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Environmental Health Monitoring for India: An Emerging Nation

To address the issue of the double burden of disease in India, which includes morbidity from communicable and non-communicable diseases (CDs and NCDs), this study has drawn a framework for an environmental health monitoring system. This system will monitor health risks of both the physical and social environments. 1451 individuals from lower and 1274 from higher socio-economic groups from Pune city were interviewed. Data on self-reported morbidity of CDs (water borne, vector borne and acute respiratory diseases) and NCDs (diabetes, hypertension, cardiovascular, chronic respiratory disease and cancer) were collected. Information on risk factors related to one’s socio-economic characteristics (individual attributes like age, education, risk habits e.g. tobacco chewing, diet, mode of transport and employment status) and those present in one’s physical environment (presence or absence of a community sanitation, water pooling habitats) were gathered with the help of a questionnaire and an observational form respectively. Relative risk was calculated to detect the presence of any kind of association between the disease reported and it’s a risk factor. An ecological approach towards monitoring of both these kinds of risk factors is suggested, as elimination of these from the individual as well as from the environment is complex (as revealed from the lack of association between certain well established risk factors with the disease that they are known to cause). Acknowledgement of not only the dynamic relationship between humans and their environments but also differentiation of this relationship into different levels are pre-conditions to focused and effective interventions.