2-3-4-5 Syndrome: Growing Health Concerns in Cities -

India

Dr. Biranchi Jena, EMS systems Research

If urban India was considered a separatecountry, it would be the fourth largest in the world

Source: Urban Health Resource Centre, New Delhi.

Overall child and women health condition among urban poor is worse than the rural India

•Evidence shows that the health status of children in urban poor settings is as bad and often worse than in rural areas• Urban poor children under-five suffer more and die more often from diarrhea and acute respiratory infections than rural children

Source: Urban Health Resource Centre, New Delhi.

Prevalence of chronic disease in urban community is much higher than the rural community and thus requires special attention

Disease

Prevalence Rate per 100,00 population

Rural Urban

Heart disease 313 790Respiratory including ear/nose/throat ailments 439 395Fever of unknown origin 1240 1507Accidents/injuries/poisioning 662 479Mental Disorder 731 897Diabetes Mellitus 585 1555 Urban Injury Pyramid - RTA

Source: SRS

Rural Injury Pyramid - RTA

Source: GVK EMRI

Cities with low prevalence of RTA would be experiencing growing number of RTAs

Source: NCRB, 2009

States with high potential of urbanization would result in more number of accidents

Note: Bengaluru city as Karnataka.Ahmadabad, Rajkot & Surat cities as Gujarat.Chennai, Coimbatore & Madurai cities as Tamil Nadu.Hyderabad, Vijayawada & Vishakhapatnam cities as Andhra Pradesh.Jaipur city as Rajasthan.Bhopal, Indore & Jabalpur cities as Madhya Pradesh.

Metro Cities are Delhi, Kolkata, Mumbai & Chennai.

CAGR (2010-15) = 0.92 %

Source: NCRB, 2009

Injury and death index for RTA indicates a quick action to prevent the RTAs

Source: estimated from NCRB, 2009Note: Index for Injury indicates number of injured person per 100 road traffic accidents and index for death indicates number of deaths per 100 road traffic accidents

Apart from RTA, chronic diseases like IHD would pose a major challenge in cities

Note: Bengaluru city as Karnataka.Ahmadabad, Rajkot & Surat cities as Gujarat.Chennai, Coimbatore & Madurai cities as Tamil Nadu.Hyderabad, Vijayawada & Vishakhapatnam cities as Andhra Pradesh.Jaipur city as Rajasthan.Bhopal, Indore & Jabalpur cities as Madhya Pradesh.

Estimated total number of Heart Attack death cases in selected states

Source: NCRB, 2009

GVK EMRI has experienced in handling all kinds of medical emergencies from cities

Pregancy related, 16%

Acute Abdomen, 14%

Trauma (Vehicular), 22%

Trauma (non Vehicular), 5%

Cardiac/Cardio Vascular, 5%

Intentional Self harm (Suicide), 4%

Respiratory, 5%

Animal Bites, 2%

Poisoning/Drug Overdose, 1%

others, 27%

Rapid and accelerated motorization are more in urban areas which causes more RTI cases. This may be one reason of higher trauma (v) reported in urban area.

Source: GVK EMRI

Geriatric population is expected to face major health challenges in cities

Age Group

Source: GVK EMRI

Growing Concerns!!!!• There is a paucity of data on urban poor who are “at risk Population”

• Environmental factors and lack of services contribute significantly to health problems in poor urban settings. Lack of water and sanitation is top on the list.

• Lesser community participation

• Managing emergencies in cities has witnessed a number of challenges

• Development of emergencies within EMS systems

• Good surveillance systems

Thank You

BIRANCHI_JENA@EMRI.IN