Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Thind, Amardeep

Abstract

Research Question: “What are the predictors of multimorbidity (defined as having diabetes + hypertension) amongst males aged 15-54 in India?”

Methods: Using mixed-effect multi-level binary logistic regression models, data from the 2019-2021 India NFHS-5 were analyzed. Separate multivariable analyses were conducted for males from urban and rural areas so the association between common predictors of interest (sociodemographic & lifestyle), and multimorbidity could be determined.

Results: Various predictors (listed below) were found to have a statistically significant association to multimorbidity with some variation across urban and rural areas:

Urban areas: Age, region of residence, wealth, religion, occupation, and BMI.

Rural areas: Age, education, region of residence, wealth, occupation, caste, BMI, alcohol consumption, media exposure, and tobacco consumption.

Conclusion: Findings from this study may have possible implications for policymakers across India. With high-risk characteristics that are predictive of multimorbidity being identified, preventative and healthcare strategies may be improved.

Summary for Lay Audience

Multimorbidity, commonly defined as the co-existence of two or more health conditions within an individual, has been a growing concern in India due to its associated challenges and burdens. With many different combinations of conditions being possible, specific combinations have emerged as being of greater concern. One such example is diabetes and hypertension. Both conditions have been found to be rapidly growing, with their multimorbidity becoming one of the most prevalent in India. More specifically, research has also found that males may be at a greater risk for both conditions with additional reports of increased prevalence when compared to females. Therefore, it has become of interest to determine which characteristics of the population, such as sociodemographic and/or lifestyle factors, may contribute to or protect against this specific multimorbidity. By understanding the association these factors share with multimorbidity, their role as a ‘predictor’ of the health outcome can be better understood. This thesis aimed to investigate and answer the following research question: “What are the predictors of multimorbidity (defined as diabetes + hypertension) amongst males aged 15-54 in India?”

Using the 2019-2021 India National Family Health Survey as a nationally representative data source, males aged 15-54 from urban and rural areas were analyzed separately. After employing relevant statistical methods, the direct association between each predictor of interest and multimorbidity was determined. Both urban and rural areas had statistically significant findings with the following factors being found to be predictors of multimorbidity.

Urban areas: Age, region of residence, wealth, religion, occupation, and BMI.

Rural areas: Age, education, region of residence, wealth, occupation, caste, BMI, alcohol consumption, media exposure, and tobacco consumption.

What these findings suggest is that various sociodemographic and lifestyle factors exist among men in both urban and rural areas of India that may be used to better predict diabetes and hypertension multimorbidity outcome. Policymakers across India should take these findings into consideration to further improve preventative and healthcare strategies and possibly reduce multimorbidity-related burden.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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