TY - JOUR
T1 - Spatial Patterns in the Distribution of Hypertension among Men and Women in India and Its Relationship with Health Insurance Coverage
AU - Kamath, Rajesh
AU - Brand, Helmut
AU - Ravandhur Arun, Harshith
AU - Lakshmi, Vani
AU - Sharma, Nishu
AU - D’souza, Reshma Maria Cocess
N1 - Funding Information:
The National Family Health Survey (NFHS) is carried out in all the states and union territories of India. The NFHS gathers population, nutrition, and health data. The fifth survey in the series (NFHS-5) was carried out in 2019–2020. The NFHS is a valuable source of high-quality district level estimates for several critical indicators. It is conducted by the Government of India under the aegis of the Ministry of Health and Family Welfare (MoHFW). The executive agency for the NFHS is the International Institute for Population Sciences (IIPS), Mumbai. The NFHS receives technical assistance from Demographic and Health Surveys Program, ICF, USA, which is supported by USAID, the National AIDS Research Institute (NARI), Pune and the Indian Council of Medical Research (ICMR), New Delhi. The NFHS all India sample size is 610,000 households. This number is expected to provide statistically significant results at the district level: as of August 2022, India has 766 districts for 1.4 billion people. For both rural and urban areas, a two-stage sample design was used. In the first stage in rural areas, villages were the Primary Sampling Units (PSUs). In the second stage, 22 households were chosen by random selection in each PSU. In the first stage in urban areas, Census Enumeration Blocks (CEB) were the Primary Sampling Units (PSUs). In the second stage, 22 households were chosen by random selection in each CEB. In the second stage in both rural and urban areas, a comprehensive mapping and listing of households was completed before households were selected for the survey [20].
Publisher Copyright:
© 2023 by the authors.
PY - 2023/6
Y1 - 2023/6
N2 - The present study explores district-level data associated with health insurance coverage (%) and the prevalence of hypertension (mildly, moderately, and severely elevated) observed across men and women as per NFHS 5. Coastal districts in the peninsular region of India and districts in parts of northeastern India have the highest prevalence of elevated blood pressure. Jammu and Kashmir, parts of Gujarat and parts of Rajasthan have a lower prevalence of elevated blood pressure. Intrastate heterogeneity in spatial patterns of elevated blood pressure is mainly seen in central India. The highest burden of elevated blood pressure is in the state of Kerala. Rajasthan is among the states with higher health insurance coverage and a lower prevalence of elevated blood pressure. There is a relatively low positive relationship between health insurance coverage and the prevalence of elevated blood pressure. Health insurance in India generally covers the cost of inpatient care to the exclusion of outpatient care. This might mean that health insurance has limited impact in improving the diagnosis of hypertension. Access to public health centers raises the probability of adults with hypertension receiving treatment with antihypertensives. Access to public health centers has been seen to be especially significant at the poorer end of the economic spectrum. The health and wellness center initiative under Ayushman Bharat will play a crucial role in hypertension control in India.
AB - The present study explores district-level data associated with health insurance coverage (%) and the prevalence of hypertension (mildly, moderately, and severely elevated) observed across men and women as per NFHS 5. Coastal districts in the peninsular region of India and districts in parts of northeastern India have the highest prevalence of elevated blood pressure. Jammu and Kashmir, parts of Gujarat and parts of Rajasthan have a lower prevalence of elevated blood pressure. Intrastate heterogeneity in spatial patterns of elevated blood pressure is mainly seen in central India. The highest burden of elevated blood pressure is in the state of Kerala. Rajasthan is among the states with higher health insurance coverage and a lower prevalence of elevated blood pressure. There is a relatively low positive relationship between health insurance coverage and the prevalence of elevated blood pressure. Health insurance in India generally covers the cost of inpatient care to the exclusion of outpatient care. This might mean that health insurance has limited impact in improving the diagnosis of hypertension. Access to public health centers raises the probability of adults with hypertension receiving treatment with antihypertensives. Access to public health centers has been seen to be especially significant at the poorer end of the economic spectrum. The health and wellness center initiative under Ayushman Bharat will play a crucial role in hypertension control in India.
UR - http://www.scopus.com/inward/record.url?scp=85161723331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85161723331&partnerID=8YFLogxK
U2 - 10.3390/healthcare11111630
DO - 10.3390/healthcare11111630
M3 - Article
AN - SCOPUS:85161723331
SN - 2227-9032
VL - 11
JO - Healthcare (Switzerland)
JF - Healthcare (Switzerland)
IS - 11
M1 - 1630
ER -
