chapter 4 - DRK

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Strictly under embargo until Wednesday 22 September at 00:01 GMT (02:01 Geneva time)108CHAPTER 5Illicit drugs are not just a source of violent crime, their use also poses a huge healthchallenge in itself and it is a problem that is heavily concentrated in cities. The samegoes for alcohol abuse. Use of illicit drugs is fuelled by social and economic pressuresand facilitated by easy availability in urban areas. According to WHO, urbanization isassociated with twice the rate of hospital admission for drug or alcohol disorders.Given the pressures of city life, it is no surprise that urban living fuels mental disturbanceand distress. Levels of fear, anxiety and mental illness have been shown to be higher inurban environments. In a study carried out in Sweden in 2004, adult Swedes living indensely populated areas had nearly twice the rate of serious mental illness as those livingin thinly populated parts of the country. A sense of lack of control, fear of unemployment,the breakdown of traditional social ties and bonds – a particular problem forimmigrants – and urban overcrowding are all factors that can trigger high levels of stress.One private clinic quoted in Britain’s Guardian newspaper reported a 33 per cent risein the number of people from the financial sector seeking advice for anxiety, depressionand stress after the global financial crash of late 2007 and 2008. Unemployment, orthe threat of it, undermined their sense of personal worth. Another group particularlyexposed to stress in urban settings is the elderly. Older city dwellers, particularly inricher countries, often face loneliness and depression unless they are rich enough to beable to pay for private care.WHO forecasts that within the next ten years unipolar depression will account for thegreater burden of disease in developing countries. Community-based studies of mentalhealth in developing countries support the view that 12 per cent to 51 per cent ofurban adults suffer from depression in some form or other. Risk factors include maritalbreakdown, poverty, exposure to stressful events, long-term stress and lack of socialsupport. Symptoms of depression are more common among urban women than menand among poor urban neighbourhoods rather than in non-poor urban areas. Inadequateshelter, unemployment and the relentless struggle to cope with adversity are alldrivers of mental ill health for the urban poor.Box 5.3 Safety on the urban roadRoad transportation has become a key elementof urbanization. By speeding up communicationsand the transport of goods and people,it has generated a revolution in contemporaryeconomic and social relations.However, this has not come about withoutcost: environmental pollution and urban stressare directly linked to growing road transportation.Above all, it is increasingly associatedwith the rapid escalation of road crashes andpremature deaths, as well as with physicalhandicaps and psychological trauma.Losses are not limited to reduced workerproductivity and trauma affecting a victim’s
Strictly under embargo until Wednesday 22 September at 00:01 GMT (02:01 Geneva time)private life. Equally significant are the risingcosts in health services and the added economicbur den (estimated between 1 and 3 per centof gross national product). In developing countries,the costs often exceed the internationaldevelopment assistance received each year.Consequently, there is a direct link betweenroad safety improvement and poverty reduction.The situation is made worse in developingcountries by rapid and unplanned urbanization.The absence of adequate infrastructurein cities, together with the lack of a legal regulatoryframework, makes the exponential risein the number of road crashes all the moreworrying.Road crash fatality numbers are comparableto the number of global deaths causedby TB or malaria. Worldwide, road traffic injuriesare the leading cause of death amongyoung people aged 15 to 29 and the secondmost common cause of death for those aged5 to 14. An estimated 1.3 million people arekilled in road crashes worldwide each yearand as many as 50 million are injured. Forevery death, 20 to 30 people are disabled,many permanently.“If significant preventive actions arenot taken, we estimate that by 2020road trauma will rank as the sixth biggestcause of death.”WHORoad crash mortality projection 2020Cost-effective solutions do exist and havealready achieved very positive results in manycountries. Together with its hosted project, theGlobal Road Safety Partnership (GRSP), theInternational Federation of Red Cross and RedCrescent Societies (IFRC) has prioritized thereduction of disastrous road safety crashesaffecting young people. IFRC and GRSP areadvocating for the adoption of straightforwardsolutions to avoid or significantly decrease thetragic human, social and economic consequencesof urban road crashes. These include:implementation of national road safety actionpolicy; better road systems; first-aid training;and closer partnerships with governments, theprivate sector and civil societyViet Nam offers a good example of success.In 2006, the Vietnamese National TrafficSafety Committee, the Asia Injury PreventionFoundation, the Red Cross of Viet Nam andthe French Red Cross contributed to efforts tocreate a national action helmet plan supportedby GRSP. That led to enactment and enforcementof a new helmet law. In 2008, Viet Namsaw the first results: 1,500 fewer lives lost comparedwith 2007 when 12,500 people diedon the road. Campaign posters produced bythe Red Cross of Viet Nam and the FrenchRed Cross in Hanoi and Ho Chi Minh Cityin millions of people per year2.020201.51.00.50.02010 2020HIC: High income countries2010LMIC: Low- and middle-income countriesSource: WHO/World Bank (2004)World Disasters Report 2010 – Focus on urban risk109
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190ANNEX 2Strictly under embargo un
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214INDEXStrictly under embargo unti
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The International Federationof Red
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