TN faces new healthcare challenges with non-communicable diseases on the rise

Chennai: Almost every birth in the state — from coastal villages to industrial towns to crowded cities — now takes place in a hospital. At 99.7%, institutional deliveries in Tamil Nadu are above the national average of 90.6%. In rural areas, institutional delivery stands at 99.6%, nearly indistinguishable from the 99.8% recorded in urban areas.This equity, comparable to Kerala, seen in the sixth round of the National Family Health Survey (2023–24), indicates that the state has won most of its old public health battles. But a harder story is tucked inside the celebrated numbers — a growing burden of non-communicable diseases. Tamil Nadu is among the most obese states in India and records one of the highest rates of adult diabetes in the country. At least 44.2% of women aged 15–49 is overweight or obese — up from 40.5% in the previous survey round (2019–21) — nearly 14 percentage points above the national average of 30.7%. In urban areas of TN, nearly one in two women is either overweight or obese. Among men, 38.8% are overweight or obese, compared to the national figure of 27.3%.The metabolic consequences are already visible in the blood. A quarter of women in the state — 25.2% — have high or very high blood sugar, well above the national 17.8%. For men, the figure is 26.7%, against a national 20.9%. Studies in peer-reviewed medical journals, the state’s own surveys, and senior public health experts warn that these trends will have serious long-term consequences, increasing hospitalisations, intensive care and premature deaths. Former WHO chief scientist Dr Soumya Swaminathan said that strengthening primary health services for prevention and early detection is the way forward. Investment in tertiary care matters, she said, but the priority must be to prevent disease or catch it early.Rising rates of gestational diabetes and pregnancy-induced hypertension are also pushing up caesarean sections in the state. At least 46.9% of all births in Tamil Nadu are now surgical deliveries — up from 44.9% in the previous survey, and nearly double the national average of 27.2%. While caesarean rates in private hospitals have edged down to 60.3% from 63.8% in the last round, they have risen in public hospitals to 39.6% from 36.0%. Nationally, 54.1% of deliveries in private hospitals were by caesarean section, against 16.9% in public hospitals. In Tamil Nadu, 63.6% of all deliveries happen in government hospitals, where care is free and out-of-pocket expenditure is among the lowest in the country. Nationally, 58.6% of deliveries occur in public facilities.Gynaecologists in state-run hospitals point out that caesarean sections are not always avoidable — and that timely surgical intervention has contributed to the decline in maternal and infant mortality, sending mothers and babies home safely.Yet experts flag one number the state will find difficult to defend. Only 71.2% of Tamil Nadu mothers registered for antenatal care in the first trimester — down sharply from 77.4% in the previous round. The proportion of mothers completing at least four antenatal visits has also fallen, from 90.6% to 87.6%. Women are arriving in hospitals to deliver, but arriving too late for the care that shapes outcomes before birth.