The need for ‘heart-resilient’ urban planning

UPSC Syllabus Topic: GS Paper 3 –Environment

Introduction

Urban India is facing a silent heart crisis. Cardiovascular diseases now cause a large share of city deaths, with urban prevalence nearly twice that of rural areas and rising cases below 50 years. Long commutes, pollution, shrinking green spaces and stress increase risk, while healthcare remains uneven and market-driven. Urban planning and governance must now treat heart health as a core priority, not a side effect of development.

Urban heart health as an urgent concern

1. Prevalence of Risk Factors: Urban environments foster lifestyles and conditions known to harm heart health, including sedentary behavior, high stress, poor diets (easy access to processed foods), and insufficient sleep.
2. Environmental Pollution: Cities concentrate environmental pollutants like fine particulate matter (PM2.5) from traffic and industry, which can enter the bloodstream, cause systemic inflammation, and may lead to heart attacks, and strokes.

3.“Urban Heart Syndrome”: Doctors observe an emerging trend, sometimes referred to as “urban heart syndrome,” where young professionals (in their 30s and 40s) present with early cardiovascular distress without traditional symptoms. This make early diagnosis difficult and increasing the risk of premature heart disease.

4. Physical Environment Challenges: Urban design often features a lack of green spaces and an abundance of heat-retaining materials (asphalt, concrete), leading to “urban heat islands”. This results in higher temperatures, which place extra strain on the cardiovascular system, especially during heat waves.
5. Health Inequities: Health disparities within cities are stark, with low-income and marginalized populations disproportionately affected. These groups often live in areas with fewer healthy food options, less green space, higher pollution, and limited access to quality healthcare, compounding their health risks.
6. Difficulty in Diagnosis: Symptoms in urban dwellers, particularly women, may be subtle (e.g., fatigue, jaw pain, shortness of breath) and are often dismissed as stress or acidity, leading to dangerous delays in diagnosis and treatment.

Planning and technology for heart-healthy cities

The Role of Urban Planning

1. Promoting Physical Activity:

• Designing walkable and bike-friendly cities is crucial. This involves creating safe, continuous sidewalks, dedicated cycle paths, crosswalks, and reducing traffic speeds.
• Proximity to parks and recreational facilities encourages regular exercise and is associated with lower rates of obesity, hypertension, and heart disease.
• Experiences from WHO’s Healthy Cities Network show that when such design is backed by governance, chronic disease risks fall.

2. Creating Mixed-Use and Compact Neighborhoods: Developing areas where residences, workplaces, shops, and amenities are all within a 15-minute walk or bike ride reduces reliance on cars, shortens commute times, and promotes active transportation.
3. Integrating Green Spaces: Incorporating urban greenery, parks, and tree canopy cover helps to mitigate the “urban heat island” effect, reduce air pollution, and provide spaces for relaxation and mental well-being, which alleviates stress on the cardiovascular system.
4. Improving Food Environments:

• Enabling food-sensitive planning ensures affordable and physical access to nutritious, fresh foods (e.g., via local markets and community gardens), while discouraging fast-food promotion in key areas like schools.
• These planning choices can work in harmony with the National Urban Health Mission (NUHM), Smart Cities Mission and AMRUT to support healthier neighbourhoods.

The Role of Technology

1. Environmental Monitoring and Mapping: Smart city technologies use sensors to monitor air and noise pollution levels in real time. This data can inform residents of environmental hazards and help urban planners identify priority areas for intervention, such as increasing tree cover along high-pollution corridors.
2. Smart Transportation Systems: Clean energy public transport and e-mobility solutions (e.g., e-bikes) can reduce vehicular emissions and noise pollution.
3. Personal Health Management: Wearable devices (smartwatches and fitness trackers) allow individuals to monitor key metrics like heart rate, sleep, and physical activity levels in real time, empowering them to manage their health proactively.
4. Digital Healthcare Access: Telehealth services, smartphone applications for self-management, and remote patient monitoring systems for chronic conditions like hypertension and heart failure can improve patient adherence to treatment plans and reduce hospital admissions.
5. Data-Driven Planning: Using AI and data analytics allows urban planners to integrate health data with urban design tools, providing evidence-based insights to create health-promoting environments and support city-level decisions.

Way forward

1. Make health a core planning goal: City plans should integrate heart health into land use, transport, housing and green space decisions, instead of treating health as a separate sector.
2. Align with national urban missions:

• Urban design should support the National Urban Health Mission (NUHM), Smart Cities Mission and the Atal Mission for Rejuvenation and Urban Transformation (AMRUT) by using these programmes to fund compact, low-pollution, activity-friendly neighbourhoods.
• It should also build on the Asian Development Bank’s $10-billion urban investment plan to embed heart health into future city development.

3. Use digital tools for risk mapping: AI-enabled air-quality and heat mapping, sensors and citizen-reporting apps should be built into planning systems to identify high-risk zones and guide targeted action.
4. Anchor all action in equity:

Cities need equity audits and priority investment in vulnerable localities so low-income groups do not remain trapped in high-risk environments.

Supportive neighbourhood design can also strengthen campaigns such as Tobacco-Free Youth 3.0 by making healthy choices easier.

5. Guard against green gentrification: New parks and greenways must be planned with communities so they are not displaced and can fully benefit from healthier surroundings.
6. Build long-term coalitions and skills: Collaboration among MoHUA, health agencies, academia, civil society and youth platforms such as Urban October can create a generation of planners trained to design heart-resilient cities.

Conclusion

Cardiovascular disease reflects how cities are built and governed. Air quality, heat, mobility and access to healthy spaces shape risk more than individual willpower. A heart-resilient future for urban India depends on planning that protects the most vulnerable first, links health with every urban decision and treats the human heart as a central design concern.

Question for practice

Discuss how urbanisation in India is increasing heart health risks and explain the role of planning and technology in creating heart-resilient cities.

Source: The Hindu