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Research

Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c4974 (Published 27 September 2010) Cite this as: BMJ 2010;341:c4974
  1. Sanjay Kinra, senior lecturer1,
  2. Liza J Bowen, research degree student1,
  3. Tanica Lyngdoh, research fellow2,
  4. Dorairaj Prabhakaran, adjunct professor2,
  5. Kolli Srinath Reddy, president3,
  6. Lakshmy Ramakrishnan, associate professor4,
  7. Ruby Gupta, research fellow4,
  8. Ankalmadagu V Bharathi, lecturer5,
  9. Mario Vaz, senior lecturer5,
  10. Anura V Kurpad, professor5,
  11. George Davey Smith, professor6,
  12. Yoav Ben-Shlomo, professor6,
  13. Shah Ebrahim, professor1
  1. 1Non-communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
  2. 2Centre for Chronic Disease Control, New Delhi, India
  3. 3Public Health Foundation of India, New Delhi, India
  4. 4Department of Biochemistry, All India Institute of Medical Sciences, Delhi, India
  5. 5St John’s Research Institute, Bangalore, India
  6. 6Department of Social Medicine, University of Bristol, Bristol
  1. Correspondence to: S Kinra sanjay.kinra{at}lshtm.ac.uk
  • Accepted 23 July 2010

Abstract

Objectives To investigate the sociodemographic patterning of non-communicable disease risk factors in rural India.

Design Cross sectional study.

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

Participants 1983 (31% women) people aged 20–69 years (49% response rate).

Main outcome measures 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.

Footnotes

  • We thank the local investigators, field workers, and participants of the Indian Migration Study.

  • Contributors: SK, TL, KSR, AVB, MV, AVK, GDS, YBS, and SE helped design the study; all authors helped conduct the study; LR and RG performed the laboratory analyses; LJB analysed the data; SK wrote the first draft of the manuscript, and all authors contributed to its redrafting and have approved the final version. All authors had full access to all of the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. SK is the guarantor of the study.

  • Funding: This work is funded by the Wellcome Trust (grant No GR070797MF). The funder had no role in study design; data collection, analysis, or interpretation; in writing the report, or in the decision to submit the article for publication. The researchers are all independent from the funding source.

  • Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work other than the funding grant; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: Ethical approval for the study was obtained from the ethics committee of the All India Institute of Medical Sciences, New Delhi. Written informed consent was obtained from the participants.

  • Data sharing: No additional data available.

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