The Unraveling of the Urban Health Advantage: The Case of South Africa

Elizabeth A. Gummerson, Princeton University

This paper examines the resilience of the ‘urban advantage’ in health in a developing country facing rapid urbanization. It uses anthropometric measurements and economic and social data collected on 31,170 individuals in 7305 households during the first wave of the South African National Income Dynamics Study. The paper uses a cross sectional analysis to investigate the comparative health advantage of urban children compared to rural children across six indicators of chronic and acute malnutrition, recent illness, disease, and obesity. It finds no evidence of an urban health advantage and, in fact, finds that, controlling for demographics and household socioeconomic status, children living in urban households are associated with higher risks for obesity and serious illness or disability.