26 June 2018 | Column | By Pavithra.N.Raj
With fast-track modernisation and rapid infrastructural developments going hand in hand with substantial economic advancement, India surely has walked considerable miles in the social and healthcare sector with life expectancy going up by nearly a decade since 1990. But along with the progress, India is having a hard time fighting the outbreak of lifestyle and malnutrition induced health crisis leading to an array of communicable and non-communicable diseases.
Lifestyle diseases are mostly induced by the prolonged exposure to certain detrimental lifestyle habits – unhealthy diet, smoking, alcoholism, and sedentary lifestyle and physical inactivity – which consequentially leads to the upsurge of chronic diseases, particularly cardiovascular disease, stroke, obesity, diabetes, nephritic and renal ailments, metabolic disorders, chronic obstructive pulmonary disease, gastrointestinal diseases and even malignancy.
These illnesses once regarded as the ailments of industrialized nations, deemed as "Western diseases" or "diseases of affluence" are now globally recognized as non-communicable and chronic diseases, which fall under degenerative diseases group. Chronic diseases can even make you disable or permanently bedridden, and even lead you to death. According to the World Health Organization (WHO) reports published in 2005, approximately 61 percent of all deaths globally and 49 percent of the global burden of disease were caused by chronic diseases. The number of total deaths attributable to chronic diseases globally is expected to sore up to 70 percent and the global burden of disease to 56 percent by the end of 2030.
The starkest aspect of this challenging problem in India is the sharp disparity among India’s more prosperous and poorer states which can potentially hamper the demographic dividend of the country. Even though India has achieved considerable healthcare success with overall mortality rate due to diseases going down to as much as one third in 2016 as compared to the last two decades, we still see that diseases related to malnutrition and malnourishment such as anaemia, rickets, scurvy and others that are caused due to low resistivity of the body, such as tuberculosis, diarrhoea, respiratory infections, claiming a great number of lives particularly in the states which are in the early stages of epidemiological transition.
According to a syndicated study, lifestyle diseases such as diabetes and ischaemic heart problems are increasing by leaps and bounds, with the former increasing as much as 174 percent and the latter by 104 percent as compared to the last decade. This crisis in the healthcare sector is also highly visible in the Disability-adjusted Life Years or DALY which is the appropriation of the total disease burden denoted as the number of years lost due to afflictions, disability or early deaths. It is nine fold for tuberculosis and diarrhoeal diseases and sevenfold for respiratory infections in 2016.
The task of improving the Health and planning for every state by assessing the state level disease burden and risk factors has been assigned to Indian Council of Medical Research (ICMR) , Institute for Health Metrics and Evaluation (IHME) , and union ministry of health and family welfare who have divided the Indian states into four groups depending upon their epidemiological transition and level of development by making use of the ratio of illness and premature death resulting from maternal, communicable, nutritional diseases alongside with non communicable diseases as an indicator. India is moving towards a rapid epidemiological transition keeping at par with the social and economic developments. India is certainly improving upon its previous scores with deaths due to communicable diseases reduced from 53.6 percent to 27.5 percent in the recent times which hints towards growing medical infrastructure.
Healthcare experts of Columbia Asia Referral Hospital Yeshwanthpur opine that India today, is suffering from danger diseases related to both over-nutrition and malnutrition. Such demanding circumstances necessitates collaborative efforts on the part of the government, NGOs and healthcare sectors to strengthen the national control programmes in order to handle this crisis!
Moreover, they also emphasised on dietary and lifestyle factors mostly responsible of major chronic diseases. Being aware of the identified, modifiable dietary and lifestyle risk factors, in most cases, are effective in the prevention of conditions, such as obesity, anorexia, stroke, cardiovascular diseases, diabetes, and malignancy among high-income populations. Moreover, prevention of these chronic ailments also demands major lifestyle changes like quitting smoking and drinking, indulging in physical activity, promoting walking or cycling to work instead of riding a bike or driving a car, and investing in a proper diet plan. The government too should assign proper funding for education and awareness about healthy living, food policies, proper immunization (especially for those who are underprivileged) and urban physical infrastructure in order to support and encourage such changes.
Pavithra. N. Raj, Chief Dietician – Nutrition And Dietetics, Columbia Asia Referral Hospital, Bengaluru