The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India.
BACKGROUND
Chronic conditions are on rise globally and in India. Prevailing intra-urban inequities in access to healthcare services compounds the problems faced by urban poor. This paper reports the trends in self-reported prevalence of chronic conditions and health-seeking pattern among residents of a poor urban neighborhood in south India.


METHODS
A cross sectional survey of 1099 households (5340 individuals) was conducted using a structured questionnaire. The prevalence and health-seeking pattern for chronic conditions in general and for hypertension and diabetes in particular were assessed and compared with a survey conducted in the same community three years ago. The predictors of prevalence and health-seeking pattern were analyzed through a multivariable logistic regression analysis.


RESULTS
The overall self-reported prevalence of chronic conditions was 12%, with hypertension (7%) and diabetes (5.8%) being the common conditions. The self-reported prevalence of chronic conditions increased by 3.8 percentage point over a period of three years (OR: 1.5). Older people, women and people living below the poverty line had greater odds of having chronic conditions across the two studies compared. Majority of patients (89.3%) sought care from private health facilities indicating a decrease by 8.7 percentage points in use of government health facility compared to the earlier study (OR: 0.5). Patients seeking care from super specialty hospitals and those living below the poverty line were more likely to seek care from government health facilities.


CONCLUSIONS
There is need to strengthen health services with a preferential focus on government services to assure affordable care for chronic conditions to urban poor.
Institute of Public Health, 250, 2nd C Main, Girinagar 1st Phase, Bengaluru, 560085, India. mrunalini@iphindia.org.
Mrunalini J
MJ
Gowda
Institute of Public Health, 250, 2nd C Main, Girinagar 1st Phase, Bengaluru, 560085, India. upendra@iphindia.org.|Department of Public Health, Ghent University, De Pintelaan 185 4K3 9000, Ghent, Belgium. upendra@iphindia.org.
Upendra
U
Bhojani
Institute of Public Health, 250, 2nd C Main, Girinagar 1st Phase, Bengaluru, 560085, India. deva@iphindia.org.
Narayanan
N
Devadasan
Institute of Public Health, 250, 2nd C Main, Girinagar 1st Phase, Bengaluru, 560085, India. thriveni@iphindia.org.
Thriveni S
TS
Beerenahally
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D012111:Residence Characteristics; D057566:Self Report; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult