(7 ii) Economy: A Major Factor in Heart Diseases

The causes of death and disability across the world have shifted from nutritional deficiencies and infectious diseases to cardiovascular disease (CVD), diabetes, cancer and other degenerative diseases. CVD is the term given to disorders of heart and blood vessels. CVD cases across the globe are increasing like never before. Today, CVDs are the leading cause of death globally. 80% deaths due to CVD are recorded in low and middle income countries. This makes one wonder about the relation between CVDs and the economical condition of states. 

Interestingly, statistics show that the incidence of CVDs increase when countries move from lowest income to low-middle income. This is attributed to the lifestyle changes that follow economic development. Obesity, sedentariness, unhealthy food practices, and low physical activity are some of them. This stems from the decline in employment in the agrarian sector and the dramatic increase in the manufacturing and service-sector. But when the countries move further up to upper middle and high income economies, there has been a decline in the risks and prevalence of CVDs. Improvement in healthcare and behavioral changes of the population seem to be the potential reasons for the decline. 

While urbanization has led to the increase in CVDs, it has also equipped us better to treat them. There have been promising technological advancements in the treatment of CVDs. Interdisciplinary collaboration has led to novel therapeutic strategies. Stem cells, nanotechnology, robotic surgery, 3-D printing and advancements in drugs are some examples. Awareness about heart health has also increased relatively. Food marketing has seen a significant shift to focus more on the nutritional value, particularly regarding heart health.        

Still a staggering number of CVD deaths

Healthcare might be reaching its peaks through research and technological advancement, but the question is, ‘is it accessible enough?’. The lowest socioeconomic sections have been the most affected by CVDs in any economy. The unaffordability or more often the inaccessibility and the lack of awareness cuts the right to decent healthcare for the poorest of any country. Who can fill this gap between healthcare and poverty? The policymakers? The Government?

Policy makers play a vital role in shaping the public health policy of the country. The health infrastructure needs to meet the essential standards even in the remotest part of a country. For FY 2023, India has allocated 88,956 crore rupees for the healthcare budget. There is a dire need to use these resources to ensure access to affordable and quality healthcare to the geographically remote and economically backward states. Such states are also accompanied by lack of awareness about essential health interventions and diseases that could be fatal if left undiagnosed. Though awareness about conditions like HIV has increased over years among the lowest socioeconomic communities, awareness about lifestyle induced conditions like CVDs is poor.

Being the highest populated country with geographical extremities, India faces challenges in ensuring equitable access to healthcare. But, there have been effective government initiatives such as the mid-day meal scheme providing afternoon meals to government school children, Pradhan Mantri Jan Arogya Yojana, the world’s largest health assurance scheme, et cetera. In 2022, Mukhya Mantri Swasthya Sarvekshan Yojna (MMSSY) was launched in Haryana to facilitate door-to-door health check-ups at free of cost to families across the state. India's public health policy has majorly focussed on health assurance. There needs to be greater importance given to health check-ups for the early diagnosis of conditions like CVDs. Schemes like the MMSSY need to be implemented across the country.