Urban Primary Health Care

Step

Activity

Response

Step 1

· Identify a specific urban area in the developing world.

· Identify one specific public health or health-related problem facing that urban area.

· Explain why this is a public health problem.

· Support your choice with reference to at least one article

New Delhi is an urban district of Delhi, which serves as the capital of India. According to the New Delhi Municipal Council (NDMC), the city population is at 257,803 with a district population of 142,004 while the metropolitan area has a populous of 26,454,000 making it one of the most populated urban areas in the world. The urban area has three main slums namely Kirti Nagar, Munnirka and Kusumpur. The poor infrastructure, food security and poor healthcare makes the area prone to public health problems. Diabetes type 2 (hereafter ‘diabetes’) is one of the major health problem among elderly persons in New Delhi. Approximately, 42.5% of the populous suffer from diabetes. The figures is a rough representation of almost half of the urban population. This also based on the information provided by 58.8% of doctors that have studied the urban area (Wells et al, 2016). Aside from the lifestyle prevalent, food security is one of the major factors behind the situation; Indians known to consume meals with high cholesterol, carbohydrates and sugars, escalating health concerns.

Diabetes is a public health problem in the urban area based on the negative implications that it has on the daily activities of the residents. They are less productive based on the inability to work properly because of their health conditions. Researches indicates that the number of deaths of diabetes have increased to 50% over the past 11 years in the urban area. In 2015, 346,000 died from diabetes (Wells et al, 2016). The figures give an indication that diabetes is a key health concern in the country.

References

Wells, J. C., Pomeroy, E., Walimbe, S. R., Popkin, B. M., & Yajnik, C. S. (2016). The elevated susceptibility to diabetes in India: an evolutionary perspective. Frontiers in public health, 4, 145. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935697/

American Diabetes Association. (2017). 2. Classification and diagnosis of diabetes. Diabetes care, 40(Supplement 1), S11-S24.

https://care.diabetesjournals.org/content/40/Supplement_1/S11

Step 2

· Determine the magnitude of the problem

· Describe those affected

· Support your information with reference to at least one article

Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease (Australas, 2014). Thus, rising number of diabetic citizens in New Delhi has overwhelmed the country’s healthcare system. In 1990 alone the number of deaths from diabetes was at 115,000, however, the numbers have increased to 346,000 by 2015 (Mithal, ansal & Kalra, 2015). This shows more than 50% increase in the number diabetic individuals over the past decade. The country’s health care facilities are not fully developed and with rising cases of hospitalization; so there is a need for other intervention techniques.

New Delhi has approximately 43% of the population that affected with the ailment (Mithal, ansal & Kalra, 2015). Additionally, it’s expected that the cases to be reported of diabetic citizens in the country will rise to 79 million by 2030. The increasing proportion of elderly persons is contributing to an increase in the prevalence of diabetes. Elderly persons living in urban slums are more vulnerable to various non-communicable diseases and their complications due to lack of basic amenities, poor health-seeking behavior and stress due to lack of social support, tobacco consumption and sedentary lifestyles. Apart from the conventional risk factors propelled by urbanization, industrialization, globalization and aging, other factors may also contribute. It has been proposed that obesity, regional adiposity, higher percentage body fat, early life influences including fetal programming and genetic factors contribute to increased risk. Indians tend to have more body fat and a higher risk of diabetes for the same BMI as compared to western populations.

References

Australas Med J. 2014; 7(1): 45–48. Published online 2014 Jan 31. doi: 10.4066/AMJ.2013.1979 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920109/#R01

Mithal, A., Bansal, B., & Kalra, S. (2015). Gestational diabetes in India: Science and society. Indian journal of endocrinology and metabolism, 19(6), 701. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673797/

Step 3

· Explore the social, physical and other determinants of the problem

· Support your analysis with reference to at least one article

Step 4

· Discuss at least two alternate solutions, their strengths and weaknesses

· Support your choices with reference to at least one article

Step 5

· Recommend one solution and defend your choice

· Support your analysis with reference to at least one article

Assignment

Items in Assignment

Highest possible score

Score

Step 1

Identify a specific urban area in the developing world

3

3

Identify one specific public health or health-related problem facing that urban area

3

3

Explain why this is a public health problem

6

4

Reference quoted information. Support your choice/analysis with at least one reference

3

3

Total for Step 1

15

13

Step 2

Determine the magnitude of the problem

6

6

Describe those affected

6

4

Reference quoted information. Support your choice/analysis with at least one reference

3

2

Total for Step 2

15

12

Step 3

Explore the social determinants of the problem

6

Explore the physical and other determinants of the problem

6

Reference quoted information. Support your choice/analysis with at least one reference

3

Total for Step 3

15

Step 4

Discuss at least two alternate solutions

6

Compare their strengths and weaknesses

6

Reference quoted information. Support your choice/analysis with at least one reference

3

Total for Step 4

15

Step 5

Recommend one solution and defend your choice

12

Reference quoted information. Support your choice/analysis with at least one reference

3

Total for Step 5

15

Grand Total

75