Task

PUBLIC HEALTH - Air Pollution in Delhi

INTRODUCTION

The prevalence of Air pollution based COPD in Delhi is 10% compared to 4.6% for India (TimesofIndia 2023). 

 Inhalation of air pollutants and particulate matters based irritation of respiratory tract is responsible for causing COPD in Delhi population. 

These reasons have been increasingly associated with blockage of airways, leading to COPD prevalence and mortalities in Delhi, India.

Heavy traffic and industrial smokes are responsible for high prevalence of COPD in Delhi. 

Policies and campaigns must focus on reducing the level of air pollution in Delhi, to reduce the overall prevalence and mortality rates. 

Air pollution is defined as the presence of substances in air, harming both the environment and human beings. This pollution leads to both respiratory and cardiovascular diseases. COPD is the focused disease for the current presentation. 

IDENTIFYING AND ANALYSING PUBLIC HEALTH ISSUES

Health implications

COPD (chronic obstructive pulmonary disorder) is a lung disease associated with several implications including chronic bronchitis and emphysema (Abdulsalim et al. 2020).

The main implications of the disease are associated with breathing problems,  chances of respiratory infections, cyanosis and cardiovascular complications .

Air pollution is one of the most significant causes of COPD in Delhi, India. 

The health implications refers to health consequences, effects or the overall outcomes of a disease (COPD) on the patient health. The prevalence of COPD in India is moderately high considering the national value. 

Economic Burden of the Health issue

New Delhi is economically affected by the higher levels of air pollution resulting in COPD.

The economic loss considering India’s values due to air pollution was equivalent to $28.8 billion (Hindustan Times 2020).

The economic loss is also expressed as 1.36% of the total GDP of New Delhi, India (Economic Times 2020). 

According to the reports of  The Times of India,  COPD is an economic burden for 204 countries as well as union territories (TimesofIndia 2023). 

This disease leads to a spending of INT$4.33 trillion per year, which is equivalent to an yearly tax of 0.11 percent on global GDP.

In Delhi, the prevalence is 10%. Therefore, it is slightly higher than the nation’s prevalence, that makes the economic burden higher in Delhi too. The high prevalence due to air pollution is associated with a higher economic burden on the state too. 

ECONOMIC IMPACTS AND COST CALCULATIONS

 Potential cost savings

 A hypothetical public health program will be helpful in addressing the chosen health issue by reducing the healthcare costs spent on it. 

The Public health program will be based on reducing air pollution by shifting towards CNG (compressed natural gas) instead of burning petrol or diesel. 

These CNG shifting based public awareness programs were launched by the Delhi Government also (Krelling and Badami 2022). 

Usage of CNG gas will save both money and environment by preventing the oxidation of fossil duels and decreasing the air pollution based economic impact on Delhi.  

Since the public health programs aim at reducing the overall burden of a disease, reduction in economic burden is also observed.

Thus, for example, if the total mean cost spent on COPD by the healthcare department of India is Rs. 28,148.24 (Lakiang et al. 2018), a public health program can reduce it by 20% at least by addressing every cost sections mentioned in the previous point. 

Concept of QALY

The chosen public health program is based on Public Health Awareness for reducing COPD burden in Delhi.
The government has saved Rs. 1,298 cr in the last 6 years, by shifting to CNG usages in Delhi, thus reducing the overall economic impact due to air pollution and COPD (Business Standards 2023). 

The concept of Quality Adjusted Life Year (QALY) is based on measuring the value of health outcomes.  Since the overall health is addressed by length of life and quality of life, the concept combines both the attributes to a single number (Lakiang et al. 2018).

After assessing with QALY, it can be said that the government organized CNG shifting program not only reduced the economic impact, but also reduced air pollution levels. This reduction in pollution level further decreased the chances of COPD occurrence and therefore increased the overall quality of health in Delhi population. 

This quality of life increment later increased the life span of Delhi people. 

The evaluation can be done by analysing the reduction in healthcare costs after the program was run. The healthcare cost before running the campaign and after running the campaign will be recorded. Both will be compared and the final value of the combined QALY based attributes in both the phases will be compared. In this way the evaluation will be done. 

DEMAND, SUPPLY AND COST IMPLICATIONS

Current demand for the health intervention

According to the recent reports, the requirement and demand for health interventions against COPD is high in India (Madas et al. 2022).
According to Dutta (2023), it can be said that the largest market of CNG is in New Delhi. 

However, the numbers of CNG vehicles fell from 7294 to 5957. 

So the demand is still high, but not so high as before. 

Demands for health interventions increase with an increase in incidence of the disease. 

Supply factors

In Delhi, the price of CNG is Rs. 74.59, which is lesser than petrol of diesel. 
Thus the supply is higher than the fossil fuels.

There are more than 725 CNG stations in Delhi.
The supply is maintained by Indraprastha Gas Limited or IGL (Iglonline 2023).

Therefore, it can be said that the government has been supplying CNG at higher levels to support the campaigns towards reducing air pollution and COPD levels. 

Non pharmacological intervention based supply services are more opted for due to lack of side effects. 

Potential economic benefits of increasing or decreasing the supply service

Calculation

Current mean healthcare cost - Rs. 28,148.24 .

Estimated cost of increasing supply or intervention factors – Rs. 5000.00.

Estimated increase in mean healthcare cost –  Rs. 33144.24

Decrease in estimated prevalence of COPD leading to a massive decrease in overall healthcare cost from Rs. 33144.24. This is the mean healthcare cost that will be reduced and will lead to increase in benefits of increasing the supply service. 

Decreasing the supply services will reduce the healthcare costs, however, can cause increase in healthcare cost due to increase in COPD prevalence in India.

 

Top Nursing Samples
 

References

Abdulsalim, S., Unnikrishnan, M.K., Manu, M.K., Alsahali, S., Alrasheedy, A.A., Martin, A.P., Godman, B. and Alfadl, A.A., 2020. Impact of a clinical pharmacist intervention on medicine costs in patients with chronic obstructive pulmonary disease in India. PharmacoEconomics-open, 4, pp.331-342.
AFDC., 2023. Compressed Natural Gas Fueling Stations .Available at: https://afdc.energy.gov/fuels/natural_gas_cng_stations.html
Business Standard., 2023. Delhi collected Rs 1,298 cr in green fund; spent only one-fifth in 6 years. India News. Available at: https://www.business-standard.com/article/current-affairs/delhi-collected-rs-1-298-cr-in-green-fund-spent-only-one-fifth-in-6-years-122010200603_1.html
Dutta, S., 2023. Why CNG-run vehicles are losing flavor in Delhi-NCR. The Times of India..Available at: https://timesofindia.indiatimes.com/city/delhi/why-cng-run-vehicles-are-losing-flavour-in-delhi-ncr/articleshow/98886080.cms
Economic Times., 2020. Deaths, morbidity from air pollution led to loss of 1.4% of GDP in 2019, says scientific paper. Available att:https://economictimes.indiatimes.com/news/politics-and-nation/delhi-had-highest-per-capita-economic-loss-due-to-air-pollution-in-2019-lancet/articleshow/79863576.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst
Economic Times, 2023. CNG share in PV sales up 3X in 3 years; top OEMs strategise for market edge. Passenger Vehicle. Available at:https://auto.economictimes.indiatimes.com/news/passenger-vehicle/cng-cars-share-in-vehicle-sales-up3x-in-3-years-strategies-of-top-oems-for-market-edge/102713671
Hindustan Times., 2023. Delhi’s economy suffered the most due to severe air pollution last year: Lancet study .https://www.hindustantimes.com/environment/delhi-s-economy-suffered-the-most-due-to-severe-air-pollution-last-year/story-7C5Khh1KcVC11KCXbPgQ7J.html
Insights10 (2023). India Chronic Obstructive Pulmonary Disease (COPD) Therapeutics Market Report 2022 to 2030 (insights10.com). Available at: www.insights10.com
Krelling, C. and Badami, M.G., 2022. Cost-effectiveness analysis of compressed natural gas implementation in the public bus transit fleet in Delhi, India. Transport Policy, 115, pp.49-61.
Lakiang, T., Nair, N.S., Ramaswamy, A. and Singhal, U., 2018. Economic impact of chronic obstructive pulmonary disease: A cross-sectional study at teaching hospital in South India. Journal of Family Medicine and Primary Care, 7(5), p.1002.
Madas, S., Londhe, J., Mudliar, K., Powar, K., Dhadge, N., Gaikwad, S., Modi, M., Pawar, B., Bargaje, M., Godbole, G. and Khatavkar, P., 2022. What are the Direct and Indirect costs of COPD in India?.
Stock Market: India could face third highest economic burden of COPD from 2020-50: Lancet Study | India News - Times of India (indiatimes.com). Available at: www.timesofindia.indiatimes.com