Environmental problems in urban areas of developing countries are increasingly manifest despite efforts to address the situation. Environmental problems are worse in areas inhabited by the urban poor where individual ingenuity has shown that the problems of no paved roads, water supply, drainage and solid waste management can not be addressed. Subsequently the environmental quality in informal settlements has deteriorated greatly leading to health problems. The management of the urban environment has been approached through environmental management tools such as EIA’s but still devoid of strategic environmental management efforts. The consequence is increasing environmental deterioration affecting a sizeable proportion of the population. The paper examines the environmental management strategies from household, community and city-wide scales and how such strategies impact on health of the urban population. Based on research in informal settlements within Kampala, the paper relates the environmental burdens of flooding, garbage heaps, poor housing due to flooding, reduced economic productivity of households and loss of community amenities to the health of the population. The paper also highlights interventions for the poor environment and health by proposing alternative action plans for addressing the environmental burdens.