Why in news?
A study by the Prospective Urban and Rural Epidemiologic (PURE) on cardiovascular diseases was recently published online in The Lancet journal.
What are the major findings?
- The study analysed the situation in 21 countries across 5 continents, categorised by income levels.
- CVD - Household air pollution has emerged as one of the key causes of cardiovascular diseases (CVDs).
- 12% of all CVDs in low-income countries are attributable to household air pollution.
- Hypertension is the largest risk factor for CVD in low-income countries including India.
- This is followed by high non-HDL cholesterol and household air pollution.
- Besides medical reasons, the single largest risk factor for cardiovascular diseases is low education level.
- Deaths - CVD remains the leading cause of mortality among middle-aged adults globally.
- However, this is no longer the case in high-income countries, where cancer is now responsible for twice as many deaths as CVD.
- In high-income countries, people have started living longer, so deaths due to CVD have reduced, and more are now dying due to cancers.
What does it mean for India?
- In low-income countries, including India, CVD is still the top killer.
- Deaths due to CVD here are three times more frequent than that due to cancer.
- Household air pollution is a greater risk factor for CVD in India than diabetes, tobacco use, low physical activity and poor diet.
- An earlier report from a PURE study showed that Indians had the lowest lung function among the 21 countries studied.
- At least 65% of homes in India use biomass fuel for cooking and heating.
- In urban areas, the use of mosquito coils, dhoop sticks and agarbattis contribute to high household air pollution.
- Household air pollution is becoming an important cause of overall and cardiovascular mortality in low-income countries.
- In other words, if the household air pollution is controlled, there will be a significant decrease in mortality including due to cardiovascular disease in India.
What does the report imply?
- The risk burden of CVD-linked mortality is inversely proportional - lower risk but higher mortality in low-income countries, and higher risk but lower mortality in high-income countries.
- PURE’s analysis concluded that the higher mortality in poorer countries was likely due to other factors.
- These primarily include ‘lower quality and less health care’.
- Access to affordable, quality health care is still not ensured in many regions in India.
- A great amount of out-of-pocket expenditure frustrates continuation of treatment, or adherence to drug routine.
- According to Health Ministry data for 2014-15, nearly 62.6% of India’s total health expenditure is out-of-pocket expenditure.
What is the way forward?
- Targeting risk factors is key to reducing deaths due to cardiovascular diseases.
- The major focus so far has been ambient air pollution i.e. pollution rising from motor vehicles and industries.
- It is now time to wake up and realise that the pollution generated in house is also responsible for significant adverse effects.
- Besides, the Centre’s Ayushman Bharat Yojana will have to take much of the burden of hospitalisation for complications of non-communicable diseases.
- National and State schemes running on mission mode will have to step up efforts to target people at risk with life-saving interventions.
- These include the National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke.
- Any plans targeting the risk factors of non-communicable diseases will have to be truly game-changing, and incorporate the environmental angle as well.
Source: Indian Express, The Hindu
