Blueprint for an Environmental Health Monitoring System in the Emerging Megacity of Pune

Abstract

To address the challenge of double burden of disease i.e. communicable (CDs) and noncommunicable newlinediseases (NCDs) in India, the study emphasizes the need for an environmental newlinehealth monitoring system. The system will monitor risks of both CDs and NCDs that include newlinerisk factors in one s physical and social environments (which also includes behavioral newlinecharacteristics). The monitoring procedure would be followed by identification of focal newlinepoints for intervention. The intervention points can be at the micro, meso and exo levels newlinewhich implies that both immediate and non-immediate part of the environment will be taken newlineinto consideration for the interventions. newlineFor the study, information on risk factors was collected through a household survey by newlineconducting a two-stage stratified convenient sampling whereby, in the first step 3 areas were newlineselected based on differing city scape typologies. The three typologies include the city center, newlinethe neo-urban and the peri-urban parts of Pune. In the next step, from each typology one newlinehigher and one lower socio-economic group was selected. Information was collected on age, newlinegender, educational status, employment status, occupational category, mode of transport, newlinedietary habits, reporting of CDs(water borne, vector borne and acute respiratory disease) and newlineNCDs (diabetes, hypertension, cardiovascular disease, chronic respiratory disease and newlinecancer), housing, sanitation and environmental management. Risk factors of the physical newlineenvironment such as presence of areas of water pooling was collected with the help of an newlineobservational survey. It was observed, that in case of all risk factors the burden was higher in newlinethe LSGs. newlineInformation was collected for 2716 individuals. Odds ratio was calculated to find out the newlinelikelihood of an individual to report a disease on being exposed to a risk factor. Results newlineshowed that the burden of all risk factors was higher in the lower socio-economic group than newlinethe higher socio-economic group.