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Urban Transition and Emerging Health Challenges in the Global South : Indian Experience

Surinder Aggarwal 

Delhi University 

For the first time, half of the world population now lives in urban areas. Furthermore, large share of new urban growth shall be borne by the developing countries like India and China and within  mega cities like Mumbai, Bangkok, Lagos and Mexico. The urban transition has certain benefits and costs. We need to examine and analyse at disaggregate level what is happening within the urban areas of the growing and globalizing economies and who is being affected and where in context to emerging health patterns. The adverse impact of globalization and advanced capitalism reflected in food consumption and lifestyle patterns is also concentrated in urban areas and that adds to their health vulnerabilities and inequities

We examine such emerging concerns of health in context to India where both urban and epidemiological transitions are happening in parallel. India is urbanizing fast in numbers and is close to 400 million now. First time absolute urban population growth has exceeded rural growth . We share in the presentation that how contemporary urbanization in India is shaping and influencing the health outcomes for the urban population and the poor in particular?  Does the health pattern vary with spatial and social determinants like the size of the urban settlements, location, income groups,  age groups  and by sex?  How contemporary urbanization and urbanism is becoming a major driving force and a social and spatial determinant in shaping the disease pattern from communicable to non-communicable diseases? Who are affected where and why? How the national, state and local governments are responding, considering NCDs predominant incidence and prevalence in urban areas. Their substantial higher cost of treatment and under capacity of the health care system is major constraints in addressing the emerging disease pattern. 

Since the poor are equally affected by NCDs, it is interesting to examine their health expenditure pattern within the total household consumption budget.  How rising costs of chronic diseases treatment is pushing low income groups into deep poverty and indebtedness? Do the national health policy and recently launched national urban health mission address such issues and concerns adequately? If not adequate response, what needs to be done to fill the gap? 

July 13, 2016