Urban living taking toll on health?

A Right to Information query revealed a startling fact that 80 Mumbaikars died every day due to heart attacks between March 2014 and March 2015. What is even more shocking is the fact that this is up from 67 deaths daily during the same period the previous year.

Turn the clock back by 15 years; death rate due to heart attacks was only 22 deaths per day. Could it only be the stress of urban living that is taking a heavy toll on the heart?
According to Dr Ajay Chaug-hule, a heart surgeon at the Global Hospital in Parel, easy availability of high-fat food items and sugary drinks makes urbanites more prone to lifestyle diseases. ‘Coronary artery disease is a lifestyle disease worsened by urbanisation’, he says. However, coronary heart disease cases in the country have more than doubled to 61 million from a rather manageable 27 million cases in 2000. The trend is ominous.

It has been reported that doubling of incomes between 1997 and 2005 contributed to heart diseases replacing diarrhoea as the erstwhile giant killer. However, if increasing prosperity on account of economic liberalisation has led to spurt in heart diseases, then economic growth ought to be viewed as a public health crisis in the making. It may indeed be so as a World Bank study estimates that cardiovascular diseases will account for 36 per cent deaths in the country in 2030.  

If such were the impact of economic change then the developed world should have been its victim longtime over. Conversely, it is a developing country phenomenon where rise in non-communicable diseases including heart ailments are attributed to unhealthy lifestyles of individuals, making no one but themselves to blame for it. Since neither a bug nor a vector causes heart ailments, people are left to fend for their new-found ailment.

‘Changing external environment and its relationships to health can no longer be an individual’s sole responsibility,’ argues Dinesh Sharma, author of ‘Know Your Heart’. The common perception that it is individual lifestyle that is the cause for rising heart ailments not only absolves the health administration of any responsibility but pushes it into further inaction as well. Health care professionals and doctors have been perpetuating such perception no less.

Clearly, there is a gap between common perception and ground reality. The reality is that as many as 3 million and 14 million cardiovascular disease deaths were averted in the UK and US respectively, in the three decades between 1970 and 2000. It has been the direct result of joint action by the government, health professionals and food companies in inculcating healthy lifestyles, by helping citizens avoid unhealthy diet and check tobacco consumption.

The World Health Organisation (WHO) has long argued that governments have a crucial role to play in improving the health of its populace by giving individuals equitable access to a healthy life. Supportive state policies can influence the behaviour of people in relation to three major factors contributing to heart disease: unhealthy diet, tobacco consumption and physical inactivity.

Heartcare treatment
India’s government response has been found patchy in this regard, focusing instead on heartcare treatment than prevention at any level. No surprise, the food processing industry enjoys incentives, concessions and loans. In the absence of regulatory restrictions on quality of processed foods, all farm-to-fork companies are having a field day. The present government has supported the Futures Group for setting up a Food Park in Karnataka.

Since demand for packaged food is growing at a rate of 3 per cent each year, need for regulating trans-fats, saturated fatty acids and sodium content ought to be given utmost priority. Far from it, the government has thus far refrained from fixing limits on permissible levels of trans-fats, saturated fatty acids and salt to be declared on food labels, which contribute to high blood pressure, diabetes and heart diseases.

Packaged food is just one aspect, tax breaks for aerated drinks and indirect subsidies for potato chips contribute significantly to sugar and salt intake. Sugar and salt intake by Indians is higher than the WHO prescribed limits. Since people have little choice over the packaged food products on offer, unsuspecting consumers become victim of the state-industry nexus. Hidden links between state policy and corporate greed are playing with the hearts of its people.   

A country that has an estimated 63 million cases of diabetics and as many as 120 million people with high blood pressure, both of which are silent contributors to heart failure, cannot remain oblivious to the impending disaster. Need it be said that the country needs change on a larger scale along with individual prevention and efforts in clinical settings to control and prevent the tide of heart diseases. Like programmes for prevention and control of blindness, cancer and HIV, specific programmes need to be initiated to discourage unhealthy diets and promote healthy food.

(The writer is a development writer and analyst)