Cardiovascular Diseases in Context: Multilevel Analysis of Risk Factors in India (2004–2014)

Cardiovascular diseases (CVDs), accounting for approximately half of all deaths owing to non-communicable diseases worldwide, have become a major public health concern. The CVD risk is high among the Indian population, as well as varies by geography. The purpose of the current study was to test the independent effects of contextual socio-economic variables, whilst adjusting for individual socio-economic variables on CVD risk factors in India. Data from the 52nd, 60th, and 71st NSSO rounds pertaining to Social Consumption related to Health have been utilized for the current study. A four-level multilevel model has been fitted to examine the measured individual, household, community, and district factors on the prevalence of CVDs.District educational attainment, household expenditure quintile, and proportion of district urbanicity have emerged as important factors with few contra-indications in terms of traditional directions of association, as opposed to extant literature. Religious and ethnic composition of the communities and districts have also been found to have an impact. In order to better manage the CVD health of the nation, there is a strong need to focus on community-level and district-level interventions, in addition to individual-level factors. Future research should investigate these factors to account for unexplained variations in CVD management