ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Urbanicity and Health

Prevalence of NCDs by Size-Class of Urban Settlements

Urban health outcomes are characterised by an epidemiologically diverse disease burden and an unequal distribution of the same, which mirrors these contrasts. This paper does a preliminary investigation of disease profiles across size-class of urban settlements in India, with a special focus on non-communicable diseases, using data from the 75th round of the National Sample Survey. This is the first such attempt using nationally representative data. This work has the potential to inform health as well as integrated urban development policies in the country. The work also holds lessons for the expansionary private health sector, which often underserves the smaller urban settlements.

The author would like to thank Shamindra Nath Roy and Krishna Ram for useful discussions on methodological issues. The assistance of Dev Mani Upadhyay on data issues is also acknowledged. The paper also benefited from comments shared by an anonymous referee of the journal.

Non-communicable diseases (NCDs), often considered diseases of anthropogenic origin, have globally emerged as the dominant health threat replacing communicable diseases, a phenomenon popularly known as epidemiological transition (Omran 1971, 1983; Caldwell 1993). Globally, the most prominent NCDs are cardiovascular diseases (CVD), diabetes, chronic respiratory conditions and cancer (WHO Factsheet on NCD 2021).

In India, 65 % of all deaths in 2019 were attributed to NCDs (IHME 2019). The share of NCDs in the total disease burden, measured by DALYs1 increased from 31% in 1990 to 55% in 2016 with a corresponding reduction in the share of communicable and other diseases. Prominent NCDs like ischemic heart disease, chronic obstructive pulmonary diseases (COPD), stroke, diabetes, and cirrhosis have all registered positive growth between 2009 and 2019 in India. The most alarming situation is with respect to diabetes, wherein the contribution to total deaths in the country has risen by 54%. Communicable diseases, on the other hand, show a negative growth during the same period. In accordance with the disease burden, metabolic risks behind NCDs, like high blood pressure, high fasting plasma glucose, high body mass index (BMI) and behavioural risks like alcohol and tobacco, have registered significant positive growth rates between 2009 and 2019. Of particular significance are BMI and fasting plasma glucose, which have registered substantial growth within a decade, making them the largest contributors to the epidemiological transition in India (ICMR et al 2017).

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Updated On : 28th Dec, 2023
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