Hypertension in Rural and Indigenous Populations in Odisha, India Öffentlichkeit

Abstract

Introduction: Indigenous communities around the world tend to reside in rural and remote areas and experience social and economic exclusions that have rendered them vulnerable to malnutrition and infectious diseases. Odisha is one of the poorest states of India, with a large indigenous and rural population. As chronic diseases expand their reach to rural settings globally, the prevalence of conditions such as hypertension are rising in indigenous communities. However, there is limited knowledge of the distribution of chronic diseases and their risk factors in indigenous and remote populations.

Methods: In this analysis, we investigate the prevalence of hypertension and its correlates among participants of a health screening camp targeting remote villages in rural Odisha. Linear and logistic regression models were used to measure the associations of age, body mass index, gender, and social group (Scheduled Tribe or Scheduled Caste) with elevated systolic and diastolic blood pressure, and hypertension (systolic/diastolic blood pressure of 140/90 mmHg or higher).

Results: Most screening participants identified as Scheduled Tribe (81.2%). Participants were 63.3% female, were an average age of 39.5 years, and had an average BMI of 19.2 kg/m². The prevalence of hypertension was 14.9%, with 10.2% in women and 22.7% in men. The strongest correlates of high blood pressure were age (coefficient=0.3 mmHg, 95% CI:0.2, 0.3 for systolic blood pressure; coefficient=0.2 mmHg, 95% CI: 0.1, 0.2 for diastolic blood pressure) and BMI (coefficient=0.8 kg/m², 95% CI:0.3, 1.3 for systolic blood pressure; coefficient=0.6 kg/m², 95% CI: 0.3, 0.9 for diastolic blood pressure). Age (odds ratio=1.0, 95% CI: 1.0, 1.1) and gender (odds ratio: 2.4, 95% CI: 1.4, 3.9 ref= women) were the strongest correlates of hypertension. The mean BMI among those with hypertension was 20.1 (18.3 in women, 21.5 in men), well within the normal range and much lower than BMI observed among adults with hypertension elsewhere. 

Conclusions: One in ten women and one in five men screened positive for hypertension among participants at a screening camp serving rural populations in Odisha, indicating a prevalence of hypertension on par with the national average. The findings indicate that individuals with BMI in the normal range must still be included in screening efforts. 

Table of Contents

INTRODUCTION.. 1

Background. 1

Scheduled Tribes of India. 1

Epidemiological transition. 3

Hypertension in India. 4

Problem statement 8

Purpose statement and significance. 9

LITERATURE REVIEW... 10

METHODS. 16

Primary Results. 21

Sensitivity Analysis. 23

IMPLICATIONS. 27

REFERENCES. 28

TABLES AND FIGURES. 32

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Stichwort	Non-communicable diseases Odisha Indigenous population Chronic diseases Hypertension Scheduled tribe Rural health Community health
Committee Chair / Thesis Advisor	Shivani A. Patel, MPH, PhD, Emory University

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