Nav: Home

Delhi's health system: Inadequate progress for a global city

January 17, 2017

Over the past decade, India has emerged as one of world's most important engines of economic growth. In the health sector, India is often associated with its accomplishments in promoting innovation in the delivery of health services and production of pharmaceuticals and drugs. At the same time, in comparison to other large middle-income nations such as Brazil, Russia and China (BRIC), India has failed to assure minimal standards of sanitation and public health. In a paper just published by the Royal Society for Public Health, Gusmano, Rodwin and Weisz document Delhi's health system exceptionalism.

In spite of recent investments in health care and public health in India's global capital city, this original research contribution finds that the capacity to leverage these investments to improve access to effective care have not been sufficient to overcome the crushing poverty and inequalities within Delhi. The Lancet reported, in 2009, that more than half of Indian households have no toilets, over 200 million people have no access to safe drinking water and WHO estimates that 900,000 people die from contaminated water and polluted air. More recently (2013), the Planning Commission reports that progress in meeting millennium development goals has been slow. In contrast to other BRIC nations, public expenditure on health care as a percent of GDP (1%), is the lowest. Total expenditure (public and private) is just 4 percent of GDP, which places India as the lowest spender. Moreover, out-of-pocket expenditure as a share of total health care spending (58%) places India as the BRIC nation that relies most heavily on patient payment at the point of consumption. Gusmano, Rodwin, and Weisz find that large and growing numbers of residents die prematurely each year due to causes that are amenable to public health and healthcare interventions.

Michael K Gusmano is associate professor at the Rutgers School of Public Health and Research Scholar at the Hastings Center, Victor Rodwin is professor at the Robert F. Wagner Graduate School of Public Service, New York University, and Daniel Weisz, MD, is research associate at the Butler Aging Institute, Columbia University. Gusmano and Rodwin, co-direct the World Cities Project, a collaborative venture of their respective institutions. More specifically, their article finds that:
  • Between 2004 and 2013, a time when the economy of India was growing rapidly, rates of premature deaths due to causes for which there are effective treatments (amenable mortality), increased by about 25% in the capital city of Delhi. The leading causes of death were septicemia and tuberculosis. Maternal mortality is well above the global level for other middle-income countries.

  • During this same time period, cities in other middle income countries, including Moscow, Sao Paulo, and Shanghai experienced a decrease in amenable mortality of at least 25%.

  • Delhi, and the rest of India, is unlikely to make substantial improvements in these outcomes unless they substantially increase public health spending, monitor health system performance, and improve government capacity to adopt policies and implement a range of programs that address the causes of extreme deprivation.

-end-
To speak with the researchers, please contact the press officer listed with this press release. Link to paper: http://www.sciencedirect.com/science/article/pii/S0033350616304449

New York University

Related Public Health Articles:

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
More Public Health News and Public Health Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...