Q 1 WRITE A NOTE ON INFLUENCE OF MIGRATION AND URBANIZATION ON MENTAL HEALTH ?
A 1 1 Urbanization is the relative increase of the urban population as a proportion of the total population
2 The United Nation’s Population Fund (UNFPA) released their “State of the World Population 2007” report in June 2007 which mentions the fact that humanity is nearing the date when for the first time more humans will be living in cities than in rural areas.
3 Cities offer the lure of better employment, education, health care, and culture and they contribute disproportionately to national economies.
4 Vv imp However, rapid and often unplanned urban growth is often associated with poverty, environmental degradation, and population demands that outstrip service capacity.
5 So , These conditions place human health at risk.
6 Urbanization has brought its own set of problems pertaining to mental health and well-being -
A ) Mostly because of increased speed and decreased costs of communication and transportation, cities are growing increasingly diverse in their population
7 Most migrants come from rural areas, bringing values, beliefs, and expectations about mental health that are often very different from the ones they encounter in their new location
8 So , In many instances, people coming from rural areas have endured years of isolation, lack of technologic connection, poor health, poverty, unemployment, and inadequate housing.
A ) They need to acculturate and adapt not only to a new challenging urban environment, but also to alternative systems of symbols, meanings, and traditions.
9 This all leads to a negative impact on the mental health specifically leading to learned helplessness and stress related disorders
10 Rapid urbanization puts immense pressure on both physician and patient , So Sound doctor-patient relationship is not established *
EPIDEMIOLOGY
1 In India, as per the 2001 census, 72.22% of the people live in more than 550,000 villages, and the remainder in more than 2000 towns and cities.
2 In Pakistan, about 68% of the population lived in rural areas in 1994, a decrease of 7% since 1970. In contrast, the number of people living in urban areas has risen substantially, resulting in an urban growth rate of 4.6% between 1980 and 1991.
3 The population of Nepal is overwhelmingly rural, with just over 15% living in urban areas such as the Kathmandu Valley.
4 The distribution of rural population in other South Asian countries is as follows -
A ) Bhutan 91%
B ) Sri Lanka 79%
C ) Afghanistan 77%
D ) Maldives 71%
E ) Myanmar 71%
HAZARDS OF URBANIZATION
1 substandard housing
2 crowding
3 air pollution
4 insufficient or contaminated drinking water
5 inadequate sanitation and solid waste disposal services
6 vector-borne diseases
7 industrial waste
8 increased motor vehicle traffic
9 stress associated with poverty and unemployment, among others
DISORDERS ASSOCIATED WITH URBANIZATION
A ) Psychoses
B ) Depression
C ) Sociopathy
D ) Substance abuse
E ) Alcoholism
F ) Crime
G ) Delinquency
H ) Vandalism
I ) Family disintegration
J ) Alienation
K ) PTSD
CONSEQUENCES
1 Urbanization alters the dynamics of society at large and family in particular.
EFFECT ON ELDERLY POPULATION
A ) Rapid urbanization has created a huge population of older men and women left to fend for themselves in the rural areas while the young make their living in the cities.
2 Among the neuropsychiatric conditions, dementia and major depression are the two leading contributors, accounting, respectively, for one-quarter and one-sixth of all disability adjusted life years (DALYs) in this group.
3 older people are among the most vulnerable groups, in part because of the continuing myths that surround their place in society.
EFFECT ON WOMEN
4 Women are particularly vulnerable and they often disproportionately bear the burden of changes associated with urbanization.
A ) In the rural setup, they would work mostly at homes but the predominantly nuclear setup of the cities and sheer economics is forcing women to venture out.
B ) Domestic violence is also highly prevalent in urban areas
5 Women usually have significantly higher prevalence rates for neuroses, affective disorders, and organic psychoses than men.
EFFECT ON CHILDREN
Development of anti social personalities
EFFECT ON ECONOMIC STATUS
Is associated with low socioeconomic status leading to higher prevalence of major depression , social abuse and personality disorders