Urban health and wellbeing

Advances in Geographical and Environmental Sciences

Aakriti Grover

R. B. Singh

Urban

Health and

Wellbeing

Indian Case Studies

Advances in Geographical and

Environmental Sciences

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R. B. Singh, University of Delhi, Delhi, India

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Aakriti Grover • R. B. Singh

Urban Health and Wellbeing

Indian Case Studies

123

Aakriti Grover

Department of Geography

School of Earth Sciences

Central University of Tamil Nadu

Thiruvarur, Tamil Nadu, India

R. B. Singh

Department of Geography

Delhi School of Economics

University of Delhi

Delhi, India

ISSN 2198-3542 ISSN 2198-3550 (electronic)

Advances in Geographical and Environmental Sciences

ISBN 978-981-13-6670-3 ISBN 978-981-13-6671-0 (eBook)

https://doi.org/10.1007/978-981-13-6671-0

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Preface

Human health is an outcome of complete physical, mental and social wellbeing; it is

not just the absence of disease. Therefore, health is a multi-dimensional concept,

which involves the physical, mental and social sphere of human life. Urban envi￾ronment has distinct natural, built and institutional elements that determine the

physical, mental and social health and wellbeing of people, living in cities, towns

and urban areas. Urban health, therefore, refers to the study of health of urban

population and its underlined basic causes including physical and environmental

and social factors. Wellbeing is a broader concept that helps meeting the basic

needs and further leads to satisfaction level of individuals and communities in

society, and an important determinant of wellbeing is good physical health together

with mental and social health.

Urban environment encompasses both physical and social environment in urban

areas. The urban environment has direct and indirect bearing on human health. The

direct influences are ones that influence human health regardless of behaviour, e.g.

the impact of environmental pollution on human health. The indirect influences

include the choices one makes, personal behaviour like lifestyle and eating habits.

In the present research, the focus is on the impact of physical environment on

health and finally wellbeing in urban areas. In the present analysis, land use and

land cover (LULC) and air quality changes have been taken as a proxy to under￾stand changing urban environment. LULC change is the modifications in existing

LULC, wherein there is transformation of natural environment into built environ￾ment. As a result, the nature and composition of surface characteristics change

leading to microclimatic changes. The pervious soil and vegetation surfaces (grass,

thatch roofs, dry soil and sand) are substituted by impervious urban built up

materials like concrete, metal, steel, stone, tiles and asphalt. The expanding

impervious surfaces, dense urban geometry, increased greenhouse gases’ (GHGs)

emissions intensify the temperature of urban areas. The comparative increase of

land surface temperature (LST) in core of urban area to the periphery is called

Urban Heat Island (UHI). The creation and intensity of UHI are dependent on

various natural and human factors like geographical location, climate, local

weather, time, city geometry, air pollution, energy, LULC and city size.

v

The comparative study between Delhi and Mumbai on changing health and

wellbeing in response to changing urban environment has showcased the paradox

of urban development in the two megacities of India. The deterministic approach

that environment is supreme cannot be totally neglected for the fact remains that

there exists intrinsic relationship between human beings and environment.

However, the degree of environmental influence is often mediated by technological

growth. The present research findings assert this undeniable fact that changing

urban environment influences human health and wellbeing, and therefore, inno￾vative pathways should be created for sustainable and healthy urban growth.

The study is broadly organized into nine chapters. Chapter 1 presents the evo￾lution of concept of health, medical geography and geography of health. It also

briefs about the measures, indicators and agencies promoting health. Further, an

overview of health in India is discussed. Chapter 2 conceptualizes the research

problem, linking changes in urban environment and human health. All major

concepts related to study have been properly defined. Further, it deals with brief

description of study area, detailed literature review about LULC, air pollution and

health, LST, urban microclimate (UMC), research questions, objectives, brief

description of methodology of each objective. Chapter 3 deals with detailed

description of study area, i.e. megacities of Delhi and Mumbai. It discusses the

geographical locations of cities, early history of cultural evolution, physiography

including elevation and slope, drainage and water resources, climatic conditions,

status of forests and vegetation cover, population trends, density, literacy and sex

ratio, age–sex composition, poverty, transport network and vehicles growth, pop￾ulation health status, growth of industries, brief description of land use and envi￾ronment, natural and human-made disasters and hazards, slums, etc. Chapter 4

discusses in detail the LULC and population change as factors of urban environ￾ment of Delhi and Mumbai. LULC change and air quality change are considered as

the indicators of urban environmental change in Mumbai and Delhi. LULC change

has been studied using Landsat satellite images, while the air quality change has

been studied based on the data collected from CPCB and MPCB. Extensive

fieldwork has also been done in order to cross-verify the results. Chapter 5 deals

with the assessment of land surface temperature, UHI and UMC using Landsat

satellite data. NDVI and NDBI have also been assessed as the predictor and factor

of urban microclimate. NDVI indicates vegetation health, and NDBI indicates built

up density (concrete surface). Chapter 6 focuses on urban health risk in Delhi and

Mumbai. Impact of air pollution on human health has been particularly dealt with

empirical evidences. Data related to deaths caused by different disease including

circulatory and respiratory system has been collected from various governmental

sources. The extensive fieldwork was also done for understanding the disease

pattern across pollution strata (occupation, gender, age, income, etc.). Further, the

incomewise analysis of mortality caused by different disease related to air pollution

was studied. Also, agewise analysis of deaths has been presented for Delhi. Chapter

7 deals with reviews of governmental plans and policies regarding the human

health, environment including air pollution, transport and land use, etc. Further, it

vi Preface

presents strategic plan for urban health and wellbeing for Indian megacities, i.e.

Delhi and Mumbai, which can be further applied to other cities for sustain urban

development of Indian cities. Chapter 8 summarizes the plans, policies, pro￾grammes, legislations, laws and international efforts for promotion of good health

and wellbeing, and the last chapter compiles the appendices.

Thiruvarur, India Aakriti Grover

Delhi, India R. B. Singh

Preface vii

Acknowledgements

It gives us immense pleasure to express our gratitude to all those who contributed in

their own ways for the successful completion of this book. We are thankful to each

soul that has come across all through the journey.

We are obliged to the Central University of Tamil Nadu (CUTN) fraternity for

their kind support. Our sincere thanks to Vice Chancellor Prof. A. P. Dash,

Registrar Dr. S. Bhuvaneshwari, Dean of School of Earth Sciences—

Prof. Sulochana Shekher and colleagues of CUTN. We are also grateful to all the

faculty members of the Department of Geography, Delhi School of Economics,

who have been a source of inspiration and motivation, especially

Prof. H. Ramachandran, Prof. S. C. Rai, Dr. Anindita Datta, Dr. Subhash Anand,

Dr. B. W. Pandey, Dr. Pankaj Kumar and Dr. N. Sahu. We appreciate valuable

suggestions of Prof. S. K. Agarwal, Dr. B. Khan, Dr. Ashis Saha, Dr. Aparajita De,

Dr. Kiran Bhairannavar, Dr. Anjan Sen and Dr. Praveen K. Pathak.

The learned authors’ contributions are the guiding light and the temples of

learning, i.e. libraries connect the ecosystems of learning from all across the world.

We are deeply grateful to the library staff of Central University of Tamil Nadu;

Dr. Lokesh Sharma (Retired Librarian) and his team at the Ratan Tata Library for

creating conducive spaces for authors. The library staffs of Indian Institute of

Technology—Bombay, International Institute of Population Science, Central

Pollution Control Board and Teenmurti Bhawan Library have been generous in

sharing the resources for the present research. We are grateful to each one of them.

The foundation and base of the research is sound dataset. We are obliged to

Dr. D. D. Basu, Retired Scientist, CSE; Dr. Padmaja S. Keskar and

Mrs. Pranita M. Tipre, Health Department, Brihanmumbai Municipal Corporation;

Dr. Sanjeev Agarwal and Dr. Sangeeta, Central Pollution Control Board;

Prof. D. Parthasarathy, Indian Institute of Technology—Bombay; and all the

interviewees for their kind assistance and patience. The research group led by

Prof. R. B. Singh has been supportive throughout. We are indebted to Dr. Ajay

Kumar for their guidance and timely assistance for the technical support. We are

ix

thankful to Dr. Chintan Chaudhary, Consultant at Safdarjung Hospital, and

Dr. P. Ram, Jaslok Hospital, for fruitful discussions.

This piece of work could not have been possible without our family, and we are

particularly indebted to all.

x Acknowledgements

Contents

1 Urban Health and Wellbeing: Emerging Trans-disciplinary

Stream ............................................... 1

1.1 Introduction ....................................... 1

1.2 The Value of Health ................................. 2

1.3 Definition and Concept of Health ....................... 2

1.3.1 Traditional Medical/Biostatistical Concept ............ 3

1.3.2 The Concept of Health Given by WHO ............. 3

1.3.3 The Ecological Concept of Health ................. 5

1.3.4 The Holistic or Normative Concept of Health ......... 6

1.3.5 Potential Alternative Universal Concepts of Health ..... 6

1.4 Approaches to Geography of Health ..................... 8

1.5 From Medical to Health Geography ...................... 10

1.5.1 Medical Geography ............................ 10

1.5.2 Evolution ................................... 11

1.5.3 Health Geography ............................. 12

1.6 Measures and Indicators of Health ....................... 14

1.7 Contribution of Other Disciplines in Geography of Health

and Medical Geography .............................. 15

1.8 National and International Institutional Mechanisms .......... 17

1.9 Overview of Health in India ........................... 23

1.9.1 Effect of Air Pollution on Health in India ............ 25

1.10 Concluding Remarks................................. 29

References ............................................. 29

2 Research Background .................................... 33

2.1 Introduction ....................................... 33

2.2 Conceptual Framework ............................... 34

2.3 Literature Review ................................... 38

xi

2.3.1 Urban Environmental Change ..................... 38

2.3.2 Urban Heat Island ............................. 40

2.3.3 Impact of Changing Urban Environment on Urban

Health ...................................... 46

2.4 Study Area ........................................ 50

2.4.1 Urban Environment of Delhi ..................... 50

2.4.2 Urban Environment of Mumbai ................... 51

2.5 Research Questions.................................. 52

2.6 Objectives ........................................ 52

2.7 Data Collection and Methodology ....................... 52

2.8 Limitations ........................................ 56

References ............................................. 56

3 Geographical Background: Delhi and Mumbai ................. 63

3.1 Introduction ....................................... 63

3.2 Geographical Location ............................... 64

3.3 Early History and Cultural Evolution ..................... 67

3.4 Physiography ...................................... 71

3.5 Drainage and Water Resources ......................... 74

3.6 Climate .......................................... 77

3.7 Natural Resources................................... 78

3.7.1 Forest and Tree Cover .......................... 78

3.7.2 Energy Resources ............................. 82

3.8 Demography ....................................... 82

3.9 Transport Network and Vehicular Traffic .................. 88

3.10 Health ........................................... 93

3.11 Industrial Growth ................................... 94

3.12 Air Quality ........................................ 95

3.13 Hazards and Disasters ................................ 96

3.14 Squatter Settlements and Slums ......................... 97

3.15 Concluding Remarks................................. 98

References ............................................. 99

4 Changing Urban Environment in Megacities .................. 103

4.1 Introduction ....................................... 103

4.2 Driving Forces of Urban Environmental Change ............. 106

4.2.1 LULC Change and Population Change .............. 106

4.2.2 Vehicular Growth ............................. 108

4.3 Data Sources ...................................... 111

4.3.1 Datasets Used in LULC Classification ............... 111

4.3.2 Data Sources of Air Pollution ..................... 113

4.4 Methodology ...................................... 117

4.4.1 Pre-processing of Images for Land Use/Cover

Classification ................................. 117

xii Contents

4.4.2 Land Use/Cover Classification, Mapping

and Change Detection .......................... 119

4.4.3 Post-classification Processing ..................... 120

4.4.4 Analysis and Quantification of Differences in LULC .... 120

4.4.5 Estimation of Trends of Air Pollution ............... 120

4.5 Results and Discussion ............................... 121

4.5.1 Land Use/Cover Change in Delhi and Mumbai ........ 121

4.5.2 Status of Air Quality Change in Delhi and Mumbai ..... 135

4.5.3 Status of Air Quality Change in Mumbai ............ 142

4.6 Concluding Remarks................................. 145

References ............................................. 146

5 Urban Microclimates .................................... 151

5.1 Introduction ....................................... 151

5.1.1 Urban Environment ............................ 153

5.1.2 Urban Heat Island ............................. 153

5.1.3 Factors Affecting UHI and LST ................... 154

5.1.4 Inter-Relationship Between LST, NDVI and NDBI ..... 158

5.1.5 UHI Studies in India ........................... 159

5.2 Data Sources ...................................... 159

5.3 Methodology ...................................... 160

5.3.1 Image Pre-processing ........................... 160

5.3.2 Relative Radiometric Correction (RRC).............. 161

5.3.3 Estimation of NDVI ............................ 161

5.3.4 Estimation of NDBI ............................ 162

5.3.5 Estimation of LST ............................. 162

5.4 Results and Discussion ............................... 164

5.4.1 Spatial Patterns and Trends of LST and UHI

in Delhi..................................... 164

5.4.2 Spatial Patterns and Trends of LST, NDVI

and NDBI in Delhi ............................ 166

5.4.3 Relationship Between LULC, LST, NDVI

and NDBI in Delhi ............................ 168

5.4.4 Spatial Patterns and Trends of LST and UHI

in Mumbai .................................. 170

5.4.5 Spatial Patterns and Trends of LST, NDVI

and NDBI in Mumbai .......................... 170

5.4.6 Relationship Between LULC, LST, NDVI

and NDBI in Mumbai .......................... 172

5.5 Concluding Remarks................................. 174

References ............................................. 175

Contents xiii

6 Urban Health Risk Analysis ............................... 179

6.1 Introduction ....................................... 179

6.2 Data Sources and Methodology ......................... 182

6.3 Results and Discussion ............................... 185

6.3.1 Impact of Air Pollution on Mortality in India ......... 187

6.3.2 Temporal Analysis of Mortality from Circulatory

and Respiratory System in Delhi................... 188

6.3.3 People’s Perception on Urban Environment

and Health of Delhi and Mumbai .................. 208

6.4 Concluding Remarks................................. 214

References ............................................. 214

7 Strategic Plan for Urban Health and Wellbeing for the Indian

Megacities ............................................. 219

7.1 Introduction ....................................... 219

7.2 Existing Plans and Policy for Health and Wellbeing

in Changing Urban Environment ........................ 220

7.2.1 International Level ............................. 220

7.2.2 National Level ................................ 222

7.2.3 Delhi....................................... 223

7.2.4 Mumbai .................................... 226

7.3 Lacuna in Existing Policies and Plans .................... 227

7.3.1 Land Use/Cover............................... 227

7.3.2 Air Quality .................................. 227

7.3.3 Urban Heat Island ............................. 229

7.3.4 Health ...................................... 230

7.4 Systems Approach and Sustainable Urban Environment ....... 232

7.4.1 Air Quality .................................. 233

7.4.2 Land Use/Cover and Urban Heat Island ............. 238

7.4.3 Health ...................................... 240

7.5 Strategic Planning for Delhi and Mumbai.................. 242

7.5.1 Concluding Remarks ........................... 244

References ............................................. 247

8 Health Policy, Programmes and Initiatives .................... 251

8.1 Introduction ....................................... 251

8.2 Health Sector in India—Structure, Roles and Functions ....... 253

8.2.1 Role of Government of India in Preservation

and Promotion of Public Health: Health Missions,

Five Year Plans and National Health Policies ......... 254

8.2.2 Historical Evolution of Health Policies, Plans

and Programmes in India ........................ 255

xiv Contents

8.3 Constitutional Provisions: Acts and Statues in India .......... 257

8.4 Role of Judiciary ................................... 261

8.4.1 Some Important Legislation Related to Health ......... 261

8.5 Ministries Related to Improving Health ................... 262

8.6 International Treaties and Conventions Ratified by India ....... 263

8.7 Concluding Remarks................................. 264

References ............................................. 265

Appendix ................................................... 267

Contents xv