Environmental and Social Conditions of Health: Placing Development in a Ugandan Context
Environmental infectious diseases, such as gastrointestinal and respiratory infections are major causes of morbidity and mortality in the global south. Beyond the physical environment, the presence and persistence of these infections are mediated by human-driven forces that create favorable social, economic, and political disease conditions. These forces may vary dramatically over space. Understanding how contextual layers of 'place' conjoin and shape differential health experiences is the aim of this work.
In sub-Saharan Africa, economic development practices increasingly involve policies that render important environmental resources inaccessible such as through land privatization and the creation of National Parks as income-generating ventures. Privatization and conservation policies not only alter material conditions, but transform social conditions. Both material and social consequences vary dramatically across space.. In this work, the combination of these conditions is termed 'vulnerability'. Increased vulnerability may manifest as poorer health. This study examines the role of 'place-specific' vulnerabilities, as both absolute and relative deprivation, in influencing health inequalities in communities in southwestern Uganda experiencing privatization and conservation policies as a form of economic development. Three communities bordering Lake Mburo National Park participated in longitudinal morbidity histories, semi-structured interviews and demographic surveys, The role of material and social conditions in health outcomes, the context of restrictive policies in a broader history of resource management and aspects of resilience were investigated. This vulnerability approach informs current efforts to manage environmental resources, reduce infectious disease burdens, and to meet the Millennium Development Goals, while bearing implications for the means to meeting those goals.