The Struggle to Create Just and Sustainable Cities

As the world becomes increasingly urban, Tufts faculty examine inequities that drive chronic poverty, poor health, and discrimination

People standing in Mumbai slum. As the world becomes increasingly urban, Tufts faculty look at inequities that drive chronic poverty, poor health, and discrimination

More than half the world’s population now live in cities, and continued global urbanization is amplifying complex challenges at the intersection of justice and sustainable development, said Julian Agyeman, a professor in the Department of Urban and Environmental Policy and Planning, as he framed a recent Global Tufts Month panel conversation.

The March 19 online panel discussion “Who Gets to Live in a Just and Sustainable Society?” brought together researchers from across the university to highlight how Tufts faculty are advancing equity issues around the world through research prism of justice and sustainability, from Mumbai, India to cities across America. (View a recording of the talk here.)

Agyeman noted that cities with differences can give rise to myriad conflicts, including those related to the environment, health, and housing. But, he said,  “we have to do better. We also have to recognize that as professionals, and especially urban planners, we’re all about dreaming about what the city can become, whether it can become sustainable, resilient, whether it can become more of a sharing city, a smart city.”

To close that gap begins with recognizing a central question, he said: who gets to belong in our increasingly expensive cities? Agyeman pointed out that cities are increasingly becoming gentrified, the result of which is that poorer residents, immigrants, the homeless, and others are being pushed out.

Agyeman, the originator of the concept of “just sustainabilities”—a perspective that illuminates how food, space, place, and culture collectively inform the world humans inhabit, said that the stakes have never been higher for framing environmental issues through a social justice lens.

Environmental degradation and human rights abuses and social injustices are inextricably linked, he said, citing regions as disparate as the Amazon, the Congo, the Delta in Nigeria.

“We must commit to improving people’s quality of life and wellbeing,” Agyeman said. “We must commit to meeting the needs of both present and future generations. We must commit to deepening and increasing justice and equity in terms of recognition.”

Tufts faculty are clearly stepping up to that challenge, as the panel spotlighted how they are rigorously exploring complex issues that create inequities and gaps in access to basic needs, including food and water. Their work, most importantly, also presses for fundamental changes to policies that will create more just and sustainable cities.

Unequal in Mumbai

One need only look at some of the world’s largest slums for evidence of how social injustice concentrates and entrenches human suffering. For that insight, Ramnath Subbaraman, associate director of the Tufts Center for Global Public Health, shared his findings that linked poor health with unjust and unsustainable legal exclusion in Mumbai.

Subbaraman, an assistant professor of public health and community medicine at Tufts University School of Medicine, noted that in 2000 the world “crossed a significant threshold” with more than 50 percent of the global population now living in cities. “Humanity has now become a predominantly urban species,” he said.

It’s a trend that also raises sharp challenges for those seeking just and sustainable societies, he said. “Nearly 1 billion people, or around one-seventh of the world’s population, now live in urban informal settlements or slums,” he said.

In Mumbai, India, about 55 percent of the city’s around 20 million people live in slums, and more than half of them live in what are called “non-notified” slums, not recognized by local governments as legitimate settlements. That means they have no access to basic services such as safe water, adequate sanitation, or waste disposal.

Among the projects Subbaraman and colleagues have undertaken is a close look at the health of those living in Kaula Bandar, a non-notified settlement where some 14,000 people are wedged onto a wharf jutting into the sea.

Researchers drawn from the community fanned out to collect health data using a questionnaire developed by Subbaraman’s team. Residents then came to a tent where the team collected basic information on biometric indicators, including height, weight, and head circumference for infants and blood pressure for adults. The team collected data on more than 1,700 households, or about 6,000 people, including more than 800 children. They then compared that data to that of a “legal” slum.

The comparison revealed dramatic differences, with the non-notified slum underperforming on almost every health indicator. The mortality rate of infants was more than twice the rate of other slums in Mumbai. The prevalence of illiteracy was more than three times as high for men and twice as high for women.

In a study in another area that has both notified and non-notified slums, researchers found substantial differences in water access. Non-notified households paid nearly twice as much for water, and about half of those households obtained water less than three times per week.

Clearly, Subbaraman said, “disparities in health outcomes between notified and non-notified slums in India map directly onto disparities and access to basic services. Legal exclusion of some settlements can therefore be thought of as the central the causes of ill health in these communities.” At the same time, they offer a starting point for policy changes to reduce the suffering of marginalized communities, he added.

Contaminated Food

Building stronger links between agriculture, food safety, and nutrition related to child growth were highlighted through research done by Johanna Andrews-Trevino, NG18, a postdoctoral research fellow at the Friedman School of Nutrition Science and Policy, and Shibani Ghosh, a Friedman School research associate professor and associate director of its Feed the Future Innovation Lab for Nutrition

They conducted field research in Nepal’s Banke District, within the western province of Lumbini, where stunted growth has been linked to food contaminated by aflatoxin, a carcinogen produced by molds found in vegetation, hay, and grains. Aflatoxin-prone foods are generally cereal staples, legumes, corn, and ground nuts.

A village in rural Nepal. The shared goal is simple: to ensure a “clean, safe, and nutritious food supply for everybody, not just for certain groups of people,” said Shibani Ghosh.A village in rural Nepal. The shared goal is simple: to ensure a “clean, safe, and nutritious food supply for everybody, not just for certain groups of people,” said Shibani Ghosh.
Among their findings was evidence that these toxins find their way into new mothers’ breast milk. More than 90 percent of breast milk samples had detectable levels of aflatoxin—thought to be related to consumption of yogurt and milk coming from livestock that consumed the toxin in contaminated feed.

Longitudinal data also revealed a strong, consistent relationship with young children not growing as expected with every increased unit of aflatoxin found in their blood samples. Toxin exposure could be traced across all 17 communities studied, urban and rural. That ubiquitous presence, the researchers noted, has important implications for new agricultural interventions that improve public health.

The researchers aim to engage with provincial and district officials, as well as national policymakers, to advance an aflatoxin mitigation strategy.

There is a department of food standards in Nepal that has “a very clear understanding that there is aflatoxin in the food system,” said Ghosh. This new research will be a useful in helping advance that understanding and target post-harvest market policies, including improving food storage, she added.

The shared goal is simple: to ensure a “clean, safe, and nutritious food supply for everybody, not just for certain groups of people,” she said. “We really need to work on a multi-sectoral level.” 

Supporting Refugees

What factors enable cities and towns to resist exclusionary policies and instead welcome and integrate refugees? That is the driving question behind research led by Karen Jacobsen, Henry J. Leir Professor in Global Migration at The Fletcher School and director of the Refugees in Towns project at the Feinstein International Center.

Over the past four years she has led a project on refugee immigration that started in the United States and then expanded globally.

“We see integration as not just the refugees fitting in with a city, but also [as] relational—it’s a mutual understanding and mutual relationship in which both refugees and the people who live in cities must work together to integrate refugees,” Jacobsen said.

Refugees and migrants face discrimination, limited access to public services, and lack of work, as well as trauma and depression. Social networks, she said, are “super important” to support mental health and are also critical for for the success of entrepreneurial migrants who go on to establish new schools, restaurants, and businesses.

“Certainly in the developing world, where most of the world’s refugees live in these cities, the role of migrant entrepreneurship—to support their own people—is really important, and enables them to become more integrated,” she said.

Other influential factors that build connections include the arts, sports, and food provision, all of which increase integration and cross communication and support livelihoods, she said.

One of the biggest problems that refugees experience when they arrive at a new place, she said, is the trauma they have experienced both in their home country and during their journey, “which is extremely dangerous, and which many don’t survive or survived by having observed horrific scenarios,” she said.

The researchers study what helps those refugees’ mental wellness, she said. “We notice, especially for young people, how important sports can be, not only for the obvious things like exercise and fresh air, but also because sport provides dignity and pleasure.”

Transportation Inequities

Another central question to achieving a just and sustainable community pivots on access: does transportation provide adequate access to basic needs? Shan Jiang, the Eileen Fox Aptman, J90, and Lowell Aptman Assistant Professor in Urban and Environmental Policy and Planning, dug deep into the profound impact of access in a recent study examining what she calls “just accessibility” and the impact of COVID- 19 in major metropolitan areas in the U.S.

Equal access to essential services such as food, job opportunities, and health care is considered a valuable metric of a just and sustainability community. Jiang, an expert in urban mobility, wanted to understand how COVID-19 might have further impacted access. Did social distancing, business closures, and public transport services—delayed or reduced due to cost-cutting measures—contribute to racial disparities in access?

Her research created maps of 25 U.S. metropolitan areas. She found that while the access gap between Black and white populations existed pre-pandemic, during the pandemic that gap became significantly larger. Accessibility decreased sharply for Black poor communities when compared to white ones, and her findings showed greater accessibility in suburbs where whites account for a greater share of the population.

Such extensive data-driven evidence brings to the forefront underlying patterns of racial disparity and inequality, said Jiang, who sees her work as a “call to action to close the gap in just accessibility.”

“Planners need to think about how to provide more equitable transportation services to the communities that are in need,” she said.

Laura Ferguson can be reached at

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