What ails the urban slums - morbidity profile of urban slum dwellers from three major cities of India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20200440Keywords:
Diabetes mellitus, Hypertension, Mobile medical unit, Morbidity profile, Urban slumsAbstract
Background: India today has over 61 million people residing in urban slums. Slums, on one hand, lack the basic requirements of housing, sanitation, and water supply that are detrimental for good health and on the other hand subject its residents to extreme poverty, unemployment and stress. Exposure to these environmental factors is expected to cause a distinct sort of morbidity pattern, which this study seeks to explore.
Methods: This cross-sectional study was a secondary data analysis of aggregated data of patients who availed health services at the mobile medical unit (MMU) of the Ujjivan program run by Piramal Swasthya in the last one year. The project has a fleet of MMUs that makes at least one predestined monthly visit to each service point in urban slums of Bangalore (42 sites), Pune (18 sites) and Mumbai (19 sites).
Results: Musculoskeletal disorders (30.69%) and cardiovascular diseases (25.56%) together accounted for 56.25% of the total disease burden. The analysis of blood pressure readings of all the registrations showed that the mean systolic and diastolic pressures were 129.71 and 84.92 mmHg respectively. 51.58% of all individuals had hypertension and 23.51 % had diabetes.
Conclusions: According to the study a major proportion of urban populous seeking healthcare at the MMU are women and elderly and do so for non-communicable diseases. Hypertension and diabetes are major health threats among them. MMU could be used as an effective mode of service delivery for women and the elderly especially, for chronic diseases.
References
Obaid TA. UNFPA- state of world population 2007 Unleashing the Potential of Urban Growth. United Nations Population Fund. 2007;2007:12-019.
Human Development Reports. Rapid urbanisation: opportunities and challenges to improve the well-being of societies. Available at: http://hdr.undp.org/en/content/rapid-urbanisation-opportunities-and-challenges-improve-well-being-societies. Accessed on 15th November 2019.
World Health Organization, Regional Office for South-East Asia. Addressing health of the urban poor in South-East Asia Region: challenges and opportunities. WHO Regional Office for South-East Asia; 2011.
Oxford Policy Management: India’s urbanisation challenge. Available at: https://www.opml. co.uk/blog/ urbanisation-challenge-India. Accessed on 15th November 2019.
Banerjee A, Bhawalkar JS, Jadhav SL, Rathod H, Khedkar DT. Access to health services among slum dwellers in an industrial township and surrounding rural areas: a rapid epidemiological assessment. J Family Med Prim Care. 2012;1(1):20-6.
Satapathy BK. Safe drinking water in slums from water coverage to water quality. Econ Polit Weekly. 2014;49(24).
Gupta V, Yadav K, Anand K. Patterns of tobacco use across rural, urban, and urban-slum populations in a North Indian community. Indian J Community Med. 2010;35(2):245-51.
Wiysonge CS, Uthman OA, Ndumbe PM, Hussey GD. Individual and contextual factors associated with low childhood immunisation coverage in sub-Saharan Africa: a multilevel analysis. PLoS One. 2012;7(5):e37905.
Riley LW, Ko AI, Unger A. Slum health: Diseases of neglected populations. BMC Int Health Hum Rights. 2007;7(1):2.
Paul K, Singh J. Emerging trends and patterns of self-reported morbidity in India: Evidence from three rounds of national sample survey. J Health Popul Nutr. 2017;36(1):32.
Mberu BU, Haregu TN, Kyobutungi C, Ezeh AC. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis. Glob Health Action. 2016;9:33163.
Kadarkar KS, Velhal GD, Tiwari SR. Preventable risk factors for non-communicable diseases in urban slum of Mumbai: A Prevalence Study using WHO STEPS Approach. Ntl J Community Med. 2016;7(8):672-6.
United Nations Human Settlements Programme: The challenge of slums: global report on human settlements 2003. London and Sterling, Earthscan Publications Ltd; 2003:310.
George CE, Norman G, Wadugodapitya A, Rao SV, Nalige S, Radhakrishnan V, et al. Health issues in a Bangalore slum: Findings from a household survey using a mobile screening toolkit in Devarajeevanahalli. BMC Public Health. 2019;19(1):456.
Palepu S, Yadav K, Ahamed F, Goswami AK, Nongkynrih B, Pandav CS. Acute morbidity profile and treatment seeking behaviour among people residing in an urban resettlement colony in Delhi, India. Nepal J Epidemiol. 2018;8(1):716-24.
Usmani G, Ahmad N. Health status in India: A study of urban slum and non-slum population. J Nurs Res Pract. 2018;2(1):9-14.
Hui L. Assessment of the role of ageing and non-ageing factors in death from non-communicable diseases based on a cumulative frequency model. Sci Rep. 2017;7(1):1-7.
Abbasi S, Mohajer H, Samouei R. Investigation of mobile clinics and their challenges. Int J Heal Syst Disaster Manag. 2016;4(1):1.
Bhan N, Madhira P, Muralidharan A, Kulkarni B, Murthy G, Basu S, et al. Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study. BMC Geriatr. 2017;17(1):156.
Khanna AB, Narula SA. Mobile health units: Mobilizing healthcare to reach unreachable. International Journal of Healthcare Management. Taylor and Francis Ltd.; 2016;9:58-66.
Dey S, Nambiar D, Lakshmi JK, Sheikh K, Reddy KS. Health of the elderly in India: challenges of access and affordability. In Aging in Asia: findings from new and emerging data initiatives 2012. National Academies Press (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK109208/. Accessed on 3 July 2019.
Suresh N, Thankappan K. Gender differences and barriers women face in relation to accessing type 2 diabetes care: A systematic review. Indian J Public Health. 2019;63(1):65.
Kumar, Kaur R, Pilania N, Manju. Morbidity pattern of patients attending a primary healthcare facility in an urban slum of Chandigarh, India. J Clin Diagnost Res. 2018;12:10-3.
Ojha S, Nikumb V, Behera A. Prevalence of musculoskeletal disorders (MSD's) in an Urban Slum Population Turbhe, Navi Mumbai, India. J Res Med Dent Sci. 2018;6(5):291-5.
Datta A, Nag K, Karmakar N, Datta S. A study to assess common morbidity pattern of an urban population of Tripura. Int J Community Med Public Health. 2017;4:4613-6.
Ajay VS, Prabhakaran D. Coronary heart disease in Indians: Implications of the INTERHEART study. The Indian J Med Res. 2010;132(5):561-6.
Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81:646-56.
Dhar L. Preventing coronary heart disease risk of slum dwelling residents in India. J Family Med Prim Care. 2014;3(1):58-62.
Checkley W, Pollard SL, Siddharthan T, Babu GR, Thakur M, Miele CH, et al. Managing threats to respiratory health in urban slums. Lancet Respir Med. 2016;4(11):852-54.
Chaturvedi S, Pant M, Neelam, Yadav G. Hypertension in Delhi: Prevalence, awareness, treatment and control. Trop Doct. 2007;37:142‑5.
Panesar S, Chaturvedi S, Saini NK, Avasthi R, Singh A. Prevalence and predictors of hypertension among residents aged 20–59 years of a slum-resettlement colony in Delhi, India. WHO South-East Asia J Pub Health. 2013;2(2):83-7.
Shivaraj BM, Vinay KB, Ranganath TS. Prevalence of hypertension and diabetes mellitus at selected urban slums in Bangalore: a cross sectional study. J Evol Medi Dent Sci. 2015;4(58):10077-83.
Patel SA, Ali MK, Alam D, Yan LL, Levitt NS, Bernabe-Ortiz A, et al. Obesity and its relation with diabetes and hypertension: a cross-sectional study across 4 geographical regions. Glob Heart. 2016;11(1):71-79.e4.
Lumagbas LB, Coleman HLS, Bunders J, Pariente A, Belonje A, de Cock Buning T. Non-communicable diseases in Indian slums: re-framing the social determinants of health. Global Health Action. 2018;11(1):1438840.
