Beyond land tenure and titling: legal recognition as a pivotal determinant of health in urban informal settlements.

Over 1 billion people across low-income and middle-income countries live in urban informal settlements, where these residents face severe health disparities. In this Viewpoint, we argue that the absence of legal recognition in informal settlements is a foundational cause of the causes of ill health, as the absence of recognition contributes to unsafe housing and inadequate access to water, sanitation, and other life-sustaining basic services. Despite the importance of legal recognition, few public health researchers have explored how legal barriers influence health outcomes in these communities. Based on the evidence identified through a systematic search, we argue that previous research focused on how tenure or titling can improve living conditions but overlooked other legal interventions that might better enhance health equity by expanding basic service access. We propose an innovative research agenda aimed at characterising the global landscape and underlying mechanisms of a wider spectrum of legal interventions-beyond tenure or titling alone-that could improve health in informal settlements.