Dhaka City: The health risks of living in small spaces

One of the major global trends that has a big effect on health is urbanisation. By the middle of this century, the World Health Organization predicts that more than 70% of people will reside in urban areas.

Similarly, Bangladesh's economic and political hub, as well as its primary source of employment creation, is the Dhaka Metropolitan Area. Due to its status as a major commercial centre, Dhaka's population has grown quickly, more than doubling in size over the past 40 years to reach about 23 million people in 2023. 

Thus, Bangladesh has one of South Asia's quickest rates of urbanisation. 

Some of the major components for a functioning and healthy city are Transport, Food and Nutrition, Housing, Access to Goods and Services, Health, Sanitation and Waste Management. However, due to this rapid urbanisation, Dhaka is unable to facilitate these components properly. 

Dhaka is one of the most densely populated cities in the world with 30,093 people living per square kilometre.

The housing situation is quite frankly, one of the worst in the world. Living spaces are becoming smaller and smaller. According to Centre for Urban Studies Chairman Professor Nazrul Islam, a family needs at least 250 square feet to live comfortably in a two-room home, but many people in Dhaka are compelled to live with just 100 square feet or even less. 

Also, offering a physical location to live is only one aspect of housing; it also includes offering services for privacy, safety, health, and utilities. It has been proven that living in small and cramped spaces results in a lot of health risks. For example, poor ventilation in such living quarters can increase the likelihood of developing respiratory problems, including asthma and chronic obstructive pulmonary disease (COPD). Adding to the fact that Dhaka is one of the most air-polluted cities in the world, this is a very serious problem. 

Living in close quarters increases the risk of infectious diseases spreading rapidly. In regions with inadequate sanitation and restricted access to clean water, this holds particularly true. 

Slum areas of Dhaka city are prime examples of such problems. There are differences between slum and non-slum households in urban regions when it comes to access to modern, hygienic sanitation services. According to the Bangladesh Urban Health Survey 2021, only 27.9% of families in slums used improved, not shared toilet facilities, compared to 54.0% of non-slum households. 

The percentage of families using improved but shared toilets was significantly higher in slums (41.9%) than in non-slum areas (17.7%). Shared sanitation facilities in densely populated areas have a huge risk of spreading diseases from one person to another. 

Living in confined and crowded spaces with limited access to natural light and fresh air can heighten the likelihood of mental health problems, including depression and anxiety. It can also increase domestic violence. 

According to research, kids who live in crowded households are more likely to experience depression, loneliness, high blood pressure, and poor academic achievement. These effects result from children feeling helpless and withdrawing from others due to a lack of personal space and the inability to avoid distractions. These behaviours can persist outside the home and into adulthood. 

In the meantime, parents may experience worry, insomnia, and a reduction in their responsiveness to their kids. Furthermore, living in one room houses affects their privacy as well. This is particularly worrying in urban slum areas. More than half (54.8%) of households in slums only had one room, compared to just 27.0% in non-slum regions and one-fifth (20.4%) in the remaining urban areas. 

Dhaka is the heart of Bangladesh. Every major activity in Bangladesh revolves around Dhaka. Although this should not be the case and we need to decentralise the capital, it will take time and long-term planning. Thus, short-term solutions to people's health and wellbeing should always be a priority. The healthcare system has improved significantly from the past. However, people don't give enough attention to housing as an important determining factor of good health. That's why the government needs to improve the housing conditions of the citizens of Dhaka, especially the people living in slums. 

Also, much research is needed to uncover how people can live a decent and healthy life by living in small households. Furthermore, housing plans must always prioritise health over all other factors. If the government wants to achieve the 11th SDG goal (Sustainable Cities and Communities), they must act now, create long-term plans and implement them properly.

Dr Md Shamim Haider Talukdar is the CEO of Eminence Associates for Social Development and a consultant for UNICEF. Ehsanul Kabir Nahid is a research assistant at the Eminence Associates for Social Development.