Transition and urban health

To successfully address the challenges of rapid population ageing, it is essential to have an understanding of health status. In this study, we describe regional variations in health status by assessing self-rated health and functional disability of older population in India. The study uses the data from the World Health Organization sponsored “Study on Global Ageing and Adult Health (SAGE-INDIA)” of 2007. This pioneering survey gathered information from 6560 persons (aged 50 years and over) from six Indian states. Analysis indicates that older population from urban areas is more likely to experience better health status and lower disability. Education plays a very crucial role in better health status and lower disability, irrespective of urban-rural differences. It also shows that higher years of education and better economic status of the households are positively related with better health condition and lower disability. Social security measures, including pensions and health insurance are crucial to ensure quality of life and well-being of older population in India.

Africa is facing the dual challenge of under-nutrition and a growing burden of overweight and obesity especially in countries that are urbanizing and globalizing fast. The WHO Commission on Social Determinants of Health framework is used to study the confluence of urbanization and wealth and their links with overweight and obesity in the Southern African Development Community (SADC). The region has some of the highest rates of obesity, but also high rates of malnutrition among children. DHS Data, along with other macro-level statistics from UN agencies were used to identify the determinants of overweight or obesity among women. 9 out of 15 countries have overweight or obesity prevalence of more than 30% among adult women. The country results show that age, educational level, household wealth, marital status, and contraceptive use are associated with the odds of being overweight or obese. The interaction between urban/rural place of residence and household wealth status shows three patterns: high overweight levels in urban compared with rural areas for the poorer countries; no difference between urban and rural levels where the national prevalence of overweight or obesity is very high; and a cross-over effect in the wealthier countries where the rural affluent women have the highest levels of overweight or obesity.

Like other developing countries, India is undergoing rapid epidemiological transition as a result of its demographic, economic and social changes. India is moving from second to third stage of epidemiological transition. However, India is facing both double burdens of diseases that burden of communicable and non-communicable. Lack of accurate data on cause of deaths is a major hindrance to comprehensive assessment of epidemiological transition. The urban Maharashtra known to be the only state where the vital events registration is above 90%. The results are evident that Maharashtra is at third stage of epidemiological transition. Among all causes of death “Diseases of the Circulatory System” is ranked first from 1990 to 2006. For youth, the leading cause of death is “Injury and poisoning” for both males and females. In the adult groups, leading cause of death is” Infectious and parasitic disease”. Among adult males the leading cause of death is” Infectious and parasitic disease” and among adult female it is “disease of circulatory system”. For the old age group, “Disease of circulatory system is the leading cause of death in Urban Maharashtra for both males and females. This indicates that state is non-communicable diseases but the state is facing double burden of diseases.

As composite of mortality and morbidity, health expectancy has advantage over single indicators when exploring socioeconomic disparities in health. Although huge income gap between urban and rural residents has been reported in China, little research has been done in discussing the urban-rural disparities in health expectancy and the underlying causes. Based on 2006 China Disability Survey, this study used attribution tool to identify the causes of disability by individual diseases and employed Sullivan method to compute life expectancy lived with disability by diseases. Urban male have 4.08 years (female: 4.95 years) lived with disability while rural male have 4.72 years (female: 5.46 years) lived with disability. Leading diseases of presbycusis, cataract, cerebrovascular disease, osteoarthritis and unclassified injury accounted for different years of disability. Different diseases patterns of disability and health expectancy exist among urban and rural areas. Such an identification provides a support to Chinese policy for fighting against disability among elderly.