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India’s cities, their Non-Communicable disease Burden
Context:
India’s urban growth, driven by rural migration, strains low-income workers like gig workers and sanitation staff. They face health risks from poor working conditions, limited healthcare, and job insecurity, compounded by the rising burden of non-communicable diseases (NCDs).
Rising Health Issues in Urban Areas:
- Urban areas in India are witnessing a growing health crisis, particularly among the poor and marginalised workers. These workers are often exposed to harsh working conditions, with long hours, low wages, and little to no access to healthcare.
- Backbone of the City: Urban workers form the backbone of city operations. Without their efforts, cities would struggle to function.
- From sanitation workers who clean the streets to bus drivers who ensure public transport, these workers perform essential tasks that keep urban life moving.
- The “Triple Health Burden” is a term used to describe the overlapping health challenges in urban India: hazardous working environments, limited healthcare access, and financial vulnerability during health crises.
Reasons for Rising Health Issues in India:
Several factors contribute to the rising health issues in India, particularly among urban workers:
- Harsh Working Conditions: Many workers, including sanitation workers and drivers, face poor working environments that expose them to physical and mental stress.
- Lack of Healthcare Access: A significant number of these workers are informal workers without job contracts. This means they do not have access to healthcare benefits, including health insurance.
- Rising Non-Communicable Diseases (NCDs): NCDs, such as diabetes, hypertension, and obesity, are becoming more prevalent in urban India.
- According to a study by the Indian Council of Medical Research (ICMR), India saw a significant rise in diabetes and other NCDs between 2019 and 2021. This trend is driven by unhealthy lifestyles, stress, poor diet, and lack of exercise.
- Poor Urban Planning and Overburdened Health Systems: Rapid urbanisation has outpaced the growth of healthcare infrastructure. Public health systems are fragmented, leading to inadequate care for urban populations, especially the marginalised.
Impact of This Health Burden:
The rising health burden in India has serious implications:
- Increased Out-of-Pocket Expenses: Poor healthcare access and lack of insurance force many workers to pay for medical treatment out of their pockets. This leads to financial instability and deepens socio-economic inequality.
- Reduced Productivity: Poor health among workers affects their productivity and work efficiency. Workers who are unwell or suffering from chronic conditions are less likely to perform at their best, which in turn affects the economy of urban areas.
- Strain on Healthcare Systems: The increasing number of individuals with NCDs places a huge strain on India’s already overburdened healthcare systems.
Actions to Be Taken:
To address these rising health issues, several actions need to be taken:
- Improving Working Conditions: Employers, especially in the informal sector, must improve working conditions, ensure proper hygiene, and provide adequate nutrition to workers.
- Access to Healthcare: The government must ensure that all workers, including informal and migrant workers, have access to healthcare services.
- Health Education and Awareness: There is a need for widespread health education programs focusing on preventive care, screening for NCDs, and promoting healthier lifestyles.
- State-Specific NCD Policies: The government must develop state-specific policies that address the unique challenges faced by urban populations.
What is the Indian Government and State Government NCD Policy?
- India’s national policy for NCDs focuses on prevention, early diagnosis, and treatment. The government has launched several initiatives to tackle NCDs, including the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS). This program aims to increase awareness, conduct screenings, and improve the treatment infrastructure for NCDs.
- At the state level, several states have implemented their own programs to combat NCDs. However, there is a significant gap in their implementation, especially in urban areas with large informal workforces. State governments need to prioritise health infrastructure, create action plans to address the rising NCD burden, and integrate health services with urban planning.
Way Forward:
The way forward lies in creating a more inclusive, health-focused urban environment. This requires coordinated efforts from local bodies, city administrations, health departments, and community organisations. Key actions include:
- Scaling Up Primary Healthcare: Urban primary healthcare systems must be strengthened to serve the most vulnerable populations.
- Leveraging Technology: Digital health technology can be used to track health data, provide virtual consultations, and offer remote monitoring for chronic conditions like diabetes and hypertension.
- Community-Led Health Promotion: Encouraging community-led initiatives can help raise awareness and reduce health disparities.
- Policy Reforms and Implementation: There needs to be a stronger focus on enforcing policies that protect the health of workers and provide them with the necessary benefits, including healthcare and job security. The government must also work on reducing the burden of NCDs through national and state-level interventions.
