Chronic Health Conditions & Public Policies

Chronic conditions are the health issues that require ongoing management over a period of years or decades. They include chronic non-communicable diseases (NCDs) but also a few communicable diseases and conditions (like disabilities) that lasts longer. The chronic conditions are on the rise globally and in India, where it has become a leading cause of deaths and disabilities. There are several factors implicated in the rise in chronic conditions, from genetics and individual lifestyle to changes in demography and the broader environment. Therefore, prevention and management of chronic conditions require an inter-disciplinary and inter-sectoral engagement.

In this cluster, we are specifically interested in how health policies and policies across other related sectors impact prevention and control of chronic conditions at a population level, including the major risk factors for such conditions such as tobacco and alcohol use, unhealthy diet and inadequate physical exercise. The cluster builds on the premise that broader social determinants of health operating at the macro- and the meso-level influence the individual behavioural choices (lifestyle) as well as shape the environment in which these choices are to be made.

Hence, our focus on public policies and intersectoral actions for health. In this context, we are also interested in studying the increasing role being played by commercial entities in shaping the epidemic of chronic conditions as well as the policy responses. The cluster aims to deepen our work on some of the relevant concepts/approaches including but not limited to ‘social determinants of health’, ‘political economy of health’, ‘health-in all policy’ and ‘harm industries’.

The following are, at present, the major thematic areas within this cluster:

Tobacco control
In India, 28.6% of adults and 14.6% of youth – in total over 26.7 crores (~ 266 million) are the current users of tobacco in some form. Tobacco use causes over 12.8 lakh (~1.2 million) deaths every year in India. Total economic cost from all the diseases caused by tobacco use in India in a year is estimated to be INR 104500 crore (~ 1045 billion). Tobacco use is a common major risk factor for chronic conditions, including cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. This thematic explores empirical ways to reduce tobacco use in India and the associated health, economic and ecologic burden.

Road Safety
Road crashes are the leading cause of death in young people aged 15 – 29 years. Globally each year about 1.3 million people lose their lives in road crashes. Nearly 90% of all road fatalities occur in low- and middle- income countries, which have less than half of the world’s vehicles. In India, one road crash happens each minute and one life is lost to road crashes every four minutes – with over 150000 individuals losing their lives in road crashes each year. Under this thematic, we explore how to strengthen policies for road safety and their implementation at different levels.

Multisectoral Actions for Health
Health is seen as a dynamic state of physical, mental and social well-being. Health, especially at a population level, is impacted by several social, economic, environmental, cultural and political factors. Hence, enhancing population health requires coordinated actions across sectors, beyond just the healthcare sector. This thematic explores ways of engendering multisectoral actions for health and promoting health through public policies across different sectors (health-in all policy approach)

Peer-reviewed

  1. Dsouza R, Bhojani U. Strategic and contested use of food laws to ban smokeless tobacco products in India: a qualitative analysis of litigationTobacco Control Published Online First: 20 August 2021. doi: 10.1136/tobaccocontrol-2020-056241
  2. Bhojani U, Varma A, Hebbar PB, Mandal G, Gupte H. LifeFirst: Impact of a school-based tobacco and supari cessation intervention among adolescent students in Mumbai, India. Population Medicine. 2021;3(May):12. doi:10.18332/popmed/134990.
  3. Varma A, Chilgod L, Bhojani UDiverse and competing interests around tobacco: qualitative analysis of two decades of parliamentary questions in India. BMJ Global Health 2021;6:e004093. doi:10.1136/bmjgh-2020-004093
  4. Chugh A, Bassi S, Nazar G P, Bhojani U, Alexander C, Lal P, Gupta P C, Arora M. Tobacco Industry Interference Index: Implementation of the World Health Organization’s Framework Convention on Tobacco Control Article 5.3 in India. Asia Pacific Journal of Public Health 2020 (doi: 10.1177/1010539520917793)
  5. Mir G, Karlsen S, Mitullah W, Bhojani U, Uzochukwu B, Okeke C, Mirzoev T, Ebenso B, Dracup N, Dymski G, Duong DTT, Ha BTT, Ouma S, Onibon F, Ogwezi J, Adris S. Achieving SDG 10: a global review of public service inclusion strategies for ethnic and religious minorities. Occasional paper 5 Geneva: United Nations Research Institute for Social Development; 2020:1-29
  6. Bhojani U. Review of “Health inequities in India: a synthesis of recent evidence.” T. K. Sundari Ravindran, Rakhal Gaitonde (eds). Springer Nature Singapore Pte Ltd. Current Science 2019;117(04):706-707
  7. Bhojani U, Madegowda C, Prashanth NS, Hebbar P, Mirzoev T, Karlsen S, Mir G. Affirmative action, minorities, and public services in India: Charting a future research and practice agenda. Indian Journal of Medical Ethics 2019;4(4):265-273
  8. Shah R, Shah R, Bhojani U, Shah S. Dentists and tobacco cessation: moving beyond the willingness. Journal of Indian Association of Public Health Dentistry 2017;15(3):263-264
  9. Hebbar PB, Bhojani U, Kennedy J, Rao V. From policy to practice: lessons from Karnataka about implementation of tobacco control laws. Indian Journal of Community Medicine 2017;42(2):77-80
  10. Bhojani U, Soors W. Bringing evidence into public health policy: enhancing equity and engendering intersectoral action for health. BMJ Global Health 2016;1(Suppl 1):A1
  11. Bhojani U, Soors W, Yellappa V, Ahluvalia A (eds.) Bringing evidence into public health policy (EPHP) 2016. Equitable India: All for Health and Wellbeing. BMJ Global Health 2016;1(Suppl 1):A2
  12. Rao N, Bhojani U, Shekar P, Daddi S. Conflicts of interest in tobacco control in India: an exploratory study. Tobacco Control 2016;25(6):715-718
  13. Bhojani U, Soors W. Tobacco control in India: a case for Health-in-All Policy approach. National Medical Journal of India 2015;28(2):86-89
  14. Bhojani U, Hebbar P, Rao V, Shah V. Litigation for claiming health rights: insights from tobacco control. Health and Human Rights 2014
  15. Bhojani U, Venkataraman V, Manganawar B. Challenging ties between state and tobacco industry: advocacy lessons from India. Health Promotion Perspectives 2013;3(1):102-112
  16. Van Olmen J, Criel B, Bhojani U, Marchal B, Van Belle S, Chenge MF, Hoeree T, Pirard M, Van Damme W, Kegels G. The health system dynamics framework: the introduction of an analytical model for health system analysis and its application to two case-studies. Health, Culture and Society 2012:2(1)
  17. Bhojani U, Elias MA, Devadasan N. Adolescents’ perceptions about smoker in Karnataka, India. BMC Public Health 2011;11:563
  18. Bhojani U, Venkataraman V, Manganawar B. Public policies and the tobacco industry. Economic and Political Weekly 2011;XLVI(28):27-30
  19. Bhojani U, Chander SJ, Devadasan N. Tobacco use and related factors among preuniversity students in a college in Bangalore, India.  National Medical Journal of India 2009;22(6):294-297
  20. Bhojani U, Devadasan N. What to do with the Epidemic of Diabetes – a Health Systems Response. Christian Medical Journal of India 2008;23(3-4):26-28

Books/Monographs

  1. Bhojani U. Youth and tobacco use: a monograph on perceptions, practices & policies. Bangalore: Institute of Public Health; 2013

Magazine/blogs/popular media

  1. Bhojani U Prevent tobacco lobby interreference. Deccan Herald; 2020
  2. Bhojani U, Lal P, Assunta M. Size doesn’t matter when it comes to tobacco industry interference: some observations from South Asia. South Asian Regional Consortium Centre for Combating Tobacco; 2019
  3. Bhojani U. Curbing tobacco: K’taka success story. Deccan Herald; 2018
  4. Bhojani U. Strengthening the governance for effective tobacco control in India. Health For Millions; 2017
  5. Bhojani U. How tobacco industry is misleading people with its ads. Newslaundry; 2016
  6. Prashanth NS, Bhojani U. Modi-fying India’s health: health in the times of India’s new prime minister. International Health Policies; 2015
  7. Pan masala – a way for the tobacco industry
  8. Jithendra A, Bhojani U. How the tobacco industry wins friends and influences policy. Newslaundry; 2015
  9. Arora R, Bhojani U. The semantics of commitment. International Health Policies; 2015
  10. Jitendra A. Pan masala – a way for the tobacco industry to bypass the gutkha ban? BMJ Blog; 2015
  11. Hebbar P, Rao V. Tobacco or job? BMJ Blog; 2014
  12. Hebbar P, Bhojani U, Rao V. Television as a public awareness tool to reduce tobacco use in India. eSocialSciences; 2013
  13. Bhojani U. Killing interference. The Week; 2012
  14. Venkataraman V, Bhojani U. India: code of conduct on dealings with tobacco industry.  News Analysis – Tobacco Control; 2011
  15. Bhojani U. When a picture paints a 1,000 words. Deccan Chronicle; 2011
  16. Bhojani U. Venkataraman V. India: court bans tobacco board from trade show. News Analysis – Tobacco Control; 2010

Others

  1. Dsouza R, Bhojani U. A report on the mapping and analysis of tobacco-related litigations in Karnataka. Submitted to the Karnataka State Anti Tobacco Cell, Department of Health and Family Welfare Services, Government of Karnataka. Institute of Public Health, Bengaluru; 2020
  2. Education pack (2009) – This educational material was developed in collaboration with the District Anti Tobacco Cell (Bengaluru Urban) to be used by school teachers (and others) to raise awareness on tobacco use and associated harms among youth
  3. Media pack: collection of factsheets (2009) – This is a collection of five fact sheets on various aspects of tobacco use and policies including (1) tobacco and adverse effects; (2) tobacco and economy; (3) tobacco and livelihoods; (4) tobacco and taxation; and (5) tobacco control and public opinion. This was developed in collaboration with the District Anti Tobacco cell (Bengaluru Urban)
  4. Research brief on ‘Pre-university students and tobacco use in Bangalore city’ – This research brief summarizes the findings of a research study assessing tobacco use and related factors among pre-university students in Bangalore
  5. Policy briefs: Preventing non-communicable diseases through specific non-health ministries (2016) – This is a collection of 12 policy briefs on how policies of specific non-health ministries impact non-communicable diseases and their risk factors.
Updates
National Summit on Tobacco or Health – 2020

National Summit on Tobacco or Health – 2020

On May 29th, 2020 the National Summit was held virtually, the main theme was on “Protecting youth from industry manipulation and preventing them from tobacco and nicotine use” , and organised “by Resource Centre for Tobacco Control (E-RCTC), PGIMER Chandigarh in...

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31st National Road Safety Week – January 2020

31st National Road Safety Week – January 2020

1.5 lakh lives are lost every year and many more are debilitated on Indian roads due to road crashes. This causes the families of victims with immense economic hardship and emotional trauma. According to the WHO reports, road crashes are one of the leading cause of deaths among the youth between the ages of 5-29 in India and worldwide.
To make our roads safe for all road users and to reduce the crash rates, every year “National Road Safety Week” is observed throughout the country. The focus of the activities of this week is to create more awareness among road users about the road safety and to emphasize good road using practices.

To observe this year’s 31st National Road Safety Week, Institute of Public Health in association with HKBK Group of institutions and Indian Degree College under banner of Safer roads Bengaluru initiative organised a bunch of activities from 14th to 17th of Jan 2020 at our selected stretch of road in Bengaluru. Signature campaign #IResolve4RoadSafety, Quiz on road safety for public and college students, Human chains at major junctions are the main activities among all other activities.

We were at all major junctions of the selected stretch of road from Hebbal to K R Puram throughout the Road Safety Week. A signature wall with student volunteers was present at all the junctions seeking public commitment for road safety. Around 3000 people committed for safer road usage through signing on our campaign wall.
Quiz on road safety witnessed more than 5000 participation. Winners of the quiz were awarded with a ISI marked 2-wheeler helmets by #SaferroadsBLR initiative. We also engaged people through our social media platform Facebook and twitter for the broader reach.

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Public lecture at IIHS

Public lecture at IIHS

The director at IPH, Dr. Upendra Bhojani, gave a public lecture at IIHS in the 'Publics' lecture series.  The talk was on Dr. Bhojani’s long standing work on the role of local health systems in poor urban neighbourhoods in Bangalore. The talk...

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ITM visit

The director at IPH, Dr. Upendra Bhojani, attended the Be-cause health international conference on Urban health, organized by the Institute of Tropical Medicine, Antwerp. It was held on 15-16 October 2019 in Brussels. The conference sought to "address the following...

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PGIMER 2019

PGIMER 2019

The Department of Community Medicine and School of Public Health, PGIMER, organized the  2nd Public Health Policy and Management Program from 30th September to the 4th of October, 2019. The program was sponsored by the Ministry of External Affairs,...

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Tobacco Control

In India, 28.6% of adults and 14.6% of youth – in total over 26.7 crores (~ 266 million) are the current users of tobacco in some form. Tobacco use causes over 12.8 lakh (~1.2 million) deaths every year in India. Total economic cost from all the diseases caused by tobacco use in India in a year is estimated to be INR 104500 crore (~ 1045 billion). Tobacco use is a common major risk factor for chronic conditions, including cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. This thematic explores empirical ways to reduce tobacco use in India and the associated health, economic and ecologic burden.


Road Safety

Nearly 90% of all road fatalities occur in low- and middle- income countries, which have less than half of the world’s vehicles. In India, one road crash happens each minute and one life is lost to road crashes every four minutes – with over 150000 individuals losing their lives in road crashes each year. Under this thematic, we explore how to strengthen policies for road safety and their implementation at different levels.


Multisectoral Actions for Health

Health is seen as a dynamic state of physical, mental and social well-being. Health, especially at a population level, is impacted by several social, economic, environmental, cultural and political factors. Hence, enhancing population health requires coordinated actions across sectors, beyond just the healthcare sector. This thematic explores ways of engendering multisectoral actions for health and promoting health through public policies across different sectors (health-in all policy approach).


People
Upendra Bhojani

Upendra Bhojani

Cluster lead

Praveen Rao S

Praveen Rao S

Associates

Werner Soors

Werner Soors

Adjunct Faculty

Pragati B Hebbar

Pragati B Hebbar

Faculty

Riddhi D'souza

Riddhi D'souza

Associates

Bruno Marchal

Bruno Marchal

Adjunct Faculty

Amiti Varma

Amiti Varma

Associates

Vivek D'souza

Vivek D'souza

Associates

Neethi V Rao

Neethi V Rao

Honorary Associates

Mahesh K

Mahesh K

Associates

Ketki Shah

Ketki Shah

Associates

Chandrashekar Kottagi

Chandrashekar Kottagi

Associates

Vishal Rao

Vishal Rao

Adjunct Faculty