A Vulnerability Index for Mitigation and Prevention of Diabetes Growth in India: A Disaggregated Analysis.

OBJECTIVES: This study aimed to provide a vulnerability index (VI) for identifying vulnerable regions in different states of India, which may serve as a tool for state- and district-level planning for mitigation and prevention of diabetes growth in the country. METHODS: Using data on 13 indicators under 4 domains, we generated domain-specific and overall VIs at state (36 states/union territories) and district levels (640 districts) using the percentile ranking method. The association of diabetes with individuals' socioeconomic status at different levels of regional vulnerability has also been observed through multivariable logistic regression models. RESULTS: On a scale of 0 to 1, there are 13 states with an overall VI of >0.70, of which 5 states are from southern regions of India. A low VI has been achieved by socioeconomically backward states. We observed that prevalence rates and vulnerability levels for most of the top and bottom 11 states are in the same line. District-level analysis showed that the 20 most vulnerable and least vulnerable districts are mostly from coastal and socioeconomically backward states of the country, respectively. Furthermore, logistic regression revealed that rural adults and females are less likely to be diabetic in all vulnerability quartiles. The oldest, Muslims, wealthiest, widowed/deserted/separated, and those with schooling ≤12 years are significantly more likely to be diabetic than their counterparts. CONCLUSION: The constructed VI is vital for identifying vulnerable areas and planners and policy-makers may use this comprehensive index and domain-specific VIs to prioritize resource allocation.

Cardiovascular Diseases and Ageing in India: A Propensity Score Matching Analysis of the Effects of Various Risk Factors.

Cardiovascular diseases (CVDs) are one of the major causes of mortality and morbidity worldwide, with a significant burden, especially on older adults. This analysis aims to estimate the exclusive effects of various risk factors of CVDs among 59,073 older adults aged 45 years and above in India. Using data from wave 1 of the Longitudinal Ageing Study in India (LASI), the exposure effects of various risk factors on CVDs are estimated through propensity score matching. This analysis is further extended to different components of CVDs, such as hypertension, heart disease, and stroke. Results indicate that risk factors groups such as environmental, behavioral, physiological, and genetic risk factors have a positive and significant impact on CVDs. In the case of independent risk factor effects, diabetes has the highest effect on CVDs, followed by overweight, cholesterol, family history, alcohol consumption, and depression. We conclude that physiological risk factors among older adults are more severe than other factors.

Analysing the burden of morbidity, associated expenditure, and coping strategies among india's elderly population: Evidence from national sample survey 75th round.

Background: An increase in average life expectancy has raised a concern about whether these extra added years are characterized by good health and independence or health problems and dependency on others for care. The current study aimed to analyze the morbidity burden, associated expenditure, and coping strategies among India's elderly population. Data and Methods: The study uses cross-sectional data of the National Sample Survey 75th round. Multivariable logistic regression has been used to examine morbidity and associated expenditure differentials among the elderly population in different socioeconomic variables in India. Results: Findings show that cardiovascular diseases (CVDs) are the leading cause of morbidity and economic burden among the elderly population in India in the case of inpatient care. However, in outpatient care, CVDs are the leading cause of morbidity, while cancer is the main cause of economic burden (measured only through OOPE). Although CVDs are the leading cause of morbidity and economic burden, psychological and neurological, injuries, cancer, and gastrointestinal ailments force the elderly population to borrow for inpatient care. Further, it is the oldest, minority (Muslims) and richest section of the elderly population who are most likely to report health issues. Gender differential is also clear from the results as females are more likely to report for ailments in outpatient care, whereas the reverse is the incident in inpatients. Conclusion: The study concluded that there is a need to increase government spending on social security such as old age pensions like Indira Gandhi National Old Age Pension Scheme, keeping in view the changing needs of the elderly population.