What is the impact of urbanization on health and sanitation in India?

Globalization, urbanization and migration have had a major impact on the health of people across rural and urban areas though with differing implications. Health is defined by World Health Organization as, ‘a state of complete physical, mental and social well-being.’ Though genes and lifestyle choices have an important role to play in the health of an individual, the physical environment is also an important determinant of health. The phenomenon of urbanization affects environmental conditions and therefore can be directly linked to problems of health in urban areas.

Sanitation in urban areas is the responsibility of the population inhabitants but also primarily of the Municipal Corporations. Sanitation can also be linked to urbanization as access to clean and hygienic living conditions is one of the significant needs of any population. It’s inadequacy is a result of a disproportionate growth in the urban population compared to that in civic facilities.

Urbanization in India has resulted from the fast pace of industrialization. Hazardous industries and poor work conditions have exposed people to rising pollution, reducing their immunity levels and increased susceptibility to various harmful diseases. The various types of pollution found in cities are :

• Air pollution: Lack of clean air and increased air pollution are predominantly responsible for spread of air borne diseases. Cold, cough, breathing problems, pneumonia and bronchitis are becoming common. The sources of air pollution are increased levels of suspended particulate matter (SPM) in air, poisonous gases emanated by industries as well as vehicular emissions of carbon. There is reduced visibility caused by smoke and fog.
• Water pollution: Lack of access to safe drinking water and poor quality of available water is the chief cause of diarrhoea and other water borne diseases, affecting the life expectancy of slum dwellers as well as children under the age of five. Lack of in-built latrines and open defecation have led to contamination of pipe water and it’s consumption has increased instances of gastro-intestinal infections. New diseases, like leptospirosis, are spreading rapidly. Use of such contaminated water in households is hazardous to health. During the monsoons, faecal matter and wastes get washed into slum areas rendering living unhygienic.
• Solid wastes: Collection of solid wastes is the duty of the civic bodies in cities but refuge disposal is one of the major problems in urban areas. Accumulated untreated wastes become the breeding ground for pests and rodents which are carriers of diseases and lead to outbreaks of epidemics like tuberculosis, dengue fever, plague .etc. Wastes are not separated into wet and dry wastes, biomedical and electronic wastes are disposed off along with other garbage and dumping sites impinge on land space that could alternatively be used for provision of housing.
• Noise pollution: The huge population of cities also leads to many transport problems like traffic jams, accidents, etc. Vehicular congestion, constant honking , use of loudspeakers during public occasions, bursting of noisy firecrackers add to the decibel levels that are abnormal and can lead to partial and complete deafness. High decibels levels according to scientific research lead to high palpitations, uneasiness, anxiety and blood pressure whilst disturbing the peace of the surroundings.
• Adulteration: Food sanitation is a major concern in the cities. Most food items in shops are uncovered, stale and prepared in insanitary conditions with impure water, which increases the probability of food poisoning. It can cause dysentery, typhoid, jaundice etc. and hence is unsafe for consumption.Even milk and food grains are adulterated and are dangerous to the health of children and adults. Malnutrition is the cause of high mortality among people in urban areas through tuberculosis and other infectious diseases.

Psychological problems are on the rise in urban areas. The vagaries of transport, competition at work, inflationary prices, diminishing health and demands for provision of services has increased stress levels. People are growing indifferent to others. The sense of loneliness, depression and frustration at unmet goals has led to an increase in suicide rates in cities. Large numbers of urban dwellers are suffering from emotional breakdowns and disturbed behavioral patterns.

A new category of diseases is appearing in the form of lifestyle diseases like obesity. The fast pace of life means people are eating less of home cooked nutritious meals, consuming more of fatty preserved fast food and leading sedentary lifestyles without much exercise. Hence obesity and related diseases such as diabetes, heart attacks are consuming the urban population.

However there have also been some positive developments in urban health that can be attributed to globalization. Entry of private sector into health has lead to the establishment of many hi tech, modern, well equipped and upgraded health centres, which cater to the health needs of the urban people albeit at high costs. The public hospitals try under various schemes to make similar services affordable to the poor. More foreigners today are choosing India as a cheaper alternative for it’s cost effective operations and surgeries. Medical tourism is proliferating opening doors for talented Indian doctors and medical practitioners. Pathology laboratories and diagnostic centres have cropped in every nook and corner of the cities aiding earlier detection of diseases and faster treatment.

The government of India has undertaken several health programmes and expenditure plans to alleviate many diseases such as National Tuberculosis Control Programme, National Cancer Control Programme and so on. It has also passed several laws to protect the environment, consumers rights .etc. such as Consumer Protection Act’ 1986, Environment Act’ 1986, Bio – Medical Waste Management Act’1998. It has implemented vaccination and immunization programmes to completely eradicate certain diseases in children. There are several agencies that work towards raising the awareness among consumers about adulteration. For. ex Consumer Guidance Society of India actually makes milk sanitation testing kits available for consumers. In keeping with the Millenium development goals of the UN the state is working towards resolving urbanization issues.

Modern housing developers are working towards increasing sanitation in housing by modeling apartments with better ventilation, sun light and more open spaces. Lot of research is drawing the attention of people towards environmental concerns.

People are getting more health and fitness conscious and trying to reconcile themselves with the burdens of urban life.