Urban Health Crisis and Heart Disease in India

The Union Ministry of Housing and Urban Affairs (MoHUA) marked World Habitat Day 2025 in New Delhi with the theme ‘Urban Solutions to Crisis’. The event brought into light urban development schemes like the Pradhan Mantri Awas Yojana-Urban (PMAY-U) and the Smart Cities Mission. However, a pressing yet less visible crisis shadows India’s urban growth — a surge in cardiovascular diseases and diabetes. These ailments are now leading causes of death in cities, with rates almost double those in rural areas and affecting younger populations increasingly.

Rising Urban Health Challenges

Urban lifestyles have intensified health risks. Long commutes, polluted air, shrinking green spaces and rising stress contribute to heart disease and diabetes. Access to healthcare remains uneven. Hospitals cluster in affluent areas, leaving many urban zones underserved. Profit-driven healthcare distribution ignores medical need, worsening inequities.

Fragmented Urban Planning and Its Impact

India’s urban planning often operates in silos. Transport, housing, green spaces and health are planned separately. This fragmentation promotes car dependence, fast-food consumption and pollution. These factors compound sedentary lifestyles and poor diets, increasing cardiovascular risks. Integrated planning can reduce these harms by creating compact, mixed-use neighbourhoods that cut commute times and encourage active living.

Health-Centred Urban Planning Strategies

Key urban design elements can improve heart health. Walkability with safe footpaths and cycle lanes promotes physical activity. Green infrastructure like parks and urban forests cool cities and improve air quality. Mixed land use reduces reliance on private vehicles. Affordable, clean public transport lowers emissions and sedentary travel. Healthy food ecosystems with local markets and junk food restrictions support better diets. These measures together encourage healthier urban environments.

Invisible Urban Threats to Cardiovascular Health

Fine particulate matter (PM2.5) from traffic and industry triggers heart attacks and strokes. Concrete-heavy urban layouts trap heat, increasing cardiovascular stress. Poor water and waste management worsen metabolic disorders. Without intervention, Asia could face a 91% rise in cardiovascular deaths by 2050. Digital tools like AI-enabled air quality sensors and heat mapping can reveal these hidden risks and guide responses.

Equity in Urban Health Planning

Low-income urban populations suffer the worst health burdens. Pollution, poor connectivity, limited green spaces and scarce healthcare hit marginalised groups hardest. A 2.3-fold rise in cardiovascular disease among these communities has been reported. Urban health projects must avoid green gentrification that displaces vulnerable residents. Equity audits and community participation are essential to ensure inclusive health benefits and build trust.

Future Directions for Healthy Cities

India’s cities face a critical choice. Unplanned growth may lock in unhealthy patterns. Health-centred urban planning can transform cities into resilient spaces. Initiatives like the National Urban Health Mission (NUHM) and the Asian Development Bank’s $10 billion urban investment plan provide frameworks. Collaboration among government, health agencies, academia and civil society can align urban development with health outcomes. Engaging youth and updating urban planning education will nurture future-ready, health-conscious cities.

Questions for UPSC:

1. Taking example of India’s urban health crisis, discuss the role of integrated urban planning in promoting public health and reducing non-communicable diseases.
2. Examine the impact of air pollution and urban heat islands on cardiovascular health. How can digital technologies aid in mitigating these risks?
3. Analyse the challenges of healthcare accessibility in urban India and discuss strategies to ensure equitable health services for marginalised populations.
4. Critically discuss the relationship between urbanisation, lifestyle changes and the rise of chronic diseases in developing countries with suitable examples.

Answer Hints:

1. Taking example of India’s urban health crisis, discuss the role of integrated urban planning in promoting public health and reducing non-communicable diseases.

1. Fragmented planning leads to car dependence, pollution, unhealthy diets, and sedentary lifestyles increasing NCD risks.
2. Integrated planning combines land use, transport, housing, and green spaces to promote active living and reduce emissions.
3. Compact, mixed-use neighbourhoods shorten commutes, encourage walking/cycling, and improve air quality.
4. Incorporation of green infrastructure (parks, urban forests) lowers heat stress and filters pollutants linked to heart disease.
5. Public transport accessibility reduces sedentary travel time and emissions, supporting cardiovascular health.
6. Health-centred governance, as advocated by WHO’s Healthy Cities Network, lowers chronic disease prevalence through evidence-based urban design.

2. Examine the impact of air pollution and urban heat islands on cardiovascular health. How can digital technologies aid in mitigating these risks?

1. Fine particulate matter (PM2.5) from vehicles and industry triggers heart attacks, strokes, and worsens metabolic disorders.
2. Concrete-heavy urban layouts trap heat, increasing cardiovascular stress and related mortality.
3. Urban heat islands exacerbate heat stress, compounding risks for vulnerable populations.
4. AI-enabled air quality sensors and heat-mapping tools provide real-time data to identify pollution and heat hotspots.
5. Digital citizen-reporting apps increase community engagement and responsiveness in urban health management.
6. Integration of digital tools into urban planning enables targeted interventions and monitoring of environmental health risks.

3. Analyse the challenges of healthcare accessibility in urban India and discuss strategies to ensure equitable health services for marginalised populations.

1. Healthcare distribution is profit-driven, clustering hospitals in affluent areas and neglecting underserved zones.
2. Marginalised groups face higher cardiovascular disease burden (2.3-fold increase) due to poor access and living conditions.
3. Urban health inequities are worsened by pollution, poor connectivity, and limited green spaces in low-income areas.
4. Equity audits and community participation prevent green gentrification and ensure inclusive planning.
5. Strengthening outreach through National Urban Health Mission (NUHM) and integrating health into urban governance improves access.
6. Policies promoting affordable public transport and local health infrastructure enhance service reach to vulnerable populations.

4. Critically discuss the relationship between urbanisation, lifestyle changes and the rise of chronic diseases in developing countries with suitable examples.

1. Rapid urbanisation leads to sedentary lifestyles due to long commutes and car dependence, increasing obesity and NCDs.
2. Urban diets shift towards processed, fast foods, contributing to diabetes and cardiovascular diseases.
3. Pollution and shrinking green spaces elevate stress and metabolic disorders, worsening health outcomes.
4. Examples – India’s urban areas show double the cardiovascular disease rates compared to rural; childhood obesity rising in Chennai due to lack of active mobility.
5. Fragmented urban planning exacerbates health risks by ignoring integrated solutions across sectors.
6. Health-centred urban policies and investments (e.g., Smart Cities Mission, NUHM) are essential to reverse trends and promote resilience.