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The poor too are prone to lifestyle diseases

Experts say government needs to step in to tackle the growing menace before it is too late

LIFESTYLE- related diseases such as diabetes, hypertension, cardiovascular disorders, strokes and cancer have been perceived for long to be the bane of the rich.

However, hard data coming out of urban health centres reveal how these lifestyle diseases are rapidly catching up with the urban poor as well. And, what’s of more concern is that there are no national programmes or preventive measures taken by the government to tackle the problem.  

Take the case of 68-year-old Venkatamma, who has been suffering from diabetes and hypertension for the last six years. Living in the Parvathipuram slum area, she receives free medicines from the urban health centre (UHC) run by KIMS Hospital. Due to her condition, she underwent angiogram and angioplasty in the last two years. Both the procedures cost her Rs 1.2 lakh with additional burden of buying medicines worth Rs 600 every month. 

Venkatamma lives with her daughter’s family and has no medical insurance. With her daughter’s monthly family income coming to just Rs 10,000, the family is leading a hand-to-mouth existence. The incidence of urban poor showing symptoms of lifestyle diseases has increased by about 10 per cent in the last five to 10 years. 

Even the United States National Institute of Health (NIH) states that about 60 per cent of all deaths in the world are due to Non-communicable Diseases (NCD), out of which 80 per cent occur in developing countries including India in the lower income groups.  

“A majority of the people who come to our centre have diabetes or hypertension,” says Dr Jayanthi Srikanth, in-charge of the KIMS UHC in Parvathipuram. Out of the 650 to 700 patients who visit the UHC every month, about 15 per cent or roughly 50 patients have diabetes or hypertension. The emergence of non-communicable diseases among the poor doubles burden on the government which is already grappling with a plethora of communicable diseases, she adds.

Similar is the situation in the urban health centre run by BBMP with the help of M S Ramaiah Medical College and Hospital at BK Nagar, Mathikere.  Dr Shalini Nooyi, Associate Professor of Community Medicine Department, points out that 30 to 40 per cent of their current patients suffer from NCD or lifestyle diseases, against 5-10 per cent a decade ago. The diseases are also appearing in people of younger age. 

Surprisingly, the reasons attributed to increase in NCDs are not much different from the upper echelons of society. Doctors attribute the rise in life expectancy, quality of healthcare, alcohol and smoking, access to junk food, etc as the causes for early arrival of the disease.

Cost burden
As most lifestyle diseases have no cure, the patients would be unable to bear the burden of treatment for long, resulting in poor follow-up. Doctors inform that nearly 30 per cent of the patients detected with lifestyle diseases don’t come for follow up and forgo the medicines. In fact, a study conducted by her department two years ago on costing in hypertension among urban poor, found that most people did not have insurance to cover the treatment cost. 

In spite of this, BBMP has no programme to offer, let alone a separate department to provide curative services in NCD, as the national and state focus is still largely on communicable diseases. Experts say the government needs to recheck its priorities as these diseases are sho- wing no signs of going away.

(Published in Deccan Herald on 17th May, 2010)

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