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Rising challenge of multiple morbidities among the rural poor in India—a case of the Sundarbans in West Bengal

Lalitha Vadrevu, Vinod Kumar, Barun Kanjilal.


Background: Multimorbidity or multiple chronic conditions increase with age and imply complicated clinical management and lower quality of life that is compounded by poverty. Yet, there is a serious dearth of evidence on this issue.

Objective: To explore the burden and predictors of multiple morbidities in the Sundarbans of West Bengal.

Materials and Methods: A cross-sectional survey of respondents aged older than 40 years was carried out in the remote islands of Sundarbans in India. A clinical algorithm was used to assess the burden of six chronic conditions, along with the risk factors. Partial proportional odds regression was used to analyze the differentials of multimorbidity.

Result: The crude prevalence of multimorbidity was 44.05%, and it was higher among women. The adjusted odds of showing multimorbidity increased with age and BMI in both the genders. Increase in education (OR: 0.48; 95% CI: 0.27–0.85), employment (OR: 0.33; 95% CI: 0.16–0.67), and sufficient vegetable intake (OR: 0.53; 95% CI: 0.28–1.00) were significant predictors among the rural male population.

Conclusion: The study provides evidence on an often ignored aspect of noncommunicable diseases in India. The evidence underlines the immediate need for attention to the issue of multiple morbidities in a fast aging population of the country’s rural poor.

Key words: Chronic disease, health-care disparities, socioeconomic factors, risk factors, rural health, morbidity

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