Malnutrition India's biggest health hazard, air pollution a close second

NEW DELHI: Child and maternal malnutrition continues to be the biggest health hazard in India since 1990, while deteriorating air quality came a close second, according to a recent report in one of the world’s oldest medical journals.

The report published in the Lancet journal has found that besides malnutrition and rising air pollution, dietary risks, high systolic blood pressure and diabetes were other major risk factors in India in 2016. In 1990, air pollution was the third largest risk factor in the country but it moved to the second rank in 2016.

The report also analyses the variations in epidemiological transition – a change in mortality rates brought about by medical advancements – across Indian states.

According to the findings, underdeveloped states, including Bihar, Jharkhand, Uttar Pradesh, Rajasthan, Madhya Pradesh and Haryana have recorded a low epidemiological transition level (ETL), and thereby suffer from a higher health burden from these risk factors.

Delhi may be one of the most polluted cities but it faces a marginally lower health impacts, when compared to states like Bihar. If calculated in terms of life years lost due to air pollution, or what medical experts call disability adjusted life years (DALYs), Delhi has a DALY rate of 1890, when compared to Bihar (4308) and Uttar Pradesh (4390).

A Centre for Science and Environment (CSE) researcher, who analysed the data for Delhi said, “Diseases that are triggered by air pollution including cardiovascular diseases, chronic respiratory diseases (COPD), and cancers have shown dramatic increase since 1990. In 1990 COPD was ranked 13 among leading causes of illness and lost life years. But this has now shot up to rank 3.

Similarly, Ischaemic heart disease that is greatly influenced by air pollution has gone up from rank 5 to number 1, diabetes from rank 22 to rank 5 and stroke from rank 16 to rank 15.” Explaining the reason for such variations, Bhargav Krishna, a research fellow at Public Health Foundation of India, said, “The population in these states may be suffering higher comorbidities – the presence additional diseases or disorders related to the main disease. The use of solid fuels, a major contributor to air pollution is also higher in these states.”

Medical experts led by the Indian Council of Medical Research (ICMR) and Institute of Health Metrics and Evaluation (IHME), who conducted the study, confirmed that number of death and disability caused by diarrhoea and other communicable diseases have declined, but diseases closely linked with air pollution and smoking, including heart ailments, have increased significantly.

Another report released by the Lancet Commission said each year over 9 million deaths occur worldwide due to air and water pollution.

Air pollution is at the top of the list contributing to over 6 million deaths. India remains one of the worst affected countries where 1.9 million premature deaths occur due to deteriorating ambient air quality.