Health challenges: A survey

Most of the studies conducted for health in Delhi are based on a sample survey; therefore, it becomes difficult to assess the real picture. Moreover, the residents of Delhi use both formal (by visiting doctors) and informal medication (self-medication) for various diseases. Some patients suffering from asthma and bronchitis attempt to be cured by taking homeopathic, ayurvedic or naturopathy treatment. Therefore, it becomes difficult to acquire authentic data on health, diseases and healthcare cost. It is thus important to study the health conditions in Delhi by incorporating the perspective of the key stakeholder, that is, the residents of the city. To understand the health perspective, the authors conducted a survey using a structured questionnaire in all nine districts of the city, with a sample size of 100 each. The respondents were people from different age and income groups, selected on a random basis. The study assessed both curative and preventive means of healthcare. The preventive aspects included visits to fitness centres, yoga classes, walking in green spaces, vaccinations, consuming vitamin supplements or preventive medication and organic food. The curative aspect included visits to a doctor and the type of medication used.

To understand the health status and healthcare aspects, various parameters were taken into account.

Presence of diseases

Urban environments are often poorly equipped to provide stable sources of food for sustaining a massive population. In low-income and middle- income megacities such as Dhaka (Bangladesh), food shortages and poverty result in increasing food prices and malnutrition. Additionally, many megacity inhabitants exhibit a shift towards more sedentary lifestyles and a western diet, leading to increased body-mass indices (BMIs) and instances of obesity and diabetes. As urban residents transition from diets sustained on home gardens to rely on cheaper, processed foods, they are at a greater risk of developing obesity and other non-communicable diseases (Jowell et al., 2017). As mentioned earlier, Delhi is a hub of various diseases such as cardiovascular, respiratory and cancer. Besides these diseases, flu, cough and cold and stomach infections also occur frequently. Nearly 20 per cent of the respondents admitted that their problems occur frequently, 20 per cent said moderately and only 12 per cent said the health problems occurred rarely in their family. In addition, there is seasonal fluctuation in the type of some environmental problems. Diseases like dengue, chikungunya and malaria spread mainly in the monsoon season (July-September), while respiratory patients increase significantly during November to January.

Type of diseases

The respondents were questioned about the type of pollution and type of diseases prevalent in their area. They were also asked about the kind of health issues their family members faced last year. Air pollution was a common problem almost all respondents mentioned. Table 4.4 lists the environmental problems other than air pollution. Nearly 48 per cent respondents found noise pollution to be the most common problem in their area, mainly due to traffic and various cultural and religious activities. About 28 per cent of the respondents mentioned the solid waste disposal and sanitation problem. Hospital waste (4.7%), burning of waste (2.9%) and industrial waste (0.9%)

Table 4.4 Major environment problems in your area

Source: Primary survey

Table 4.5 Disease that family members suffer from

Source: Primary survey

were next in the respondents’ list. Almost 16 per cent of the respondent felt that all of these environmental challenges were prevalent in their area.

On enquiring about the diseases that family members suffered from, 13.8 per cent respondents cited respiratory diseases, 11 per cent mentioned dengue and 4.2 per cent pointed at malaria (Table 4.5). About 3.1 per cent of the respondents mentioned heart problems, while a significant 20 per cent listed fluctuating blood pressure, due to sedentary lifestyle or eating habits.

Figure 4.3 shows that environmental diseases like respiratory diseases are common in south, northwest and northeast Delhi. Dengue is more common

Figure 4.3 Diseases in Delhi (Zonewise) in per cent. Source: Primary Survey in southwest, east and New Delhi. High or low blood pressure is more of a lifestyle disease common in almost all the administrative divisions of Delhi but more prominent in west Delhi, followed by south Delhi. Heart diseases were more reported in west Delhi, followed by south and northwest Delhi, respectively.

Visit to doctors

Most of the respondents opt for a formal method of visiting a doctor for any health issue other than cold and cough. Although cough is a common health issue, it can have varied intensity, from flu to bronchitis, ТВ or cancer. Mostly respondents said if the cough remains persistent for a week or so, they visit a doctor. When enquired about the type of healthcare centre they visit, it was found that nearly 27 per cent visit local clinics, 6 per cent go to nursing homes, 31.5 per cent visit government hospitals and the rest 35.5 per cent go to private hospitals. Regarding the frequency of visits, 35 per cent of the families visited a medial practitioner more than 15 times a year, while nearly 15 per cent of the families visited about 10-15 times a year. This shows a high frequency of visit to the doctors.

Preventive healthcare options

‘Prevention is better than cure’, almost all respondents believe in this phrase. They all mentioned taking some or the other precautions to prevent health problems. Some people invest a lot of money in healthcare, while people in the low-income group also take small steps. Masons and carpenters, for example, take jaggery to prevent cough. Due to increasing health issues in the city, people prefer going for walks, yoga or other exercises. Some people pay a huge amount to go to gymnasiums, hire dietician services, or participate in aerobics and dance classes. Many people are shifting to ayurvedic and organic range of food products, toiletries, etc.

Table 4.6 shows that almost 80 per cent of the population takes some preventive measure. Nearly 15.3 per cent respondents opt for walks or

Table 4.6 Types of preventive healthcare

Source: Primary survey some form of physical exercise. About 17 per cent take vitamin supplements and vaccinations (which is mainly for kids, but in a few cases, adults have also started taking vaccination for flu and typhoid). Organic food is also becoming popular. Since it is more expensive than the generally available food products in the market, only 8.7 per cent respondents buy organic products. These preventive healthcare measures are becoming popular and a habit. This is because the constantly occurring diseases affect people both in physical and monetary terms.