class of the family.
• Prevalence of overcrowding was 56.4%.Chi square value was 5.100a and P value was 0.024.
• Overcrowding was found to be significantly associated with low socio-economic class of the family.
• This research may help in understanding the role played by social determinants of health which in turn will
help in improving community health with a holistic approach.
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Introduction:

• Socio-economic status has been defined as the position that an individual/ family occupies with reference to
prevailing average standards of cultural and material possession, income and participation in group activity
of community.1
• Families can be categorized into various socio-economic classes according to the modified Kuppuswamy’s
socio-economic scale in context of Nepal 2019.2
• People with high income can afford better housing but family members of lower socioeconomic status can
experience crowding within home which is problematic for health.3
• Overcrowding refers to the condition in which more people are living within single dwelling which restricts
movement, disturbs privacy and sleep and leads to lack of hygiene, all of which leads to poor health. 4

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 Materials and Methodology
• A descriptive cross-sectional community based study was carried out in ward 2 of Gokarneshwor municipality.
Data was collected from the logbook used by medical undergraduates of Nepal Medical College for their family
health exercise in that ward over a 6 week period from February to March 2020 AD. Family health exercise is a
part of the Community Medicine undergraduate posting.
• One hundred and sixty five households were covered in which convenience sampling technique was applied. As
the total number of households in Gokarneshwor-2 is 1078 (Gokarneshwor Municipality Plan & Policy 2075 BS),
165 households represents approximately 15% of the total households in that ward.
• Caste was categorized as in Nepal Demographic and Health Survey 2006; caste,ethnic and regional identity in
Nepal. Socio-economic status was classified on the basis of the modified Kuppuswamy's Scale in context to
Nepal.2 Presence of overcrowding was considered when the total floor area per unit person was less than 70
square feet. A baby under 12 months was not counted and children between 1 to 10 years were counted as half
unit.4
• Data was entered and analyzed using SPSS student version and descriptive statistics was applied. Chi square test
was applied to find association between the variables and level of significance was set at 5%. 

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Results:
Table. 1
Distribution of households by caste/ethnicity (N -165)
Caste/Ethnicity Number of House holds Percentage (%)

• Tamang 74 44.8

• Brahmin/Chhetri 49 29.7

• Newar 11 6.7

• Magar 7 4.2

• Dalits 5 3.0

• Gurung 5 3.0

• Sherpa 5 3.0

Total 165 100.0

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Table : 2
Distribution of household by the type of family (N= 165)
Type of family Number of households Percentage (%)

Nuclear 111 67.3

Joint 54 32.7

Total 165 100.0

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Table: 3
Socio-economic class distribution of households

Socioeconomic status
Number of households Percentage (%)
Upper middle 36 21.8

Lower middle 56 33.9

Upper lower 72 43.6

Lower 1 0.6

Total 165 100.0

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Table: 4
Prevalence of overcrowding in households

Overcrowding
Number of households Percentage (%)
Present 72 43.6

Absent 93 56.4

Total 165 100.0

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 Table: 5
Association between Socio-economic class of households and prevalence of
overcrowding
Socio economic status Present Absent P value

Middle 33(20.0%) 59(35.8%) 0.024

Lower 39(23.6%) 34(20.6%)

Total (n= 165) 72(43.6%) 93 (56.4%)

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Prevalence of Overcrowding

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DISCUSSION
• In this study of 165 households, the most common caste was Tamang (44.88%), followed by Brahmin/Chhetri
(29.7%) and Newar (6.7%).
• In a similar research held in Nuwakot, the most common caste was Tamang (42.84%), followed by Brahmin
and Chhetri (32.54%), Magar (2.3%) and other caste (23.32%).5
• In a study conducted in Mumbai 67.8% were joint families and 32.1% were nuclear families. 6
• In a study conducted in semi-urban slum area in Vellore, Tamil Nadu in southern India, 55.3% of households
out of total 7925 belonged to low Socio-economic class according to the modified Kuppuswamy's scale 7
• In our study, 111 households (67.3%) were nuclear families and 54 households (32.7%)were joint families,
44.2% households out of 165 belonged to low socio-economic class.
• According to the UN-habitat in 2003 AD, 40% of the urban population lived in overcrowded dwellings in
South Asian countries. Prevalence of overcrowding in some of these countries was as follows :
Nepal -56% India-55% Bangladesh-85% Pakistan-74% .8
• Similarly in our study 43.6% of population lived in overcrowded dwellings whereas in a study conducted in
USA 2.4% of population lived in overcrowding.9

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Cont..
• In our study among 43.6% of population living in overcrowded dwelling, 20% belonged to middle class
whereas 23.6% belonged to lower class.
• Among the 56.4% population living in an optimal setting, 35.8% belonged to the middle class whereas 20.8%
belonged to lower class.
• This result depicts that overcrowding is more in lower class as compared to higher classes.
• Similarly in a study conducted in Nigeria, it showed that households with high level of poverty generalizing
the low socio economic class experienced overcrowding to a significant high degree . 10
• In addition, researchers have connected overcrowding to poor educational attainment and also low income
compelling people to live in dwellings with inadequate space for their needs 11 which are both the
parameters of Kuppuswamy's scale. As socio-economic status, overcrowding and health are interrelated,
health professionals should focus on social determinants of health aimed at improving the health status of
families which will ultimately improve the health status of the community.

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REFERENCE
1. K Park .Environment and Health. Park’s Textbook of Preventive and Social Medicine (23rd edition). M/s Banaridas
Bhanot Publishers 2015: 689
2. Joshi S Kumar, Acharya K. Modification of Kuppuswamy's Socioeconomic Status Scale in the Context of Nepal,
2019.KUMJ 2019;17 1-2.
3. Evans GW. The built environment and mental health. J Urban Health. 2003;80(4):536-55
4. K Park. Environment and Health. Park’s Textbook of Preventive and Social Medicine (23rd edition). M/s
BanaridasBhanot Publishers 2015:752
5. National Population and Health census.2011; vol1
6.Chettiar C. A study of need satisfaction in joint and nuclear families in mumbai. 2015;vol10:85-90
7. Kattula D, Venugopal S, Velusamy V, et al. Measuring Poverty in Southern India:A Comparison of Socio-Economic
Scales Evaluated against Childhood Stunting. PLoS One. 2016;11(8)
8 .UN Habitat: Asia – Pacific Ministerial Conference on housing and human settlement 2006
9. Blake K, Kellerson R, Simic A. U.S Department of Housing and Urban Development Office of Policy Development
and Research: Measuring overcrowding in Housing. Virginia, 2005
10. Makinde O. Overcrowding as a risk factor for domestic violence and antisocial behavior among adolescents in
Ejibo, lagos, Nigeria. 2016:1-9
11. WHO Housing and Health Guidelines. Geneva: World Health Organization. Household crowding.2018 3
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Strength of the research:

● As the research was conducted by collecting data going door to door, data regarding family size, area of the
houses and living conditions are reliable.
● With the motive of eliminating discrepancy socio-economic status of all households were solely
categorized through Modified Kuppuswamy's Scale.
● The area per unit person is calculated in square feet for all cases to maintain the uniformity.

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 Weakness of research:
● All the households of Gokarneshwor-2 municipality weren't included leading to a small sample size.
● As socio-economic status of households are classified under Modified Kuppuswamy's scale which rely on
occupation and education of only the head of family which may not truly portray the actual status of the
family as other family members may have better education and occupation .
● People were reluctant to share their income so the family income might not depict the real figures.

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Take home message:

• Our research "Overcrowding in household and its relation to Socio-economic status of the families" basically
looks around the quality of life of people.
• Through this study we were able to know that overcrowding is significantly associated with the socio-
economic status of a household.
• This makes us clear that people in lower socioeconomic classes are more vulnerable to overcrowding and its
health hazards; and these are the people who need the initial intervention.
• This research also helps us to know that In order to eliminate overcrowding, amelioration of social
determinants of health plays a crucial role.
• As this research helps to improve the quality of life in a community by highlighting the vulnerable ones and
the measures needed to looked after to improve the quality ,this sort of research should be encouraged and
conducted.

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THANK YOU

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20th batch MBBS
Group E
Community Medicine