TOPIC: General Studies 2
- Government policies and interventions for development in various sectors and issues arising out of their design and implementation
- Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions
A new report, India- state level disease burden, released by Vice- President, showed that lifestyle diseases such as heart and chronic respiratory problems, cancer and other non-communicable diseases have toppled communicable ones, including TB and other communicable diseases as leading causes of death in India. There is a correspondent increase in non-communicable diseases where it was 40% of the total disease burden in 1990 which has now increased to 55% in 2016. This report brings forward the state-level disease burden and risk factors estimates to improve health and planning for every state in India, thereby demanding a need to refocus India’s health policy.
- India is undergoing a major epidemiological transition in consonance with social and economic development. Contribution of communicable diseases to deaths in India reduced from 53.6% to 27.5%, while that of NCDs rose from 37.9% to 61.8%.
- Three of the five leading killers in India in 2016 were NCDs — ischaemic heart disease, chronic obstructive pulmonary disease and stroke.
- The worse part is that the health crisis is characterized by widening disparity between India’s relatively more prosperous and poorer states and can potentially impair its demographic dividend. The report positions the fact that the more affluent states are in fact facing the biggest burden of non-communicable disease whereas the communicable diseases are still there in EAG- Empowered Action Group states, erstwhile BIMARU states like UP, Bihar, Jharkhand.
- Under-five mortality rate has decreased significantly in all states. But, in the states that recorded the highest number of such mortalities, such as Assam and Uttar Pradesh, it was four times that of the states with the lowest incidence, such as Kerala.
- The fastest-growing causes of ill health over the past 26 years were diabetes (increased by 174%) and ischaemic heart disease (up 104%).
The transition :-
Since 1990 to 2016, the Indian healthcare sector has improved considerably and that’s why there is a sudden turnaround of lifestyle diseases causing more deaths rather than communicable disease. The causes of heart diseases are known but no steps are taken to change it. The single leading individual cause of death in India in 2016 was coronary artery disease. This is due to change in lifestyle, food habits, sedentary habits developed, and the hassled mental makeup- achieve everything in short time, whether material or physical wealth. However, now even the lower section people are also being affected by lifestyle diseases. What is more alarming is that the age for heart attacks has preponed.
But it doesn’t mean that as lifestyle diseases are increasing, the communicable diseases are decreasing. Malnutrition is still the single largest risk factor responsible for 15% of total diseases burden in India. Malnutrition includes over and under-nutrition. In rural areas, despite government run anganwadi centres providing free nutrition, not much impact is seen in health status of women and children.
Neglected health sector :-
1.2% of GDP is spent on health sector. Consecutive governments have failed to spend more on health sector. The problem is that it is not a live political issue. Health is thought of as medical care with more hospitals and more professionals. Preventive health is not considered as important. This is where government and policy makers have to come in and make it impossible for public to access junk food, high salted food, and sugar food. Also, this sedentary lifestyle has come in last 20-30 years because of tv, computer which has not encouraged outdoor activities.
The policy makers have to use this data to translate it into things that will affect families and growing children. The government has to give children spaces where they are able to enjoy sports and recreational activities. There should be IEC activities implemented.
How to bring about a turnaround in lifestyle?
There needs to be focus on :-
- Food habits
- Exercise habits
- Mental composition
- Setting biological clock to right time. It is important as late to bed and late to rise gives high cholesterol, high BP, high sugar. These are the driving factors for early cardiovascular diseases.
Lifestyle diseases are no longer a rich man’s disease. Access to low quality fast food, affordable sugar food has aggravated the growth of diseases. Hence, an environment for healthy lifestyle has to be created and there should be policies which are keeping control over them. It is necessary to create awareness among the people. The easiest way to create it is to meet children in school. The government, industrialists, local bodies and civil societies have to keep an eye on food that is being consumed by common man. Good food is also an important part- things that carry lot of transfat, salt pesticides are adulteration. The advertisements have to be monitored. There should be ban by government, civil society and people themselves too. The media should also be involved and made responsible partner to spread health.
90% of items in home are adulterated. The food adulteration authorities are not touching the fringes. If few people are arrested every month and there is a logical conclusion to every of the case, there will be an awakening. There has to be deterrent punishment as adulterated food can get the public highly ill.
The report states that India has made substantial gains in health since 1990, with the overall health loss from all diseases and conditions about one-third less per person in 2016. But, progress has been mixed. India needs to be awakened and the communities should be sensitised about the need for change. As good health and well-being feature in the list of Sustainable Development Goals, it is even more crucial for India—one of the signatories of SDGs—to meet the goals.