Mortality from Diseases of Respiratory System (URT, LRT and ORD) in Delhi • The URT diseases steeply increase for Delhi after 2009 • ORD mortality: high for Delhi (major contributor Pneumonia) 600 1200 3000 500 1000 2500 400 800 2000 300 600 1500 200 400 1000 100 200 500 0 0 0 Year a b Year c Year Deaths from a: Diseases of URT, b: Diseases of LRT and c: ORD in Delhi (2001‐2011)
Deaths due to major respiratory diseases in Delhi 400 5000 700 70 377 635 4500 350 600 60 Number of deaths 60 4000 4386 305 305 300 4206 Number of deaths Number of deaths 500 282 3500 3935 Number of deaths 50 50 250 248 3000 239 237 400 3179 40 3042 2500 200 198 2896 36 2797 300 2000 2405 30 2353 154 150 234 222 1500 208 200 1678 1697 20 100 161 1000 122 108 100 98 12 500 50 10 7 0 0 6 0 0 2 1 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 0 2001 2004 2005 2006 2007 2008 2009 2010 2011 2001 2004 2005 2006 2007 2008 2009 2010 2011 2001 2004 2005 2006 2007 2008 2009 2010 2011 Year Year Year Year b c d Deaths due to major respiratory diseases from a. Pneumonia (Institutional and hospital deaths in Delhi only) b. Influenza c. Bronchitis, broncholitis, asthma and unspecified emphysema d. Whooping cough in Delhi Source: Compiled from Directorate of Economics and Statistics and Office of Chief Registrar (Births and Deaths), 2001‐2011 (excluding 2002‐03) Delhi (2001-11) Max: 2010 (4,386); min: 2006 (1,678) Pneumonia Rose from 6 to 635 (2001‐10); declined later Influenza 282 deaths in 2011 Bronchitis, broncholitis, asthma 1 to 60 (2001‐08); declined in 2009 & rose again (50 in 2010) Whooping cough
Spatial Analysis of Impact of Air Pollution on Human Health in Delhi • The urban area is administered by three agencies/statutory towns: NDMC, MCD, DCB • Data for segregated rural pockets is also collected • Maximum area and population: MCD • Lowest population: DCB Statutory towns Area (2001) (in Population (2001) Density (2001) Total and rural areas per cent) (in persons per institutional km 2 ) deaths (2001- 2012)** MCD 94 13,423,227 (97%) 9,607 460,038 NDMC 3 302,363 (2%) 7,074 224,902 DCB 3 124,917 (1%) 2,907 16,035 Urban 62 NA 13,957 NA Rural 38 NA 1,692 NA
Trend of mortality due to pneumonia in statutory towns and rural areas of Delhi • Rural areas having poor amenities, infrastructure and living conditions have 1500 y = 57.921x + 325.53 highest proportion of deaths R² = 0.5297 1000 from pneumonia (2001‐2012) 500 0 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 y = 5.5273x + 628.8 1200 • MCD that represents mixed 100 R² = 0.0053 y = 1.7939x + 45.133 1000 80 R² = 0.0867 population with relatively 800 60 low quality of environment 600 40 400 in comparison to NDMC and 20 200 0 DCB also experienced rise in 0 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 mortality from pneumonia 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 (2001‐2012) RURAL 150 Total y = 10.624x + 3.8667 R² = 0.6815 100 Male • Note: does not include data for Female 2002 and 2003 50 0 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012
Trend of mortality due to bronchitis and asthma in statutory towns and rural areas of Delhi • Urban and rural regions of Delhi observed steep y = 59.491x + 205.8 1000 R² = 0.6215 increase in cases of 800 600 bronchitis and asthma 400 related deaths since 200 0 2002 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 1500 y = 10.018x - 14.8 150 y = 126.12x - 324.93 R² = 0.563 R² = 0.7503 1000 100 • Bronchitis and asthma 500 50 are majorly caused due 0 0 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012 to SPM (Department of -50 -500 environment and conservation NSW, RURAL 2005) and the health Total y = 6.6182x + 20.2 100 condition becomes R² = 0.5425 Male 80 severe due to the 60 Female 40 exposure to SO 2 (Chen 20 0 and Kan, 2008). 2001 2004 2005 2006 2007 2008 2009 2010 2011 2012
Age wise composition of deaths due to major divisions of the respiratory systems (a) URT, (b) LRT and (c) ORS in Delhi • a.URT • 55-64 year age group: most vulnerable • b. LRT • Child mortality dipped to 42 (2010) from 106 (2006) • 64-69 age group is most vulnerable • c. ORD • Accounts for a major share for all age groups • 1 to 14 years experienced twice as much as deaths from 2006 to 2010 • Sharp rise in infant deaths from 151 in 2006 to 414 in 2010 • Elderly are most vulnerable group to ORD
Inter linkages between Pollutants and mortality due to respiratory system illness • The regression analysis between the pollutants and diseases of respiratory systems suggests that • URT diseases are rising mainly on account of RSPM (r2=0.45) and SPM (r2=0.40) • Mortality from LRT diseases is largely dependent on SO2 (r2=0.44) and RSPM (r2=0.27) • The other diseases of the respiratory system seem to be largely reliant on RSPM (88 per cent), SPM and SO2 (75 per cent each)
Continued • SO2 has positive relation with abnormalities in breathing (73 %), pneumonia (64%) and heart attack (62%) • NO2 shares positive correlation with whooping cough (93%) , influenza (59 %) • PM are positively correlated with all the diseases; breathing abnormalities (89%) , pneumonia (88%) and influenza
Conclusion • Results reveal that asthma, bronchitis and pneumonia are responsible for most deaths due to air pollution in Delhi. • Spatial and temporal analysis of mortality from these diseases is presented for Delhi (2001‐2012). • The results reveal that there has been increase in the number of death of children due to respiratory illness. • The other major age group facing impact of rising pollution levels is above 60 years age group. 60
SUGGESTIONS • Promote urban planning for sustainable practices and healthy behaviors . • Stimulate decent lifestyle by improving urban living conditions • Ensure participatory governance • Build sustainable, inclusive and peaceful cities that are accessible and people‐friendly • Make urban areas resilient to emergencies and disasters
Source: UK Climate change 62
Dimensions of Sustainable Habitat
W hy is health important for 21st century cities? And why is urban development important for health and wellbeing-(Source-WHO at HABITAT III) • 1. Healthy urban policies can significantly reduce infectious and noncommunicable diseases and enhance wellbeing. • 2. Sustainable design and proactive development can enhance health equity by protecting urban populations from health risks and the impacts of extreme weather events. • 3. Health indicators can help document how citizens benefit from urban investments in infrastructure and environmental and social protection.
Cont.- • 4. A large body of scientific evidence on the health impacts of urban policies can clarify risks and inform decision-making for sustainable development. • 5. Vulnerable populations can be afforded additional protection when health risks are fully considered in urban planning. • 6. The “right to the city” includes the right to access to spaces that promote social cohesion, support healthy lifestyles and deliver economic benefits. • 7. Considering health impacts promotes fuller participation in urban decision-making by various stakeholders and members of different communities. 65
THANK YOU Awareness goes a long way… Cab with green roof in Kolkata Source: The Telegraph, 17 th May 2015
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