Human beings have become an increasingly powerful environmental force over the last 10,000 years. With the advent of agriculture 8,000 years ago, we began to change the land, and with the industrial revolution, we began to affect our atmosphere. The recent increase in the world's population has magnified the effects of our agricultural and economic activities. But the growth in world population has masked what may be an even more important human-environmental interaction. While the world's population is doubling, the world's urban population is tripling. Within the next few years, more than half the world's population will be living in urban areas. Urbanization is fast gathering impetus all over the world and dense urban population at the same time throws up challenges for better employment, education, economics and above all health care. According to an estimate 1 out of every 9 Indians lived in an urban setting in 1901. Today, every fourth Indian is a city-dweller and it is believed that by 2030, 6 out of every 10 people will be city dwellers. Urbanization brings with it a unique set of advantages, but at the same time challenges on health certainly outweigh its positives by miles! Cities are a centre of immigration from rural areas and they experience a constant influx of people from other cultures and climates. The cost of housing may force people to live in different areas ranging from posh localities to slums and to streets. Closer proximity increases the rates of transmissible diseases such as tuberculosis and other respiratory infections. Naresh Gupta, a 42 year old railway employee opines, "It is excessive rural-urban migration primarily caused by improper balance of economic and social opportunities such as the availability of social amenities like good roads, hospitals, schools, opportunity for advancement, proper health care between the rural and urban areas. However, most people leave their village behind but take their beliefs, traditions and customs with them which are sometimes difficult to carry out in such localities leading to unwanted pollution of air, water and soil". The food availability in urban areas differs by income level, even educated parents feel proud to be able to afford pizzas and burgers of multinational food chains for their kids. They show off their affluence by buying loads of goodies (which really are baddies) and cans of colas for their 2 and 3 years old darlings, thus developing their taste buds for fast foods. Homemade food and traditional cuisine has by and large become old fashioned for them. Even the poor people do not eat nutritious food. They very often depend on roadside food which is cheap, oily and full of fat. Water supply through taps is another health hazard since urban governing bodies in India are yet to wake up to the need to supply clean water to the residents all the year round. Water supply systems need regular maintenance and main pipes installed decades ago remain a regular rupture hazard in older urban areas. "I feel fortunate that I have grown up in a rural area. I would never trade in my memories of playing in a stream, climbing trees galore, swimming in the river, and hiking up hills for a breathtaking view... all within a half mile from my house, says Wasim Sayeed, a 28 year old scholar of Management. "I sometimes feel sorry for my friends who are surrounded by pollution, concrete, and power lines". The concentration of populations in urban areas also means an increased buildup of waste products. Efforts to recycle waste have met with varying degrees of success. Moreover, both air and noise pollution are of great concern in urban areas. Comput Those were the days when we had all the time for 'Us'... Those were the days when we played on open grounds and walked to school without the bus! Those were the days when we ate as much as our mothers made us eat... Those were the days when the air seemed as pristine as a crystal could be! Those were the days when falling sick were known only for the old... "Health is Wealth" is what we were always told! rs and cell phones complete the parents' pride and neighbours' envy syndrome, making the children lose the appetite for any outdoor activity, be it walking, running or playing. Aakriti, a 32 year old fashion designer says, "I think city life is much less healthy, what with all the waves radiating from wireless items like cell phones and bluetooth, smog, unhealthy water (tap water in the villages is so much better than city tap, I can't even explain the difference), vegetables and fruits, heaps of garbage etc. etc. The people I know in my vicinity go to gyms and parlors, color their hair, eat fast food, take sugar free in tea, are always under anxiety and blame their fast city life for their health problems". Comfort in cities in the form of various electronic gadgets have made our work faster but removed any scope of physical activity. Even our postures start getting affected with long hours of sitting jobs/ computer work, leading to severe back ache problems and even migraine. "We no longer grind spices and grains, like our grand-mothers used to, on the traditional stone crusher helping them shape their backs, stomach and arms nor do we walk anymore to work! We have our own transport to even take us to the nearest market" says Anshu, a 40 year old teacher. Another important factor that needs to be pointed out is the dismal patient-doctor ratio of 1 doctor for every 10,000 Indians. However, India holds the top position in migration of physicians to developed countries like UK and the US. While we love to ape the West as far as Dominos, Pizza Huts and McDonalds' are concerned, we seem to be happily unconcerned when it comes to littering our surroundings. Our lessons in basic hygiene are confined to throwing our garbage in front of someone else's house or, better still, on the road. Spitting and urinating on the streets comes naturally to the Indian males. "It would have been better if a compulsory fine was imposed on us for making our surroundings garbage dumps" says Shanti, a retired doctor. Thanks to Swachch Bharat Mission though, for making its efforts. Harpreet Singh, a businessman believes, "In the city, it seems like you're on a zillion schedules, and you have to depend on traffic, coworkers, prices... city life is too fast sometimes, but that can be exciting in a good way, too". Urban health issues are as multifaceted and complicated as the city itself. The city cuts off the poor migrant from his emotional and conservative support systems. The city also offers him/her a hope in the form of livelihood and access to better healthcare, better education opportunities for his offspring. But the city is the obvious prospect for the hopeful and the aspiring, and consequently urban healthcare is of paramount significance for a developing country like ours. Today, the number of people who think that big cities bring happiness is rapidly decreasing, whereas the number of people who fear and worry about developments in cities is gradually increasing. It is time to wake up and understand why we and our children are easily becoming are susceptible to diseases which were unheard of, even two decades ago? Who would have imagined youngsters suffering from heart ailments, diabetes, liver diseases or obesity? These dreaded diseases are fueled by factors like diet, rising incomes and the modern lifestyle. Smoking, drug abuse, alcohol and lack of physical exercise also play their parts in the promotion of these diseases. All these factors can be related to the impact of urbanization on our health, but with small changes in our lifestyle, we can protect our health from these changes and yet stay modern and urbane. |