Unhealthy Urban India

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November 20, 2023

Why in news?

Unhealthy diets, reduced physical activity and air pollution are posing a greater risk to morbidity and mortality in urban areas.

Status of Urban India

  • The number of people who live in places that are closer together and have a higher population density as compared to the rural areas is referred to as the "urban population."
  • The urban population of India attained a value of 475 million people in 2021.
  • India’s urban population is estimated to reach 675 million in 2035, the 2nd highest in the world.

What are the multiple risks faced by urban India?

  • Multi-scalar health risks- India’s urban inhabitants experience world’s highest levels of air and noise pollution, limited greenery, lack of access to sidewalks and parks that limit active lifestyles, limited access to nutritionally dense unhealthy foods and unprecedented exposure to toxic chemicals and heavy metals.
  • The series of exposures dramatically magnifies health risks for heart disease and diabetes, referred to as cardio metabolic disease.
  • The dietary ingestion of excess calories without adequate physical exercise fuels a vicious cycle of insulin spikes, excess fat deposition that sets the stage for heart disease.
  • Infrastructural deficit- Walking and biking on many Indian roads is not only hazardous but also nearly impossible, as sidewalks are overwhelmed by building and human waste, parked vehicles or street hawkers.
  • Dysfunctional provisioning system-  It consume more than 90% of the world’s water and global CO2 emissions and facilitate an estimated 19 million premature deaths annually.
  • Social inequalities- The socio-spatial-political design of urban provisioning systems in India exacerbates social inequalities in cities, by class, race, age, migrant and disability status, translating to vast disparities in health risks and outcomes.

What measures can be taken to combat unhealthy urban India?

  • Green investments- Investments on clean energy and electric mobility will offer a lifetime opportunity to improve health, while helping meet India’s climate and equity goals.
  • Triple duty interventions- Studies show that even small changes in the urban systems may have a large catalytic effect on health and productivity and serve as double-duty or triple duty interventions.
    • For example, making way for safe walking and biking lanes, and pavements, can help not only improve physical activity but also reduce the risk from air pollution.
  • Physical exercise- Regular physical exercise effectively mitigates the impact of other risk factors such as poor diet, particularly those rich in calories and saturated fats.
  • Non-motorized modes of transport- Walking and cycling has much greater positive effects on health and wealth than just switching to electric vehicle.

Health benefits

Economic benefits

Increased physical activity reduces the risk of chronic diseases

Reduced fuel consumption and greenhouse gas emissions

Reduced exposure to air pollution

Reduced congestion and travel time

Reduced traffic injuries and fatalities

Increased access to opportunities and services

  • Holistic urban policy- Policies that encourage fresh fruits and vegetables and limit sugars and salt in beverages may help contribute to better health outcomes.
  • Urban policies are powerful public health interventions that can serve to promote population health.

What lies ahead?

  • A new narrative for improving health and well-being in cities as reflected in several high-level policy frameworks, such as the United Nations Sustainable Development Goals (SDG) framework, the New Urban Agenda, and the Health in All Policies approach, is needed.


    • SDG 11 goal - To make cities inclusive, safe, resilient and sustainable is closely related to urban health.
    • The New Urban Agenda- A global framework for sustainable urban development that was adopted by the UN in 2016 to make cities and human settlements more inclusive, safe, resilient and sustainable by 2030.
    • Health in All Policies (HiAP) - An approach to public policy across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts



  1. The Hindu- Unhealthy urban India must get into street fight mode
  2. WHO- SDGs in urban health
  3. UN- New Urban Agenda to accelerate SDGs  
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