Small Area Geographic Estimates of Cardiovascular Disease Risk Factors in India
Authors' conclusion
This cross-sectional study found a substantial small area variability, suggesting the necessity of precise policy attention specifically to small areas in program formulation and intervention to prevent and manage CVD risk factors. Targeted action on policy-priority districts with high prevalence and substantial inequality is required for accelerating India's efforts to reduce the burden of noncommunicable diseases.
Study context
- Population
- Individuals aged ≥15 years in India, National Family Health Survey 2019–2021; >30,000 small areas, 707 districts, 36 states or Union Territorieshypertension 1,715,895
- Outcome
- CVD risk factors (hypertension, diabetes, obesity): geographic variability partitioned by state/Union Territory, district and small area
Methodological detailsnationally representative, four-level logistic regression models, Data analyses July 1, 2022, through August 1, 2023
- Nationally representative
- Four-level logistic regression models
- Data analyses July 1, 2022, through August 1, 2023
Main finding
As reported in the abstract
Share of total geographic variability, female participants
- Small areas: diabetes
- 32.0%
- Small areas: obesity
- 34.5%
- Small areas: hypertension
- 56.2%
- States: hypertension
- 30.0%
- States: obesity
- 46.6%
- States: diabetes
- 52.8%
- Districts: hypertension
- 13.8%
- Districts: diabetes
- 15.2%
- Districts: obesity
- 18.9%
Observational data: associations, not effects.
Further findings
Prevalence
- Hypertension, female
- 21.2%
- Hypertension, male
- 24.1%
- Diabetes, female
- 5.0%
- Diabetes, male
- 5.4%
- Obesity, female
- 6.3%
- Obesity, male
- 4.0%
Correlation between district-wide mean and within-district variability
- Hypertension
- r = 0.66
- Obesity
- 0.94
- Diabetes
- 0.96
- Significant discordance between district-wide mean and within-district small area variability for hypertension
Original publication
Small Area Geographic Estimates of Cardiovascular Disease Risk Factors in India. JAMA Netw Open. Published 2 October 2023. doi:10.
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