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Research Article

Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study

  • Christopher Millett mail,

    c.millett@imperial.ac.uk

    Affiliations: School of Public Health, Imperial College, London, United Kingdom, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India

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  • Sutapa Agrawal,

    Affiliation: South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India

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  • Ruth Sullivan,

    Affiliation: Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom

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  • Mario Vaz,

    Affiliation: St. John's Research Institute, Bangalore, India

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  • Anura Kurpad,

    Affiliation: St. John's Research Institute, Bangalore, India

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  • A. V. Bharathi,

    Affiliation: Indira Gandhi National Open University, Bangalore, India

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  • Dorairaj Prabhakaran,

    Affiliation: Centre for Chronic Disease Control, New Delhi, India

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  • Kolli Srinath Reddy,

    Affiliation: Public Health Foundation of India, New Delhi, India

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  • Sanjay Kinra,

    Affiliation: Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom

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  • George Davey Smith,

    Affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom

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  • Shah Ebrahim,

    Affiliations: South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom

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  • for the Indian Migration Study group

    Membership of the Indian Migration Study group is provided in the Acknowledgments

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  • Published: June 11, 2013
  • DOI: 10.1371/journal.pmed.1001459
  • Featured in PLOS Collections

Reader Comments (1)

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Active travel in India requires major policy change by the Government of India

Posted by nakul on 18 Jun 2013 at 10:09 GMT

In their article "Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study" authors Millett C et al correctly identify a link between lack of “active” transport options in India and lifestyle related diseases. However, while the link has been correctly identified, it does not imply that the suggested remedial measures can be implemented. India has poor infrastructure with scant attention paid to scientific road construction. Urban planning is haphazard and chaotic. Lack of space on roads and rampant presence of hawkers on footpaths has meant that dedicated cycling tracks are highly unlikely to be planned in Indian cities.

A significant amount of public funds is supposedly spent toward Indian roads, yet with their poor condition one wonders how it is possible to accommodate cyclists and pedestrians on already crowded and inadequate roads. Unlike developed nations where high speed crashes are a leading cause of road traffic accident fatalities, in India injuries are often sustained in low-velocity impacts. These happen because roads are unscientifically constructed, illegally occupied and driving licenses are obtained illegally by routes other than training and testing. A significant number of injuries at our hospital are sustained by pedestrians knocked down from behind by cars.

Add to this the Government of India's decision to substantially increase the import tax on imported bicycles (ostensibly to encourage domestic manufacturers) and the stage is set for young professionals abandoning the idea of cycling to work and instead taking to cars.

Arresting the near-epidemic proportions of diabetes and ischemic heart disease in India will require more than advocating the use of "active" forms of transport: the government itself has to actively construct and implement policies that will promote cycling and save our oil import - and medical - bills. Perhaps what is most worrying is that India has no declared policy on the promotion of bicycling as a means of transport. "Urban planning" is a deafeningly silent word in India.

No competing interests declared.