Socio-economic patterning of cardiometabolic risk factors in rural and peri-urban India: Andhra Pradesh children and parents study (APCAPS)

• Published in: Journal of public health Vol. 23; no. 3; pp. 129 - 136
• Main Authors: Gupta, Vipin, Millett, Christopher, Walia, Gagandeep Kaur, Kinra, Sanjay, Aggarwal, Aastha, Prabhakaran, Poornima, Bhogadi, Santhi, Kumar, Aniket, Gupta, Ruby, Prabhakaran, D., Reddy, K. Srinath, Smith, George Davey, Ben-Shlomo, Yoav, Krishna, K. V. Radha, Ebrahim, Shah
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2015; Springer Nature B.V
• Subjects: Cardiovascular disease; Economics; Epidemiology; Health Promotion and Disease Prevention; Health risks; Households; Medicine; Medicine & Public Health; Original; Original Article; Public Health; Risk factors; Rural areas; Socioeconomic factors; Socioeconomics; Standard of living; Urban areas; India; Status; Metabolic disease; Socioeconomic position; Cardiovascular; Risk factors
• ISSN: 2198-1833; 1613-2238
• DOI: 10.1007/s10389-015-0662-y

Aim To assess the prevalence of cardiometabolic risk factors by socio-economic position (SEP) in rural and peri-urban Indian population. Subjects and methods Cross-sectional survey of 3,948 adults (1,154 households) from Telangana (2010–2012) was conducted to collect questionnaire-based data, physical measurements and fasting blood samples. We compared the prevalence of risk factors and their clustering by SEP adjusting for age using the Mantel Hansel test. Results Men and women with no education had higher prevalence of increased waist circumference (men: 8 vs. 6.4 %, P  < 0.001; women: 20.9 vs. 12.0 %, P  = 0.01), waist-hip ratio (men: 46.5 vs. 25.8 %, P  = 0.003; women: 58.8 vs. 29.2 %, P  = 0.04) and regular alcohol intake (61.7 vs. 32.5 %, P  < 0.001; women: 25.7 vs. 3.8 %, P  < 0.001) than educated participants. Unskilled participants had higher prevalence of regular alcohol intake (men: 57.7 vs. 38.7 %, P  = 0.001; women: 28.3 vs. 7.3 %, P  < 0.001). In contrast, participants with a higher standard of living index had higher prevalence of diabetes (top third vs. bottom third: men 5.2 vs. 3.5 %, P  = 0.004; women 5.5 vs. 2.4 %, P  = 0.003), hyperinsulinemia (men 29.5 vs. 16.3 %, P  = 0.002; women 31.1 vs. 14.3 %, P  < 0.001), obesity (men 23.3 vs. 10.6 %, P  < 0.001; women 25.9 vs. 12.8 %, P  < 0.001), and raised LDL (men 16.8 vs. 11.4 %, P  = 0.001; women 21.3 vs. 14.0 %, P  < 0.001). Conclusions Cardiometabolic risk factors are common in rural India but do not show a consistent association with SEP except for higher prevalence of smoking and regular alcohol intake in lower SEP group. Strategies to address the growing burden of cardiometabolic diseases in urbanizing rural India should be assessed for their potential impact on social inequalities in health.