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Loss of green space in India shown to be associated with higher cardiometabolic risk


Loss of green space due to urban development may be associated with an increase in several cardiometabolic risk factors, according to a study conducted by the Barcelona Institute for Global Health (ISGlobal). 

The study investigated the association between land-use changes in a periurban area south of Telangana state capital Hyderabad where urbanisation – involving the conversion of natural to built-up land – was found to have possible links to cardiometabolic risk factors. It did so by examining health data from over 6,000 adults and the changes in land use over a fourteen-year period across an area of 700km2. 

The findings, published in Environmental Health Perspectives, showed that a fast increase in built-up land use within 300m of a person’s residence was associated with an increase in cardiometabolic risk factors such as hypertension, obesity, and hyperglycaemia. ISGlobal researcher Cathryn Tonne, who led the study, said: “The findings of this study support the need to integrate health into urban planning to reduce the negative health impacts of urbanisation, especially in cities or neighbourhoods that are undergoing rapid land-use changes.”

The study is one of the first to analyse the relationship between urban development and health in a low or middle-income country, building on a growing body of evidence that shows the health benefits of green space. These positive effects include a reduction in stress, improved mental health, and lower risk of cardiovascular disease, metabolic syndrome, and premature death

A previous study by ISGlobal linked urban green space to a reduction in premature deaths and an ability to promote health. Speaking on the necessity for these areas, Mark Nieuwenhuijsen, director of the Urban Planning, Environment and Health Initiative at ISGlobal, said: “Urban greening programmes are not only key to promoting public health, but they also increase biodiversity and mitigate the impacts of climate change, making our cities more sustainable and livable.”

Cardiometabolic disease prevalence in India 

The importance of recognising the correlated risk between cardiometabolic risk factors and the loss of green space is underlined by an understanding that over thirty million people have now been diagnosed with diabetes in India as of 2019. However, the estimated actual number of diabetics in India may be around 40 million. India’s diabetes crisis is a growing one. As previously noted by Health Issues India, “by 2045, the number of diabetes cases in the Southeast Asia region will increase to 151 million compared to 82 million at present according to the International Diabetes Federation. 

“India will see 98.0 million cases of type-2 diabetes alone by 2030 according to some estimates with some estimates anticipating an overall total of 134 million diabetes cases by just 2025 – such numbers reflecting India being a driver of the southeast Asia region’s growing diabetes crisis. The disease is one of the fastest-growing conditions in the country.”

The crude prevalence rate (CPR) in the urban areas of India is thought to be nine percent, compared to rural areas where it sits at approximately three percent. With a population of more than 1.3 billion, these statistics mean that India actually has the highest number of diabetics of any one country in the entire world. 

“The remarkably high lifetime risk of developing diabetes and the low diabetes-free life expectancy in urban India, especially for individuals with high BMI (body mass index), implies that interventions targeting the incidence of diabetes may be of paramount importance moving forward,” states “Lifetime risk of diabetes in metropolitan cities in India”, an article published in Diabetologia

To date, potential effective interventions have included high and sustained sugar-sweetened beverage taxation, and diabetes prevention programmes involving a combination of culturally tailored lifestyle interventions. Integrating methods that consider the value of rural areas may become part of cardiometabolic risk prevention in the future, particularly in a country that displays such a need for intervention.

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