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02nd November 2024 (9 Topics)

India’s cities, their Non-Communicable Disease Burden

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Context

A recent tragic incident where a BMTC bus driver died due to cardiac arrest while on duty has brought attention to the rising poor health outcomes in urban India, especially among marginalised and informal workers. This incident highlights the urgency of addressing the health challenges faced by those working in hazardous environments, often with limited access to healthcare and social protections.

Health Challenges in Urban India

  • Triple Health Burden of Marginalised Communities: Marginalised urban communities face a triple health burden due to hazardous work conditions, limited healthcare access, and financial instability during health crises. These factors are compounded by social and economic marginalisation, leading to poor health outcomes for informal workers, migrants, and people living in slums.
  • Rising Non-Communicable Diseases (NCDs): Data from the National Family Health Survey (NFHS) show a worrying rise in NCDs like hypertension, diabetes, and obesity in India, even as tobacco and alcohol consumption have declined. The silent nature of NCDs necessitates regular screening and early detection, but the lack of preventive care and health education creates significant financial burdens for vulnerable populations.
  • Inadequate Access to Public Health Systems: Public healthcare, which should cater to the lowest socio-economic strata, is often inaccessible to urban marginalised populations. Poor availability and access to primary health care in urban areas, especially for informal workers and migrants, prevent the effective implementation of universal health coverage and exacerbate the health crisis in these communities.

Importance of Early Detection and Screening

  • Screening and Early Detection: Regular screening for NCDs can help in early detection and reduce out-of-pocket expenditures by identifying risks at an individual and community level. This, in turn, supports evidence-based public health planning and informs strategies for health education and promotion, particularly in underserved urban areas.
  • Community-Based Health Promotion: Community engagement is crucial for sustainable health interventions. By co-creating health promotion activities, communities can reduce the burden on public health systems while simultaneously increasing awareness about healthcare pathways, social protection schemes, and preventive measures for NCDs.
  • Leveraging Technology for Monitoring: In the era of digital technology, real-time health monitoring could help track vital parameters like blood pressure and blood sugar levels, providing accessible health data for vulnerable groups. This could aid in epidemiological modelling and inform public health responses to prevent the spread of NCDs in urban areas.

Pathway for Action

  • State-Level Action Plans for NCD Care: India needs comprehensive state-level action plans for NCD care, with a focus on improving access to primary healthcare for marginalised urban communities such as migrants, informal workers, and people in informal settlements. Collaboration between urban local bodies, health departments, and community-based organisations will be key to addressing these gaps.
  • Scaling Up Community-Led NCD Surveillance: Establishing community-based NCD surveillance systems in marginalised urban areas will ensure that health risks are monitored and addressed at the grassroots level. This can create healthier cities by fostering a collective approach to health promotion, surveillance, and education.
  • Multi-Stakeholder Collaboration for Healthy Cities: Creating healthy cities requires collaboration between city administrations, health experts, think tanks, and community organisations. Through co-created solutions, urban health systems can be improved, ensuring better access to healthcare and reducing health inequities in growing urban populations.
Practice Question:

Q. Assess the health challenges faced by marginalised urban communities in India, particularly concerning non-communicable diseases. How can early detection, technology, and community-based approaches contribute to improving health outcomes in urban areas?

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