More than 50 per cent of the Indian population lives in villages that are located more than five kilometres from the nearest town. This half of India is more likely to experience illnesses of different kinds and simultaneously less likely to get qualified medical treatment. The incidence of premature deaths, infant and child mortality and malnutrition are all significantly higher within villages located further from towns. In consequence, such villagers are more susceptible than others to being overcome by the medical poverty trap. Poverty has increased within villages located more than five kilometres from towns, even as the national economy was surging ahead. Globalization privileges cities, disadvantaging locations at greater distances from towns. Public policy is required to compensate. Efforts to limit spatial inequalities must take precedence in future health policies.