Before the Gujarat model of development, there was—and is—the Kerala model of development, its silent success set to be reflected in the latest health statistics of Malayalee (Kerala) men and women over the next decade.

Other things remaining the same, Malayalee men are expected to live to 75.2 years by the year 2025, as against the Indian average of 69.8. Malaylee women are expected to do much better: they are likely to live till 78.6, as against the national average of 72.3, says the analysis of an expert committee of the Ministry of Health and Family Welfare, quoted in the Health & Family Statistics In India 2013.

IndiaSpend had earlier reported that Himachal Pradesh had the best social indicators. So, is something working in Kerala and Himachal that can be replicated across the nation?

Kerala has also reported the highest per capita public (Rs 287) and private expenditure (Rs 2,663) on health among major states (with a population above 20 million), based on 2004-05 data, as reported by the Ministry of Health. The other top states, based on per capita public expenditure, were Punjab, Karnataka, Tamil Nadu and Maharashtra.

Now, here is a question some may have answered: Which was the state that witnessed explosive urbanization between 2001 and 2011? Maharashtra? Karnataka? Andhra Pradesh? Gujarat?

The answer: none of these. The state is Kerala, which saw its share of urban population to total population increase from 26% in 2001 (8.27 million) to 47.7% in 2011 (15.9 million). Kerala was followed by followed by Sikkim, which saw its urban population increase from 11.1% to 25.2% and Goa from 49.8% to 62.2%.

India’s Most Urbanised States, 2001 to 2011

Urbanised States

Source: Ministry of Health; Figures in million

But, as we noted when discussing Kerala’s rising life expectancy, urbanization is among the many things that do not remain the same and, in some way, these issues are likely to affect the quality of life—and, possibly, the chances of staying alive.

The flipside of the Kerala model is that the state is also fast gaining notoriety as the diabetes and lifestyle-disease capital of India.

Men in urban Kerala (between 15-49 years) have the highest incidence of high blood sugar: 5,056 per 100,000 as against the national average of 1,383 i.e. almost four times. Women in urban Kerala also reported a very high incidence of diabetes: 3,033 per 100,000 as against the national average of 1,374.

Diabetes Cases In Major States

In a study published in 2013 by UK-based BioMed Central on "Lifestyle change in Kerala, India: Needs Assessment And Planning For A Community-Based Diabetes Prevention Trial”, the authors pointed out that physical inactivity and sedentary living among both genders was common across India, but Kerala led the way.

"Indirect evidence from national consumption surveys (2009–2010) also reflects high sedentariness (sic), as Keralites spend five times more money on TVs, 10–15 times more on motorcycles and 430–1,250 times more on cars as compared to the rest of India," the study reported.

Kerala also has the highest spending inequity and extreme numbers, as we reported earlier, and high alcohol consumption (nearly 7 litre per person every year) and high suicide rates (25.3 per lakh population during 2011).

So, is fast urbanisation and increasing health spending changing the face of Kerala? It is, but this development comes at a high price, a harbinger, perhaps, of things to come for the rest of India.

Image Credit: Flickr

“Liked this story? Indiaspend.org is a non-profit, and we depend on readers like you to drive our public-interest journalism efforts. Donate Rs 500; Rs 1,000, Rs 2,000.”