Socioeconomic Inequalities and Environmental Health in Urbanizing Pakistan

Pakistan, the fifth most populous country, is experiencing rapid urbanization, with cities growing due to rural-to-urban migration, industrial expansion, and economic opportunities. While urbanization fosters economic growth, it also intensifies socioeconomic inequalities, disproportionately exposing low-income communities to severe environmental health risks. The lack of equitable access to clean air, safe drinking water, and proper sanitation has led to serious public health concerns, particularly for marginalized populations in urban slums and industrial zones. Air pollution, unsafe housing, contaminated water, and climate change-driven extreme weather events contribute to worsening health outcomes, disproportionately affecting laborers, women, and children in low-income households. Without targeted policies and interventions, the urban poor will continue to bear the burden of environmental hazards, leading to an expanding health disparity between socioeconomic classes.

One of the most pressing environmental health challenges in Pakistan’s cities is air pollution, which ranks among the worst in the world. The rapid increase in vehicular traffic, industrial emissions, and unregulated construction activities has led to dangerously high levels of fine particulate matter (PM2.5), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO). This has caused a surge in respiratory diseases, cardiovascular illnesses, and premature mortality, particularly among low-income workers, street vendors, and those living near congested roadways and industrial zones.

Beyond air pollution, poor sanitation and water contamination remain major public health threats, particularly in urban slums and informal settlements, where access to clean drinking water and proper sewage systems is severely limited. Over 70% of urban wastewater in Pakistan remains untreated, leading to the contamination of groundwater sources and increasing the prevalence of waterborne diseases such as cholera, typhoid, and hepatitis A. Additionally, improper waste disposal and open dumping of garbage in densely populated areas contribute to vector-borne diseases like dengue and malaria. These conditions disproportionately impact the urban poor, who have limited healthcare access and often live in overcrowded, unsanitary environments, making them more vulnerable to outbreaks of infectious diseases.

Another critical aspect of environmental health inequity in Pakistan is climate change, which has disproportionate impacts on marginalized communities. As one of the top 10 most climate-vulnerable countries, Pakistan faces extreme heatwaves, urban flooding, and water scarcity, which primarily affect those living in poorly constructed homes, flood-prone slums, and heat-trapping urban centers. Heat stress, dehydration, and cardiovascular issues are becoming more common in low-income urban areas, where residents lack access to cooling infrastructure, green spaces, or reliable electricity for fans and air conditioning. Additionally, climate-induced migration from rural areas further strains urban resources, leading to overcrowded housing, food insecurity, and increased environmental degradation in cities.

To address these growing environmental health disparities, Pakistan must implement urgent and inclusive policies that focus on air quality improvement, clean energy adoption, water and sanitation access, climate resilience, and occupational health protections. Strengthening pollution monitoring systems, enforcing industrial emission limits, and promoting low-emission public transportation can significantly reduce urban air pollution levels. Expanding access to cleaner energy sources such as solar power, LPG, and biogas can help mitigate indoor air pollution and reduce gender-based health disparities. Additionally, investing in wastewater treatment facilities, ensuring safe drinking water, and improving urban drainage systems is essential to prevent the spread of waterborne diseases in vulnerable communities.

Furthermore, climate-resilient urban planning should focus on flood-resistant housing, green infrastructure development, and heat mitigation strategies to protect at-risk populations from extreme weather events. Providing occupational health protections for workers in high-risk industries, such as those in petrol stations, factories, and construction sites, is crucial to ensuring long-term environmental health equity. Finally, community engagement, research-driven policymaking, and international collaborations can help bridge the gap between science and policy, ensuring that scientific findings translate into tangible health and environmental protections for Pakistan’s most vulnerable populations.

Without urgent policy interventions and systemic reforms, low-income communities will continue to suffer the most from environmental hazards, further deepening socioeconomic disparities. By adopting data-driven policies, investing in sustainable urban infrastructure, and prioritizing health-focused environmental regulations, Pakistan can work toward a more equitable and resilient future for all.

By: Rafia Muhammad Din

The author is Research Associate in Eco-Health Research Group led by Prof. Audil Rashid at University of Gujrat. She can be contacted at: rafi.rani66@gmail.com