Morbidity transition at the national and sub-national level and their determinants over the past and contemporary period in India.

The study delves into the epidemiological transition, examining the intricate changes in health status patterns and their connection to morbidities. Specifically, it assesses morbidity transition at both national and subnational levels in India and their determinants from 1995 to 2018. This study examines self-reported morbidities in India by utilising four rounds of National Sample Survey Organisation (NSSO) data (52nd, 60th, 71st, and 75th) from 1995-2018. We estimated prevalence by conducting descriptive analysis on socio-demographic determinants and morbidities such as: Infectious and Communicable Diseases (In&CDs), Non-communicable diseases (NCDs), Disability and other diseases. Moreover, we employed pooled regression analysis to explore morbidity risk transitions over the past decades. The study revealed a steady upsurge in morbidity prevalence in India, doubling from 56 (per thousand) in 1995 to 106 in 2014. However, a considerable decline was observed in the most recent round in 2018 (79 per thousand). From 1995 to 2018, NCDs gained a prominent share in morbidity trends. Kerala in the southern region reported the highest rates, followed by states like Lakshadweep, Andhra Pradesh, Karnataka, West Bengal, Punjab, and others. Age, sex, residence, education, caste, religion, and wealth are pivotal factors in determining the severity of different disease burdens in different sections of the population in India. Over the study period (1995, 2004, 2014, and 2018), the odds of reported morbidities risk transition significantly increased over successive decades: 1.81 times in 2004 (95% CI: 1.78-1.84), 2.16 times in 2014 (95% CI: 2.12-2.2), and 1.44 times in 2018 (95% CI: 1.41-1.46), compared to 1995 (52nd round). The study reveals significant disparities in morbidity reporting across Indian states from 1995 to 2018, attributed to distinct demographic, social, and economic determinants. India continues to grapple with the dual burden of diseases, but the NCDs burden is mounting at a faster pace than CDs.

Exploring the financial burden due to additional mobility among cancer patients: A cross-sectional study based on National Sample Survey.

BACKGROUND: Cancer imposes a substantial economic burden due to treatment costs, supportive care, and loss of productivity. Besides all the affecting factors, major concerns lead to significant financial burdens of cancer treatment, bringing unwanted huge unbearable direct and indirect treatment costs. The aim was to explore the nature of additional mobility/travel required for accessing health care for cancer patients and also to assess financial burden due to additional mobility/travel costs for cancer treatment. METHODS: This study employed unit-level cross-sectional data from the 75th round (2017-18) of India's National Sample Survey (NSS). The primary analysis commenced with descriptive and bivariate analyses to explore mean health spending and out-of-pocket expenses. Subsequently, multivariable logistic regression models were utilized to estimate the associations between catastrophic health expenditure, distress financing, and the treatment location. RESULTS: The findings highlight distinct healthcare utilization patterns: inpatient treatments predominantly occur within the same district (50.4 %), followed by a different district (38.8 %), and a smaller share in other states (10.8 %). Outpatients largely receive treatment in the same district (65.5 %), followed by a different district (26.8 %), and around 8 % percent in other states. Urban areas show higher inpatient visits within the same district (41.8 %) and different districts (33.5 %). Outpatients, particularly those seeking treatment in other states, experience higher total expenditures, notably with higher out-of-pocket expenses. Distress financing is more common among inpatients (20.6 %) and combined inpatient/outpatient cases (23.9 %), while outpatients exhibit a lower rate (6.8 %). CONCLUSION: The findings collectively suggest the importance of developing local healthcare infrastructures to reduce the additional mobility of cancer patients. The policy should focus to train and deploy oncologists in non-urban areas can help bridge the gap in cancer care proficiency and reduce the need for patients to travel long distances for treatment.

An assessment of self-rated life satisfaction and its correlates with physical, mental and social health status among older adults in India.

Life satisfaction refers to the assessment of one's own life in terms of self-perceived favourable qualities. It is an integral part of healthy and successful course of ageing. It is widely associated with the health status and social well-being. The present study attempted to determine the constructing factors of self-rated life satisfaction, such as socio-demographic, physical, social, and mental well-being of older adults. We analysed information from the Longitudinal Ageing Study in India (LASI-1), the initial phase conducted during 2017-18 for the population of older adults in India. We applied descriptive statistics for prevalence assessment and association was checked using chi-square test. Further, to determine the adjusted outcome of predictor covariates on the likelihood of an individual being satisfied from life estimated by applying hierarchical multiple logistic regression models. Several noteworthy affirmations on the relationship between the socio-demographic variables and health risk behaviours with life satisfaction were observed. The results were consistent with studies showing change in life satisfaction subject to the state of physical and mental health, presence of chronic diseases, friends and family relations, dependency, and events of trauma or abuse. While comparing respondents, we found varying degrees of life satisfaction by gender, education, marital status, expenditure and other socio-economic features. We also found that besides physical and mental health, social support and well-being play a pivotal role in achieving higher life satisfaction among older adults. Overall, this work contributes to the study of the subjective well-being of older adults in India based on self-reported levels of life satisfaction and further narrows the gap in knowledge about associated behaviour. Hence, with on-going ageing scenario, there is need for multi-sectorial policy-oriented approaches at individual, family, and community level, which helps to take care of older-adults' physical, social, and mental health for the betterment of healthy ageing.

Association of multi-morbidity, social participation, functional and mental health with the self-rated health of middle-aged and older adults in India: a study based on LASI wave-1.

Self-rated health (SRH) is a well-established measure in public health to administer the general health of an individual. It can also be used to assess overall health status' relationship with the social, physical, and mental health of a person. In this study, we examine the association of SRH and various socio-economic & health-related factors such as multi-morbidity status, mental health, functional health, and social participation. Data used in this paper is collated from the first wave of Longitudinal Ageing Study in India (LASI) 2017-18. A total of 65,562 older adults aged 45 or above are considered in our study. Various indices (multimorbidity, social participation, functional and mental health) have been created to measure factors influencing the SRH of an individual. Overall, in the study population, around 18.4% of people reported poor SRH. Dominance Analysis results show that the contribution of multimorbidity in predicting poor SRH is highest, followed by functional health, mental health, and social participation. In a developing country like India, there is a dire need for policies having a holistic approach regarding the health and well-being of the older population.

Spousal violence against women and its consequences on pregnancy outcomes and reproductive health of women in India.

BACKGROUND: Globally, one in three women experienced domestic violence. Alike the scenario observed in India, and a very few studies talk about violence and its consequences on women's health. Hence, the purpose of this study is to access the level of various types of spousal violence in India and to understand the association between physical, sexual and emotional violence against ever-married women by their husbands. The study further examines the consequences of spousal violence on women's health in terms of adverse pregnancy outcomes and reproductive health in India. METHODS: The study uses secondary data from National Family Health Survey-4 (NFHS-4, 2015-16). The analysis was based on a sample of ever-married women aged 15-49 years. Bivariate descriptive analysis and multiple regression analyses have been carried out to understand the association between spousal violence and its consequences on women's health. RESULTS: The study finds that the physical, sexual and emotional violence experienced by ever-married women in India are 29.8%, 13.8% and 7.0%, respectively. Further, the physical and sexual violence experienced by women have a significant association with an unwanted pregnancy, abortion, miscarriages and ever had termination of pregnancies. The regression analysis shows that violence by sexual partners among battered women increased the likelihood of unwanted pregnancy. Similarly, abortion and ever had a termination of pregnancies are also adversely affected by partner violence. Further, the risk of sexually transmitted infection increases 77% by sexual violence and 44% by emotional violence among battered women. Also, Sexual violence substantially increases the risk of prolonged labour during pregnancy. CONCLUSION: This study revealed that one in three women experiencing violence by their husband and also it is evident that various forms of spousal violence adversely affect pregnancies outcomes and reproductive health among battered women compared to not battered.

An assessment of anthropometric indices and its association with NCDs among the older adults of India: evidence from LASI Wave-1.

BACKGROUND: The purpose of this study is to assess the status of physical body indices such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) among the older adults aged 45 and above in India. Further, to explore the association of anthropometric indices with various non-communicable morbidities. METHODS: The study uses secondary data of the Longitudinal Ageing Survey's first wave in India (2017-18). The national representative sample for older adults 45 and above (65,662) considered for the analysis. The prevalence of the non-communicable diseases (NCDs) included in the study is based on the self-reporting of the participants. Diseases included are among the top ten causes of death, such as cancer, hypertension, stroke, chronic heart diseases, diabetes, chronic respiratory diseases, and multi-morbidity. Multi-morbidity is a case of having more than one of the morbidities mentioned above. BMI-obese indicates an individual having a BMI ≥30, and the critical threshold value for high-risk WC for men is ≥102 cm while for women is ≥88 cm. The critical limit for the high-risk WHR for men and women is ≥0.90 and ≥ 0.85, respectively. Descriptive statistics and multiple logistic regressions are used to assess the association BMI, WC, and WHR with non-communicable morbidities. RESULTS: Based on the multivariate-adjusted model, odds shows that an Indian older adult aged 45 and above is 2.3 times more likely (AOR: 2.33; 95% CI (2.2, 2.5)) by obesity, 61% more likely (AOR: 1.61; 95% CI (1.629, 1.631)) by high-risk WHR and 98% more likely (AOR: 1.98; 95% CI (1.9, 2.1)) by high-risk WC to develop CVDs than their normal counterparts. Similarly, significant positive associations of obesity, high-risk WC, and high-risk WHR were observed with other NCDs and multi-morbidity. CONCLUSION: Our study shows that obesity, high-risk WC, and high-risk WHR are significant risks for developing NCDs and multi-morbidity among the older adults in India. There is a need for a multi-sectoral approach to reduce the share of the elderly population in high-risk groups of BMIs, WHR, and WC.