The effect of urbanization on health in a mining area of Sierra Leone

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Abstract
The health levels in the industrial new town of Lunsar were compared with those of the villages of similar tribal composition, in the surrounding region. A 10% sample census of Lunsar was made and a 40% clinical sample of Lunsar was examined. The population of Lunsar was 9540 on 31 July 1959. Data were collected on environmental conditions such as housing, water supplies and the disposal of human waste. The 4 villages studied were situated 7-20 miles from Lunsar. Total populations were seen in 3, and a half sample was taken of a 4th, a total of 1,010 persons. The village populations resemble each other in structure, civil state, morbidity and survival rates. In population structure, Lunsar is evenly balanced between the sexes; there is a female predominance in the villages. Half the males aged 20-35 in Lunsar were married compared with 75% in the villages; 93% of females in Lunsar and all females in the villages in this group were married. Twice as many marriages were polygamous in the villages as in Lunsar. The villagers are mainly farmers whereas in Lunsar industrial work is the commonest male occupation. Lunsar is more crowded than the villages. The houses in Lunsar are bigger in size and number of rooms and better constructed than those in the villages. There is piped unpurified water in Lunsar but only contaminated streams or ponds in the villages. For morbidity rates in the 2 situations direct standardization was used in view of the differences in population structure. There is less malaria, onchocerciasis and nutritional deficiency in the town but there is a higher DMF [decayed, missing filled] rate. The crude birth rate and general fertility rates are higher for Lunsar, but on standardization, Lunsar has fewer expected births /female than the villages. The mean family size for Lunsar is 4.7 compared with 5.6 in the villages. The infant mortality and stillbirth rates for the town are lower than for the country, and the infant/toddler deaths ratio is more favorable in Lunsar. The town is well served by medical and public health services. For Africans of the same tribal groups, the effect of urbanization is favorable for the viability of the population, for the physical environment and in the morbidity experience for the conditions studied.

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