Land use laws key to health, well-being of Indians, says Lancet

C Shivakumar @ CHENNAI:

Radical changes are required in the India’s laws pertaining to built-in environments, roads and transport systems including public transport for active living and physical activity in daily living, according to Lancet Obesity Commission Report- India perspective.

The report by Dr Shifalika Goenka – Commissioner on the Lancet Obesity Commission states that built environment and land use laws have a profound impact on health and wellbeing and need urgent attention in India.

“This should become a mandatory requirement

through legislation. Health considerations should become the basis of thinking of laws related to road design, pavements and pedestrian pathways, urban design and built  environment, green areas available to the public, agriculture zoning, land use and built up- area including FSI,” the report adds.

This comes after Lancet Commission, a three-year project by 43 experts from a broad range of expertise from 14 countries, stated that powerful vested interests, misplaced economic incentives are major drivers of joint pandemics of obesity, undernutrition and climate change.

Terming the global interplay of obesity, undernutrition and climate change as ‘The Global; Syndemic’, Lancet Commission says that it is driven by food and agriculture policies, transportation, urban design and land use systems that promote overconsumption and inequalities.

Calling for establishing of Framework Convention on Food Systems similar to global conventions for tobacco control and climate change to restrict influence of food industry in policy making, the report by the commission states that supporting active transportation through infrastructure, taxes and subsidy shifts and social marketing strategies will lead to increased physical activity and less sedentary time, with an impact on obesity prevention, cheaper transport access to healthy food and employment, potentially reducing poverty and undernutrition and lower green house gas emissions from transportation.

The report calls for fostering active transportation through contextually relevant interventions towards pedestrian, safety and comfort should become a mandatory requirement across

Departments in India.

“Pedestrian prioritization over motorised transport which ensures safety from accidents is urgently required. Some of the India specific measures urgently required are -- wide pedestrian paths, preferably as wide as the width of the road on either side are required. These should be well maintained and free of encroachments. The width of the motor-carriageways (roads for motorized

transport) should not exceed 2 car lanes on each side,” the report stated.

“Anything more than two car lanes within a city or town, is threatening to pedestrians and also becomes difficult to cross on foot,” the report added.

The report also states that worksite and buildings construction should make stairwells as the centre in planning rather than escalators. “Attention to the quality of the staircases and possible sites of

physical activity, making buildings disabled friendly is an understood mandate which synchronizes with ours,” the report added. The report also suggested encouragement of indigenous drinks with large scale training for hygiene and use of “potable water” with regular quality checks is required.

Factfile:

--- 38pc of the children under 5 are stunted (too short for their age an indicator of chronic undernutrition); 21% are wasted (too thin for their height; acute under nutrition); and 36% are underweight and 58% are anaemic.

--- The prevalence of diabetes has increased in every state since 1990 to 2016. The number of people with diabetes in India increased from 26·0 million in 1990 to 65 in 2016. The most important

risk factor for diabetes is overweight to which 36% of the diabetes related burden could be attributed. --- The prevalence of overweight in adults in India increased from 9pc in 1990 to 20·4% in 2016

--- 650m Indians will be affected by climate change leading to high heat and precipitation which is going to have a major dent on agriculture, production, and overall productivity and heat related morbidity.

--- In the absence of a major climate mitigation, nearly 148 million Indians will be living in

these severe hotspots in 2050