29 January 2010
Rural infrastructure and services
While urban living is now the dominant form globally, the balance of rural and urban dwelling varies enormously across areas – from less than 10% urban in Burundi and Uganda to 100% or close to it in Belgium, Kuwait, Hong Kong SAR, and Singapore. Policies and investment patterns reflecting the urban-led growth paradigm have seen rural communities worldwide, including Indigenous Peoples, suffer from progressive underinvestment in infrastructure and amenities, with disproportionate levels of poverty and poor living conditions, leading ultimately to out-migration to unfamiliar urban centres. This, combined with population growth and stagnant agricultural productivity, saw sub-Saharan Africa experience one of the highest rates of urban growth internationally between the 1960s and 1990s (140%), with rural-urban migration accounting for roughly half of this. These major inequities, to the disadvantage of rural conditions, contribute to the stark health inequities between urban and rural dwellers in many low-income countries.[Source: Commission on Social Determinants of Health Final Report, 2008, p.60]