Context

• On October 8, 2025, India’s Ministry of Housing and Urban Affairs (MoHUA) observed World Habitat Day under the theme Urban Solutions to Crisis.
• Even as national missions such as the Pradhan Mantri Awas Yojana-Urban (PMAY-U) and the Smart Cities Mission advance, a quieter emergency is unfolding: a surge in cardiovascular disease and diabetes across urban India.
• Cardiovascular ailments now account for major urban deaths, with prevalence nearly twice that of rural regions and increasing cases among individuals under 50.

The Urban Living Paradox: Opportunity and Ill-Health

• Urban life promises mobility and opportunity, yet long commutes, polluted air, shrinking green cover and rising stress shape unhealthy routines.
• Access to care remains uneven because hospital distribution follows profit rather than need, with high-income neighbourhoods attracting most facilities while vast areas remain underserved.
• This creates an urban paradox, prosperity for some, heightened lifestyle disease risks for many.

Fragmented Urban Planning and Its Health Consequences

• India’s rapid urbanisation has been accompanied by fragmented planning. Transport networks, housing developments, and environmental systems often evolve in isolation.
• Such disjointed growth locks in sedentary lifestyles, increases emissions, and reduces access to natural spaces.
• Expressways deepen car dependence; concentrated fast-food zones shape unhealthy diets; and gridlocked roads intensify exposure to PM2.5, a major trigger for heart attacks and strokes.
• Without health-oriented design, cities unintentionally create environments that endanger cardiovascular health.

Towards Health-Centred Urban Design

• Integrated planning offers a path toward healthier cities.
• The experience of global Healthy Cities initiatives shows that embedding health into urban governance reduces chronic disease risks.
• Coordinating land use, mobility, environment and public health can reshape Indian cities into more resilient and human-centred spaces.
• Five pillars underpin heart-healthy urban planning:
  • Walkability and Active Mobility: Shaded sidewalks, cycling lanes and safe pedestrian crossings encourage routine physical activity, lowering hypertension and diabetes risk.
  • Green Infrastructure: Tree cover, urban forests and parks cool neighbourhoods, filter air and reduce heat stress, cutting pollution-linked cardiovascular events.
  • Mixed Land Use: Combining residential, commercial and recreational spaces reduces commute times and promotes active living, making neighbourhoods more liveable.
  • Robust Public Transport: Affordable, clean-energy systems cut emissions, shorten sedentary travel and improve access for low-income groups.
  • Healthy Food Ecosystems: Local markets, community gardens and limits on junk-food advertising improve dietary choices and support heart-friendly habits.
• Together, these interventions create compact, green and transit-friendly urban environments that support healthy lifestyles and reduce pollution.

Invisible Threats and Technological Remedies

• Many urban risks remain unseen but deadly. PM2.5 from vehicles and industry, heat trapped by concrete-heavy layouts, and inadequate water and waste systems significantly worsen cardiovascular health.
• Without intervention, Asia could face a 91% rise in cardiovascular mortality by 2050.
• Holistic planning can mitigate these threats. Expanding green cover improves ventilation; renewable energy lowers emissions; and modern water and waste systems reduce toxic exposure.
• Digital tools, AI-enabled sensors, heat-mapping platforms and citizen-reporting apps, make invisible risks visible, enabling targeted urban action and strengthening public preparedness.

Equity: The Foundation of a Healthy City

• Cardiovascular disease disproportionately affects low-income communities, which endure the worst air quality, the least greenery, the poorest connectivity and the scarcest health services.
• The disease burden among marginalised groups has risen sharply, underscoring structural inequities.
• To create healthier cities, equity must anchor all planning decisions.
• Prioritising vulnerable neighbourhoods, conducting equity audits and ensuring community involvement can prevent green gentrification, where improvements displace those they aim to benefit.
• Such participation strengthens trust, embeds prevention in daily life and supports national health initiatives.

Conclusion

• Cardiovascular disease reflects not only individual choices but the design of cities themselves.
• The air people breathe, the routes they travel and the spaces they inhabit shape health outcomes profoundly.
• As India seeks urban solutions to its crises, the most enduring one lies in building cities that protect and strengthen the human heart.