Half Lives

A disease that mainly affected the rich has now afflicted the poor in India. This is the disturbing finding of a major study conducted by the Indian Council of Medical Research (ICMR). Until some years ago, Diabetes Mellitus was considered to be a lifestyle disease that mainly afflicted the socio-economically better off sections of society. The “epidemic” sweeping large swathes of Asia was assumed to target consumers of high-fat and sugary foods, the overweight and the sedentary. However, recent studies have found that the urban poor both in the developed and the developing world are increasingly becoming diabetic. Termed the diabetes capital of the world, India too is going the same way. The largest national study conducted by the ICMR and the Ministry of Health and Family Welfare has found that in the urban areas of the more economically advanced states, diabetes is higher among people from lower socio-economic status than those from the upper strata. However, in all the states, in the rural areas the disease was seen among those of a higher socio-economic status. The findings imply that overall the disease is spreading to sections that were hitherto considered unaffected or less affected—poorer urban dwellers and better off rural dwellers.

This is a cause for not just concern but even alarm. Diabetes is a “high maintenance” disease that leads to severe damage to the heart, kidneys and eyes apart from risk of gangrene if mismanaged. Given the state of the public health system in the country, and the fact that the poor have to pay for healthcare, the findings must be treated as a distress signal on an urgent basis. According to the ICMR study, while the overall prevalence of diabetes in all 15 states was 7.3%, it varied from 4.3% in Bihar to 10.0% in Punjab. With a sample size of nearly 60,000, the study noted that since 70% of the population lives in rural areas, even a small increase in percentage adds up to a large number of people who need sustained medical attention but have access to poor health services.