HEALTH GEOGRAPHY OF ANDHRA PRADESH DEPARTMENT OF GEOGRAPHY OSMANIA UNIVERSITY HYDERABAD Dr. B.Shrinagesh Prof. Kalpana Markandey Mr. Kiran Baktula Mr. Bhagiaiah

Globalization “is the closer integration of countries and peoples of the world…..brought about by the enormous reduction of costs of transportation and communication,and the breaking down of artificial barriers to the flow of goods, services, capital, Knowledge, and people across borders. Joseph Stiglitz

Globalization and its Impact The world has become increasingly interconnected and interdependent This has positive and negative consequences Rapid industrialization and urbanization Demand for energy and land Profits maximized : no focus on standards and regulation Pollution, improper waste disposal Depletion of natural resources Increased consumption Globalization and infectious diseases

With changing climate, people have become more vulnerable to health risk at global level. With the changing climate and the environment, and the change in the seasons, which in turn, affecting agriculture globally. India, is not far behind, the current drought and flood situation is an indication to the future. The deficiency in food nutrition has set new challenges to the government.( Food Bill was Passed in Parliament on 26/08/2013 IST ) Common person has become a soft target to various new diseases.

Factors that Influence the Earth's Climate Source: Internet

Health effects Temperature-related illness and death Extreme weather- related health effects Air pollution-related health effects Water and food-borne diseases Vectorborne and rodentborne diseases Health Effects Temperature-related illness and death Extreme weather- related (floods, storms, etc.) health effects Air pollution-related health effects Human exposures Regional weather changes Heat waves Extreme weather Temperature Precipitation Regional weather changes Heat waves Extreme weather Temperature Sea-level rise Contamination pathways Transmission dynamics rodent Microbial changes: Contamination paths Transmission dynamics Water and food-borne diseases Vectorborne and borne diseases Climate Change Climate Change Changes in agro- ecosystems, hydrology Socioeconomic and demographic disruption Effects of food and water shortages Mental, nutritional, infectious-disease and other effects Modulating influences

Changes in climatic phenomenon Confidence in observed changes (latter half of 1900s) Probability of projected changes to 2100 Higher maximum temperatures - more hot days LikelyVery likely Higher minimum temperatures, - fewer cold days and frost days Very likely Increase of heat index over land areasLikelyVery likely More intense precipitation eventsLikely, (N mid to high latitudes) Very likely Increased summer continental drying and associated risk of drought Likely, in a few areasLikely, over most mid- latitude continental interiors. Increase in tropical cyclone peak wind intensities Not observed in the few analysis available Likely, over some areas Increase in tropical cyclone mean and peak precipitation intensities Insufficient dataLikely, over some areas IPCC WORKING GROUP I, Third Assessment Report, 2001

Physical Environment Pollution Respiratory Diseases Skin Diseases Eye Diseases Cluttered Built Environment Sewerage, Garbage and Hygiene related problems Workplace Deadlines Stress in interpersonal relations Psychosomatic diseases Distances travelled Impact on family time, relations and social distress Social Environment Anonymity and Crime Transiency in social relations Stress in interpersonal relations Social Pathology

In fact, different locations on earth are usually associated with different profiles: physical, biological, environmental, economical, social, cultural and sometimes even spiritual profiles, that do affect and are affected by health, disease and healthcare. These profiles and associated health and disease conditions may also change with time (the longitudinal or temporal dimensions).

Since the 1970s, newly emerging diseases have been identified at the unprecedented rate of one or more per year. There are now nearly 40 diseases that were unknown a generation ago. In addition, during the last five years, WHO has verified more than 1100 epidemic events worldwide. Today’s highly mobile, interdependent and interconnected world provides myriad opportunities for the rapid spread of infectious diseases

Epidemic-prone diseases Food borne diseases Accidental and deliberate outbreaks Toxic chemical accidents Radio nuclear accidents Environmental disasters The categories and examples given below illustrate the variety and breadth of public health threats confronting people today.

Infectious diseases such as  Malaria,  Leprosy,  Filariasis,  Tuberculosis,  Hepatitis and  Sexually transmitted infections including HIV/AIDS are major health issues Infectious diseases

Significance of the study Health geography plays a vital role in public health surveillance, including the design and monitoring of the implementations of health interventions and disease prevention strategies. Geographical research into healthcare services can also help identifying inequities in health service delivery between classes and region, and in the efficient allocation and monitoring of scarce healthcare resources. As a modelling and decision support tool, GIS can help determining the geographical distribution and variation of diseases (e.g. prevalence, incidence) and associated factors, analyzing spatial and longitudinal trends, mapping population at risk and stratifying risk factors.

Andhra Pradesh is one of the fastest growing states in the country. IT development has made A.P. as the most preferred global destination. Many MNCs have established themselves. In spite of development in IT field, there is considerable backwardness in Health sector. During the last ten years, the state has witnessed many new health related problems mainly in the rural areas. When it comes to the urban areas, the city of Hyderabad, which is considered as the health capital of India, has its own drawbacks.

Objectives To study the prevalent diseases across the state of Andhra Pradesh. To study the infrastructural facilities available and suggest the alternatives.

Methodology Data Collection Spatial Data Primary (Attribute Data) Secondary (Attribute Data) Satellite Image ( Medium & High Resolution) Sample Survey of villages DMHO data AP Map & Survey of India Toposheets Data from DME And other private hospitals APVVP data Digitization of Layer Boundaries Carving of AOI Linking of Spatial & Attribute Data

D ATA S OURCES Primary Data through a sample survey of households by means of a multidimensional questionnaire Directorate of Medical and Health Office Andhra Pradesh Vaidya Vidhana Parishad National Sample Survey Directorate of Medical Education Private Hospitals and Research centres Census of India Satellite Imagery of the disasters form NRSC Toposheet and ground checks

PHYSICAL ENVIRONMENT AND HEALTH

LANDUSE/LANDCOVER OF ANDHRA PRADESH

WATER BODIES OF AP

DISEASES PREVALENT IN ANDHRA PRADESH YEAR NO.0F CASES

YEAR No. OF CASES DISEASES PREVALENT IN ANDHRA PRADESH Contd.

DEATHS AS PER DISEASES PREVALENT YEAR No. OF DEATHS

YEAR No.OF DEATHS DEATHS AS PER DISEASES PREVALENT Contd.

Gastroenteritis cases in Andhra Pradesh

MALARIA CASES IN ANDHRA PRADESH DISTRICTS CASES

MALARIA DEATHS IN ANDHRA PRADESH DISTRICT DEATHS

MALARIA CASES & DEATHS IN ANDHRA PRADESH YEAR CASES AND DEATHS

PROJECTION OF VITAL STATISTICS

INFRASTRUCTURE FACILITIES

Nobel laureate Amartya Sen said that India needs to invest more on providing basic health care services, especially in rural areas and backward states. The elementary health care services are worst in some of the backward states like Chhattisgarh, Bihar, Jharkand. He also lauded India’s growth trajectory but he emphasized that health care planning is not able to tackle various problems in its implementation. Amartya Sen for better health care ( ) (The Hindu)

DISTRICT Sub CentresPHCsCHCsSDHDist Hosp ADILABAD ANANTHAPUR CHITTOOR CUDDAPAH EAST GODAVARI GUNTUR HYDERABAD KARIMNAGAR KHAMMAM KRISHNA KURNOOL MAHABOOBNAGAR MEDAK NALGONDA NELLORE NIZAMABAD PRAKASHAM RANGA REDDY SRIKAKULAM VISHAKAPATNAM VIZIANAGARAM WARANGAL WEST GODAVARI STRENGTH OF HOSPITALS IN AP, DISTRICT WISE 2011

PUBLIC HEALTH CENTRES ANDHRA PRADESH

Climate change and Health – Impact on Health through Climate change, Mitigation and Adaptation.

CASE STUDY – I NETWORK ANALYSIS

 Rural-urban differences are quite high both in Andhra Pradesh and at the national level.  More health workers are located in urban areas than in rural areas. The availability of health workers and therefore health services is much better for the urban population as compared to the rural.  There is also a large difference in the per capita availability of health workers between rural and urban areas, indicating the disadvantage of rural people in terms of access to health services in general and public health services in particular.  Owing to inadequate public health facilities, while awareness and demand for health services are increasing, private health care has developed on a wide scale.  The rising cost of health care at the household level is a cause of concern and needs public action. The average share of household budget spent (7 per cent) on health care is relatively higher than the share of public budget spent (5 per cent) on health care in the state. Conclusions