Breathe In, Breathe Out: Air Pollution and Inequity
First Place Winner of the 2024 Global Health Unfiltered Op-ed Competition
New Delhi, India - November 12, 2012. Daily street life in the early morning during extreme smog conditions. New Delhi air quality has plummeted over the last few years and is now considered some of the worst in the entire planet. Credit: BDphoto
Every trip back to India has evoked mixed emotions since I arrived in the UK in 2022. I come home with the utmost excitement and leave with profound guilt. My guilt is because as I strive for a joyful and successful life in the UK, my friends and family back home are confronted with the haunting reality of their lives being potentially cut short by almost 12 years.
Delhi has consistently been recognized as one of the most polluted cities in the world. Breathing in an AQI (Air Quality Index) that is sometimes beyond 500 in the festive month of Diwali, my father jokingly remarks, “I wonder what it must feel like to breathe in your air in the UK. At this point, I think it will be more difficult for us to breathe there than here!” When I was in Delhi, I certainly did encounter incidences of sore throat, cough, and burning eyes, but like most, I, too, became accustomed to the pollution around me. The realization that inhaling the hazardous air in Delhi was equivalent to smoking 25-30 cigarettes daily didn't seem to concern me significantly. In hindsight, the subtle nature of air pollution causes individuals, including those in good health like myself, to overlook the lasting, harmful effects of breathing in toxic air. It is this quality and the dissonance experienced by citizens like myself that make air pollution the silent killer.
The levels of particulate matter (PM2.5) in New Delhi have exceeded the World Health Organization's health limit by 100 times. Due to poor air quality regulations, the widespread use of older and more polluting machinery and vehicles, subsidies for fossil fuels, crowded urban transport systems, rapidly growing industrial sectors, and the adoption of cut-and-burn practices in agriculture, approximately 2 million Indians lose their lives each year.
The WHO has attempted to raise awareness about the health implications of air pollution, highlighting its potential links to strokes, heart diseases, lung cancer, as well as acute and chronic respiratory conditions. Additionally, a review conducted by the University of Oxford also determined that air pollution can act as a risk factor for the development of mental health disorders such as depression, anxiety, personality disorders, and neurodevelopmental disorders. It has been found to have mental health effects throughout the various life stages, ranging from the prenatal period in the uterus to adulthood.
“The levels of particulate matter (PM2.5) in New Delhi have exceeded the World Health Organization’s health limit by 100 times.”
Even though every one of India's 1.4 billion residents resides in regions where they breathe unhealthy air that exceeds the air-quality guideline set by the World Health Organization, the marginalized and disadvantaged communities face the disproportionate effect of such high levels of air pollution.
Underlying all global health challenges is a subtle interplay with social challenges. The stark divide in society is often reinforced by air pollution. A study on the association between global air pollution and poverty claimed that low-income communities are the most exposed to unsafe air and most significantly affected. Therefore, certain groups are expected to be more affected in India. Though studies on the unequal impact of air pollution in India are still limited, a few institutes were keen to investigate the differences. In 2015, 75% of air pollution-related deaths in India happened in rural areas. This is potentially due to the nature of jobs that rural people undertake, more industrial power plants in these areas, and the lack of access to affordable healthcare.
Unsurprisingly, individuals have also contemplated the potential gendered nature of the air pollution issue. Equally unsurprising has been the tendency to overlook the impact on women when discussing the unequal effects of air pollution. Women in India often cook meals for their families and may be more exposed to indoor air pollution. At this juncture, it also becomes exceedingly important to bring in the intersectionality theory. People belonging to multiple disadvantaged groups face amplified struggles when dealing with various issues due to their combined identities. This was supported by a study that showed that Indian women from rural areas, particularly, are the most affected because they experience prolonged exposure to indoor air pollution due to unclean or solid fuels for domestic cooking.
A woman in rural India making chapatti at home using a mud stove with continuous wood fire. Credit: pixelfusion3d
This problem mandates solutions, and the solution to air pollution lies in adopting multilateral and collaborative approaches. For instance, internationally coordinated policies such as the 2030 Agenda for Sustainable Development, the Health and Energy Platform of Action (HEPA), and the Climate and Clean Air Coalition (CCAC) can play a pivotal role in addressing global challenges and promoting a cleaner environment. At both the national and state levels- investments, policies, and programs should strive to implement stringent air quality regulations, promote sustainable industrial machinery and transport systems, advocate for renewable energy, and encourage improved agricultural practices;
Large corporations in developed and developing countries should implement power plant and fuel use regulations. Countries in the Global North, which have started acknowledging the politics of pollution, should also actively advocate for evidence-based political decisions that impact the climate and air quality of numerous countries in the Global South.
Education will consistently remain an essential tool for fostering change. Individuals from all walks of life must be aware of the long-term adverse physical and mental health effects of air pollution. Furthermore, it is crucial to encourage youth to actively participate in research, influence policymakers, and advocate for society's betterment.
Lastly, but most importantly, the privileged sections of society must acknowledge that any decision they take disproportionately impacts the underserved, leading to significant suffering for the marginalized and oppressed. Therefore, making thoughtful choices becomes all the more important.
I sometimes worry that by the time we reduce or even eradicate air pollution, certain communities might have already faced irreparable damage. I also recognize that my relatively privileged position in Indian society spares me from being as severely impacted. I had the opportunity to leave the place I once called home in search of a future that suited my desires. Nevertheless, I am optimistic that one day, this nation of 1.4 billion will enjoy the privilege of breathing clean air. And when that day comes, it will be cherished and never taken for granted again.
