Increasing urbanisation, inequality and in-migration resulting from SEZ establishment can have impacts on health and safety and associated services provision.

Local healthcare facilities may come under pressure from a growing population in the area, spurred by a rapid influx of migrants moving to the SEZ area for work. This is especially the case if the zone is in a remote, rural or peri-urban area and cannot draw on a well-established urban healthcare infrastructure. Living conditions in migrant accommodation and informal settlements can be unsanitary, leading to disease spread, while the large numbers of young migrants may lead to new sexual freedoms with the potential for unwanted pregnancies and sexually transmitted diseases. All this may pose a challenge to under-resourced local health facilities.

Dietary changes may also create health problems, since the reduction in agricultural land typically associated with SEZ creation can result in new nutritional deficits, due to declining local availability of grains and fresh fruit and vegetables (also see section on Food security).

Other changes in livelihoods may also raise health-related concerns, particularly for already marginalised groups. Examples include the shift from farming to unregulated, informal waste collection work around zones, which carries a high risk of skin disease through contact with harmful chemicals; and the decline of the farm and fish produce trade in informal markets, which can leave local women out of work and subject to increased domestic violence by male family members.

The safety of areas surrounding SEZs may also be compromised in the urbanisation process, with increases in tensions, crime and violence. Locals who have difficulties earning a living in the changed circumstances and migrant workers on low pay may engage in theft and/or extortion. Ethnic differences and inter-tribal competition also tend to be exacerbated by increasing inequalities, differentiated hiring practices and rapid shifts in internal and cross-border in-migration. Where countries are emerging from protracted ethnic conflicts, enhanced ethnic tensions may be a particular risk.