Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study.
OBJECTIVE
To investigate the sociodemographic patterning of non-communicable disease risk factors in rural India.


METHODS
Cross sectional study.


METHODS
About 1600 villages from 18 states in India. Most were from four large states due to a convenience sampling strategy.


METHODS
1983 (31% women) people aged 20-69 years (49% response rate).


METHODS
Prevalence of tobacco use, alcohol use, low fruit and vegetable intake, low physical activity, obesity, central adiposity, hypertension, dyslipidaemia, diabetes, and underweight.


RESULTS
Prevalence of most risk factors increased with age. Tobacco and alcohol use, low intake of fruit and vegetables, and underweight were more common in lower socioeconomic positions; whereas obesity, dyslipidaemia, and diabetes (men only) and hypertension (women only) were more prevalent in higher socioeconomic positions. For example, 37% (95% CI 30% to 44%) of men smoked tobacco in the lowest socioeconomic group compared with 15% (12% to 17%) in the highest, while 35% (30% to 40%) of women in the highest socioeconomic group were obese compared with 13% (7% to 19%) in the lowest. The age standardised prevalence of some risk factors was: tobacco use (40% (37% to 42%) men, 4% (3% to 6%) women); low fruit and vegetable intake (69% (66% to 71%) men, 75% (71% to 78%) women); obesity (19% (17% to 21%) men, 28% (24% to 31%) women); dyslipidaemia (33% (31% to 36%) men, 35% (31% to 38%) women); hypertension (20% (18% to 22%) men, 22% (19% to 25%) women); diabetes (6% (5% to 7%) men, 5% (4% to 7%) women); and underweight (21% (19% to 23%) men, 18% (15% to 21%) women). Risk factors were generally more prevalent in south Indians compared with north Indians. For example, the prevalence of dyslipidaemia was 21% (17% to 33%) in north Indian men compared with 33% (29% to 38%) in south Indian men, while the prevalence of obesity was 13% (9% to 17%) in north Indian women compared with 24% (19% to 30%) in south Indian women.


CONCLUSIONS
The prevalence of most risk factors was generally high across a range of sociodemographic groups in this sample of rural villagers in India; in particular, the prevalence of tobacco use in men and obesity in women was striking. However, given the limitations of the study (convenience sampling design and low response rate), cautious interpretation of the results is warranted. These data highlight the need for careful monitoring and control of non-communicable disease risk factors in rural areas of India.
Kinra
Sanjay
S
Non-communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. sanjay.kinra@lshtm.ac.uk
Bowen
Liza J
LJ
Lyngdoh
Tanica
T
Prabhakaran
Dorairaj
D
Reddy
Kolli Srinath
KS
Ramakrishnan
Lakshmy
L
Gupta
Ruby
R
Bharathi
Ankalmadagu V
AV
Vaz
Mario
M
Kurpad
Anura V
AV
Smith
George Davey
GD
Ben-Shlomo
Yoav
Y
Ebrahim
Shah
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004032:Diet; D050171:Dyslipidemias / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007194:India; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012923:Social Class; D014029:Tobacco Use Disorder / Q000453:epidemiology; D055815:Young Adult