As per the World Health Organization, all but 1% of the world's population is exposed to unhealthy air and also exceeds the WHO limits for pollutants. However, there are some parts of the world where aur quality has improved through policies that limits pollution, while in other parts, it has not reached the desired results.

For US, more than 25% of the population is exposed to "unhealthy" air as per the Environmental Protection Agency (EPA), this is according to the report by the climate non-profit First Street Foundation. By 2050, the number of people exposed to "unhealthy" air will increase by more than half. The worst days of air pollution, reports BBC, "hazardous" or maroon under the EPA's system will rise by 27%.

Why are we talking about this today? It is because of the recent wildfire in California, which started on January 7. This is also one of the factors that is spiking the PM2.5 levels. It has increased by up to five micrograms per cubic metre in the western US in the past decade.

What is PM2.5?

It is a type of air pollution which is made of particulate matter and measures 2.5 micrometres across or less. It is roughly 30 times smaller than the width of a human hair. These particles are made with a mixture of solid and liquid substances, which varies in their chemical composition, including carbon, metals, and organic compounds.

These specks of airborne soot, dust and other substances can also trigger inflammation, which could also damage your brain.

As per a 2021 study titled The Changing risk and burden of wildfire in the United States, a quarter of US's PM2.5 pollution was caused by wildfire smoke. In 2023, US also witnessed a significant dip in air quality and visibility as smoke from wildfires north of the Canadian border entered across the continent. In May 2024, Canada also saw a start to its wildfire season, and one town was evacuated in British Colombia.

Wildfire smoke and its effects

Wildfires do not only affect those who live near forests, peatlands, and grasslands, but also to the cities and environment in general. It can send plumes up to 14 miles or 23km into the stratosphere, and from there, it can spread all over the globe. For instance, in 2023, the Siberian wildfires released smoke that travelled across the Pacific Oceans to reach Alaska and Seattle.

Other than PM2.5, wildfire smoke is also harmful to immune cells in lungs, and the toxicity could be four times greater than particulates from other types of pollution.

Another 2019 study titled Effects of Atmosphere Processing on the Oxidative Potential of Biomass Burning Organic Aerosols found the toxicity of smoke doubled in the hours after it was first emitted and reached four times greater toxicity at its peak.

Health Impact

There have been research that shows how pollution affects your brain. It can lead to impaired judgment, poorer performance in school and even higher levels of crime, as per the 2018 study by the London School of Economics.

Other health concerns include weight gain. There have been researches that links airborne pollution such as PM2.5 to obesity. The studies have found that children who live in most polluted areas are twice as more likely to have obesity. Some studies also find the link of air pollution harming our sense of smell. As per an Italian study from 2022, titled Association between environmental air pollution and olfactory functioning among Italian adolescents and young adults in Northern Italy, noses of teenagers and young adults became less sensitive to odors after being exposed to nitrogen dioxide, which is a component in traffic fumes.

In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.

This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.

While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.

The Challenge of Low Health Literacy in India

The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.

Several factors explain this reality:

• Low literacy levels: A significant proportion of the population cannot read or interpret basic medical instructions, leading to mismanagement of conditions.

• Poverty and affordability: For millions living on less than INR 100 a day, awareness alone is not enough when healthy choices remain unaffordable.

• Gender and cultural barriers: Women often have lower access to information and autonomy in health decisions, particularly around reproductive and maternal health.

• Distrust in healthcare systems: Overcrowded facilities and inconsistent care erode confidence, driving many to informal or unverified sources.

Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.

Blockbuster drug Ozempic, known for treating type 2 diabetes and obesity, has a surprising side effect. A new study published in The Lancet Psychiatry showed that the GLP-1 receptor agonists might prevent worsening of depression and anxiety.

People with diabetes or obesity are generally more likely than the general population to suffer from depression and anxiety. It is because both diabetes and obesity increase the risk of mental ill-health, and vice versa.

The findings showed that people with diabetes using semaglutide had a substantial decrease in hospitalizations and sick leave due to mental illness, including less worsening of depression, anxiety, and self-harm.

“Our findings suggest that GLP-1 drugs, particularly semaglutide, might contribute to better mental health in people with diabetes and obesity, but since this was an observational study, controlled clinical trials are needed to confirm the results,” said Jari Tiihonen, specialist physician and professor at the Centre for Psychiatry Research, Karolinska Institutet.

What Did The Study Find?

The research, led by an international team from Griffith University, the Karolinska Institutet, and the University of Eastern Finland, tracked Swedish national registers between 2009 and 2022.

It included 95,490 people, of which GLP-1 receptor agonists were used by 22,480 individuals during the follow-up period.

Semaglutide was associated with a decreased risk of worsening

• depression
• anxiety
• substance use disorder
• self-harm.

Patients using semaglutide experienced a 42 percent lower risk of hospitalization for mental health issues during periods of use, compared to periods when they were not taking the drug.

More specifically, the risk reduction was 44 per cent for sickness absence or hospital care due to depression, 38 per cent for anxiety disorders, and 47 per cent for substance use.

Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying

The team also found some benefits with Liraglutide. The drug was associated with an 18 per cent lower risk of sickness absence and hospital care due to psychiatric reasons.

How Does Semaglutide Work?

Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.

They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

Read More: Can Semaglutide Help Fight Cancer In The Brain?

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and the body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.

In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.

The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.

However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.

Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".

"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.

What Is ICU? Who Needs Critical Care?

The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.

They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.

Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.

Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:

• a serious accident
• a serious short-term condition
• a serious infection
• a major surgery.

"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.

ICU Admissions: What India’s Guidelines Say

India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:

• ICU admissions must be based on the severity of organ failure and the necessity for organ support or in anticipation of a potential deterioration in the patient's medical condition.
• Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives.
• ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival.
• Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.
• Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.
• Blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status among other parameters should be monitored in a patient awaiting an ICU bed

1. patients with altered level of consciousness,
2. hemodynamic instability,
3. need for respiratory support,
4. patients with acute illness requiring intensive monitoring
5. organ support or any medical condition or disease with anticipation of deterioration.

Guidelines For ICU Discharge Criteria In India

The guidelines stress the importance of physiological parameters returning to near-normal or baseline status.

Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors.

Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.