Syllabus
GS Paper 2 – Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Context
An unhealthy lifestyle and the influence of globalisation are silently shaping a major global health issue.
Source
The Hindu| Editorial dated 14th November 2024
The CKM syndrome as the price of modernity
Cardiovascular Kidney Metabolic (CKM) syndrome is an emerging global health crisis with a complex interplay of factors like lifestyle changes and the impact of globalisation on health. This syndrome is marked by a progressive escalation from weight gain to conditions like obesity, diabetes, hypertension, and kidney disease, ultimately leading to premature death.
Addressing CKM requires a holistic public health strategy, given its growing burden on health systems, economies, and communities worldwide.
The Growing Burden of Non-Communicable Diseases (NCDs)
- Prevalence of NCDs: Non-communicable diseases now account for 69% of premature deaths and 68% of years lost to disability globally, with CKM syndrome as a key contributor.
- Obesity and Diabetes Epidemic: National data reveal that 16.1% of people have diabetes, while obesity affects approximately 40.3% of the population.
- Hypertension Management: Over 24% of men and 21% of women have hypertension, but less than a quarter achieve target blood pressure control.
- Low Awareness and Glycemic Control: Poor awareness and inadequate management of diabetes and hypertension, particularly in poorer communities, heighten the CKM crisis.
Health Economics and the Cost of CKM
- Insurance Costs: Annual insurance expenses to manage CKM-related conditions are significant, with coronary angioplasty and dialysis among the most claimed treatments.
- Economic Impact on Health Budgets: Rising NCD cases threaten both health budgets and the overall economy as more resources are allocated to manage CKM-related issues.
- Impact on Productivity: CKM’s economic toll extends to lost productivity due to frequent medical visits and treatment needs, adding to indirect costs.
- Threat to Sustainable Development Goals (SDGs): The UN SDGs aim to reduce NCD deaths by one-third by 2030, but the rising CKM-related expenses challenge these goals.
The Need for Integrated Clinics
- Importance of Integrated Care: Current models often treat diabetes, hypertension, and kidney disease separately; integrated care can address CKM holistically.
- American Heart Association Recommendations: Shift from isolated treatment to unified risk management across CKM conditions.
- Reducing Fragmented Care: Integrating services would minimize drug interactions and reduce loss of productivity due to multiple clinic visits.
- Multidisciplinary Clinics: Establishing multidisciplinary teams with diabetologists, cardiologists, nephrologists, dieticians, and physiotherapists can enhance CKM management.
Preventive Measures for Future Generations
- Early Health Interventions: Programs for pregnant women and young mothers to address low birth weight, a risk factor for future CKM conditions.
- School Health Programs: Regular screenings for weight and obesity in schoolchildren to identify and intervene with high-risk individuals early.
- Dietary Interventions through PDS: Introducing millets as a partial replacement for high-glycemic foods like rice in the Public Distribution System can curb obesity.
- Low Sodium Salt Pilot: Trials replacing common salt with low sodium salt to reduce hypertension, with caution for those with CKM-related conditions.
Globalisation’s Role in CKM
- Work Culture and Health: Long working hours and night shifts, driven by global economic demands, disrupt sleep and hormone regulation.
- Impact on Eating Habits: Long hours lead to consumption of high-calorie, salty, and sugary foods as a response to brain fatigue and low serotonin levels.
- Hormonal Impact: Increased cortisol levels affect carbohydrate and lipid metabolism, contributing to obesity.
- Need for Regulated Work Hours: Regulating work hours and shifts is critical, as it can help reduce stress and improve health outcomes, reducing the CKM burden.
Case Study: Tamil Nadu’s Public Health Approach
- Public Health Framework: Known for its strong public health framework, Tamil Nadu surpasses national averages in life expectancy, maternal mortality, and infectious disease management.
- NCD Burden: Despite its achievements, non-communicable diseases are responsible for 69% of premature deaths in the state, highlighting a national trend.
- 2020 STEPS Survey Data: Survey results indicate 28.5% overweight individuals, 11.4% obesity, 33.9% hypertension, and 17.6% diabetes, underscoring the CKM crisis.
- Preventive Measures: Programs like the Muthu Lakshmi Reddy scheme provide direct cash transfers and nutritional support, while schools conduct regular health screenings for children.
Conclusion
The escalating burden of CKM syndrome demands an integrated, preventive approach at the public health level. The syndrome’s economic and health impacts emphasize the need for multidisciplinary clinics, early interventions, and dietary changes. As CKM continues to impact health budgets and productivity, rethinking policies related to work-life balance, preventive healthcare, and public health investments is crucial. A coordinated effort will be essential to manage CKM syndrome and achieve a healthier, more resilient society.
Related PYQ
“Besides being a moral imperative of Welfare State, primary health structure is a necessary pre-condition for sustainable development.” Analyze? [ UPSC Civil Services Exam – Mains 2021]
Practice Question
Discuss the rising prevalence of Cardiovascular Kidney Metabolic (CKM) syndrome and its economic implications in India. Evaluate strategies for prevention and management to reduce its impact on public health and the economy? [250 words]
Guidelines for Answering the Question
- Introduction:
- Define CKM syndrome and explain its rise as a major health issue due to lifestyle changes and globalization.
- Briefly state its economic burden and impact on public health in India.
- Body:
- Explain the burden of CKM syndrome on major organs (heart, kidneys, liver) and its role in increasing mortality and disability.
- Describe the economic strain due to rising healthcare costs, productivity loss, and insurance claims.
- Highlight how rising rates of obesity, diabetes, and hypertension threaten India’s progress on Sustainable Development Goals (SDGs) related to NCD reduction.
- Mention need for holistic and preventive approaches to manage CKM effectively.
- Conclusion:
- Conclude with the importance of coordinated public health policies to alleviate the long-term health and economic burdens of CKM syndrome in India.