These contrasting signals reflect a deeper truth: while the urgency is widely acknowledged, implementation often lags. But pollution is not just an environmental issue. It is a growing economic crisis, which reduces productivity and disrupts livelihoods.
By 2047, India aspires to stand among the world’s leading economies. Achieving this vision will also depend on the health and productivity of our workforce.
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To date, there has been limited evidence on how pollution affects daily life and workforce participation. From 11-13 November last year, at the peak of the pollution crisis, Artha Global’s Centre for Rapid Insights conducted a rapid survey of more than 8,600 individuals across the eight states of Bihar, Delhi, Haryana, Madhya Pradesh, Punjab, Rajasthan, Uttar Pradesh and Uttarakhand using Interactive Voice Response (IVR) technology.
We focused on three simple questions: whether respondents or their family members reported respiratory illnesses due to pollution, whether they or their children had missed work or school as a result, and what measures they took to cope with poor air quality.
Overall, 55% of respondents said that they or a family member had experienced pollution-induced respiratory illnesses, with 34% reporting it as a “regular occurrence.” In Delhi, 43% of respondents reported respiratory illness as a regular occurrence, as did 39% of respondents in Punjab and Rajasthan.
Pollution appears to have a direct impact on economic activity. Of those who reported experiencing some respiratory illness, 65% had missed at least one day of work or school in the previous two weeks.
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Uttar Pradesh and Rajasthan experienced even higher disruptions at nearly 70%. Of working-age adults, aged 18-45, about 70% of those affected missed at least a day of work. And across states, roughly 40% of those affected missed over three days of work, with Delhi and Rajasthan at 43%, Madhya Pradesh at 46% and Haryana at 40%. Taken together, these disruptions represent a drag on India’s economic potential.
Masks appear to be the most common coping mechanism. In Bihar, Madhya Pradesh and Punjab, 40% of respondents rely on masks, while in Delhi this number rises to 50%. Unsurprisingly, only a small share use air purifiers with usage rates generally below 10%, except in Delhi at 12%.
Avoiding outdoor exposure seems to be a common strategy in states like Uttar Pradesh and Rajasthan at 16% and 17%, respectively. This strategy increases significantly with age. We found that 26% of adults over 60 reported that they avoided going outdoors altogether, with obvious implications for social and economic engagement.
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Finally, nearly a quarter of respondents across all states reported taking no protective measures at all, highlighting the urgent need for greater public awareness and increased access to effective mitigation strategies across income levels.
India’s changed disease burden stands testament to the growing risk posed by air pollution and other environmental and lifestyle factors. Chronic obstructive pulmonary disease is the second leading cause of death in India, after ischemic heart disease.
The shift from communicable to non-communicable illnesses (including growing rates of obesity) indicates the need for a multi-sectoral, whole-of-government approach to tackle a health and productivity crisis that cannot be addressed by the health sector alone.
A crucial missing piece has been the role of land use and transportation policy. While source attribution surveys are limited, transport emissions can account for up to 56% of pollution in some cities. But addressing this is not as simple as replacing the existing modes of transport with electric alternatives.
The bulk of India’s peri-urban expansion is unplanned and lacks wide arterial roads or public transport. As cities—and the corresponding economic activity—spills beyond administrative boundaries, these areas suffer from congestion and gridlock. Even when planned, our outdated planning norms encourage land-intensive and therefore car-dependent development in place of a more compact and walkable urban form.
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Efficient and affordable public transport both at the local and metropolitan level is limited, and last mile connectivity remains a persistent impediment to using metro systems and other forms of mass public transit.
Within cities, better traffic management can play a significant role in reducing transport emissions. Artha Global in partnership with Transport for London and TERI is supporting the cities of Vijayawada and Visakhapatnam to develop ‘clean air zones’ around schools and hospitals where air quality is improved by using targeted traffic management measures.
A rapidly urbanizing country like India, which will add thousands of new cities and hundreds of thousands of square kilometres of built-up area growth, simply cannot ignore the role that better urban planning and management will play in reducing emissions. And what works for reducing emissions will support greater economic productivity, not just via improved health outcomes but also better mobility and efficiency.
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India is not the first fast-growing economy to grapple with toxic air. Beijing, Seoul and Bangkok are just some recent examples of cities that made improving public health and productivity a key plank of their economic growth strategy.
The question is not whether India can tackle air pollution, but whether we will act decisively to turn this challenge into an opportunity to create long-term prosperity.
The authors are, respectively, chief executive officer (India) at Artha Global and principal at Artha Global’s Centre for Rapid Insights.
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