Spatial stratification of urban neighbourhoods and their influence on health outcomes
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Date
2025
Authors
Msuya, Ibrahim
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Publisher
University College Cork
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Abstract
This thesis investigates the spatial and socio-environmental determinants of non-communicable diseases in Dar es Salaam, Tanzania, with a focus on respiratory and cardiovascular health outcomes. Through a series of three interlinked studies, it explores how urban spatial inequalities intersect with environmental risks to shape health disparities in a rapidly urbanizing African context. The first chapter establishes a foundation by examining how neighbourhoods can be more meaningfully stratified to reflect socio-economic realities. It contrasts a participatory, locally informed classification method with a statistical approach using latent profile analysis (LPA) on census data. This chapter demonstrates the value of nuanced neighbourhood typologies in capturing the lived experience of inequality and sets the stage for spatially sensitive health analyses. Building on this foundation, the second chapter investigates the spatial prevalence of chronic respiratory diseases using household survey data and environmental indicators such as the Topographical Wetness Index. It highlights the role of urban hydrology proximity to stagnant water and flood-prone areas as a key environmental determinant of respiratory health, particularly in vulnerable communities. The third chapter turns to cardiovascular health, examining how satellite-derived measures of urban greenness (NDVI) and surface temperature (LST) relate to hypertension across socio-economic strata. It reveals that environmental exposures like heat and limited greenery disproportionately affect urban residents, contributing to higher disease prevalence. Together, these chapters provide an integrated understanding of how spatial, socio-economic and environmental factors combine to shape urban health outcomes, offering insights for more equitable and context-specific urban planning and public health interventions.
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Keywords
Non-communicable diseases , Urban health , Spatial epidemiology , Health inequalities , Environmental determinants
Citation
Msuya, I. 2025. Spatial stratification of urban neighbourhoods and their influence on health outcomes. PhD Thesis, University College Cork.