The urban populations of the developing world are increasing at an unprecedented rate. In South Africa the black population has an urbanisation rate of 3.5%; this, coupled to a population growth rate of almost 3%, will lead to an increase in the urban black population from 6.5 million in 1985 to over 20 million by the year 2000. Such an urbanisation rate has major implications for a variety of support services, not the least of which is health care. This paper reviews current knowledge of the health status and growth of South African black children. Health status is examined through the broad measures of infant mortality rates, nutritional status, notifiable diseases, environmental factors and psychological measures of wellbeing. Physical growth is examined through a comparison of the latest studies describing the growth patterns of urban and rural children. Urban children of good socioeconomic status have growth patterns that are similar to those of the NCHS norms and significantly better than those of average urban children. Rural children from studies of farm labourers and subsistence farmers display significant differences in mean weights and body fat, but not height, and have superior growth to average urban children. The rationale, methods and pilot studies used in a new birth cohort study of children born in Johannesburg and Soweto are reviewed to highlight the methodological problems of urbanisation studies in developing countries.

Introduction

The urban environment of the Third World is increasing in size at an unprecedented rate.