Urbanising India and health issues
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Transcript of Urbanising India and health issues
Why new or emerging cities need
to be different in India?
Amit Samarth
UNHABITAT, State of the World Cities, 2008-09
Our collective purpose as a society
• To be economically progressive• To be socially cohesive• To promote health and well-being• To enable individuals to achieve
their intellectual and physical potential
• To ensure that citizens today and tomorrow will be able to enjoy the basic amenities of life in a sustainable and eco-friendly way
Ecological model of Human Health
Human health should be seen in a physical, social, behavioural, and ecological context.
Health promotion activities should involve other sectors making a contribution to health, such as education, food, nutrition, and environment.
Source: Barton and Grant, 2006
What have our cities achieved?
• Drivers of economic growth• Hubs of world class education,
commerce and specialized health care services
• 400 million are already living in Urban India
• 590 million will be living in urban India by 2030
• 68 million plus cities by 2030• 13 cities with more than 4 million
people• 6 Megacities with more than 10
million peopleSource: India’s Urban Awakening. Building Inclusive cities , Sustaining Economic Growth
Cities in India are of great contrast
• 80 million or more urban poor live in cities of India
• Informal sector one of the key drivers of cities economic growth
• Maharashtra, Andhra Pradesh, Uttar Pradesh and West Bengal have highest slum population
• Mumbai, Delhi and Kolkata have highest slum population
• Growing inequalities and growing exclusion
• Poor living conditions• Poor health outcomes
Source: India Urban Poverty Report 2009
Poor health indicators of the urban poor
• High infant and maternal mortality• High water-borne diseases• High vector borne disease like
malaria and dengue• Higher incidence of chronic diseases
like hypertension, diabetes and coronary heart disease
• Poor occupational health• Higher mental illnesses• Road traffic injuries
Urban areas in India have better specialized healthcare services but facilities for promotive and primary care are non-existant
In Andhra Pradesh, there are 7500 slum localities but there are only 250 Urban Healthcare Centres
Source: Living conditions in 8 cities of India. NFHS-III Survey 2005-06
Urban environment affects each one of us
• Only 2 per cent cities have low air pollution on the basis of PM10
• In 80 per cent of cities at least one criteria pollutant exceeded the annual average ambient air quality standards
• Exponential growth in private vehicles in last few years -17 million vehicles in last 7 yrs
• Personal vehicles – cars and two-wheelers -- use up more than 75 per cent of the road space, but meet only 20 per cent of the city’s commuting demand
Source: State of Air Pollution in Indian Cities 2007, Centre for Science and Environment
Are we creating more space for cars rather than for our
own self?
Promoting and protecting health has become a challenge
• Lack of good footpaths• Absence of dedicated
cycling tracks• Lack of green spaces• Lack of sports facilities• Lack of social space• Changing food systems
and nutritional transition
• Food inflation
Threats to cities due to climate change
• Urban flooding due to heavy rainfall
• Flooding provides opportunities for breeding of disease carrying insects such as mosquito
• Lack of adequate water can compromise hygiene and thus increasing rates of diarrhoeal disease
• Decreased crop yields can stress food supplies
What we need to do in
emerging cities of India?
To promote and protect
health….!
Healthy Urban
Population
Good urban governance & healthy urban
planning
Improve health and
social equity
Improve living and working
condition
Improve availability
and access to healthcare
services
Embedding health in all
policies
Make Healthy Choice – The Easy Choice
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Health and Social equity leading to
Healthy Urban Population
Good water quality
Housing
Waste management
Cheap and nutritious
Access to food
Roads
Green Spaces
Cheap transport
Cheap
Clean
Information & Education
Social & Cultural activities
Sanitation
Good air quality
NutritionInfrastructure
Energy
Community Basic services
Lightings
Education and employment
Healthcareservices
Government services
Healthy Environment
Reduce carbon emissions and air pollutants Increased physical activity Improved social capital
Provide better public transport
Facilitate more walking and cycling
Improve Transportation
Reduced levels of cardiovascular diseases Reduce obesity Reduced respiratory diseases Improved mental health and decreased depression
Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits
Improved air quality Increased physical activity Decreased heat island effects
Provide convenient and well lit stairs Natural ventilationIncrease facilities such as parks, and opportunities for physical exercise
Better buildings and land use
Reduced levels of cardiovascular diseases Reduced respiratory diseases Improved mental health and productivity Reduced susceptibility to heat related illnesses
Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits
Improved and better balanced nutrition Reduce carbon emissions
Sustainable agriculture Promote locally grown food Provide healthy food options and information Reduce demand for meat consumption
Improve nutrition
Reduced obesityReduced levels of cardiovascular diseases and diabetes
Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits