Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23

Abstract Background We assessed sex and socioeconomic disparities in the care cascade, i.e., awareness, treatment, and control (ATC), for hypertension and diabetes among Odisha’s tribal communities. Methods We surveyed 14 tribal districts via multistage cluster sampling covering 10,090 households fr...

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Main Authors: Tanveer Rehman, Chinmayee Sethy, Afeeq K., Jaya Singh Kshatri, Manikandanesan Sakthivel, Kavitha A.K., Ansuman Panigrahi, Mohan Kumar Raju, Archana Ramalingam, Sanghamitra Pati
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Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23587-2
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author Tanveer Rehman
Chinmayee Sethy
Afeeq K.
Jaya Singh Kshatri
Manikandanesan Sakthivel
Kavitha A.K.
Ansuman Panigrahi
Mohan Kumar Raju
Archana Ramalingam
Sanghamitra Pati
author_facet Tanveer Rehman
Chinmayee Sethy
Afeeq K.
Jaya Singh Kshatri
Manikandanesan Sakthivel
Kavitha A.K.
Ansuman Panigrahi
Mohan Kumar Raju
Archana Ramalingam
Sanghamitra Pati
author_sort Tanveer Rehman
collection DOAJ
description Abstract Background We assessed sex and socioeconomic disparities in the care cascade, i.e., awareness, treatment, and control (ATC), for hypertension and diabetes among Odisha’s tribal communities. Methods We surveyed 14 tribal districts via multistage cluster sampling covering 10,090 households from 2022 to 23. Data from individuals aged > 18 years were analyzed for hypertension (BP > 140/90 mmHg) and diabetes (RBS > 200 mg/dL). The outcomes included (i) awareness (prior diagnosis or medication use), (ii) treatment (self-reported medication use), and (iii) control (BP < 140/90 mmHg for hypertension, RBS < 180 mg/dL for diabetes). Multivariable log-binomial regression was used to estimate adjusted prevalence ratios (aPRs with 95% CIs) for gender and wealth quintile associations with ATC stages. Results Of the 21,100 participants, 33.7% had hypertension and 9.7% had diabetes. Among the 6,620 hypertensive individuals, 19% were aware, 13·8% were on treatment, and 6·8% had controlled BP. Women with hypertension (N = 3,609) had significantly better outcomes than men did: awareness (aPR: 1·4;1·2–1·6), treatment (aPR: 1·5; 1·2–1·7), and control (aPR: 1·7; 1·4–2·2). Compared with those in the poorest quintile, hypertensive individuals from the richest quintile (N = 1,804) were more likely to be aware (aPR: 1·5; 1·2-1·9) and on treatment (aPR: 1·5; 1·2–2·7); however, BP control was not significantly different (aPR: 1·6; 0·9-2·8). Among the 1,883 individuals with diabetes, 49% were aware, 44·4% were on treatment, and 40·7% achieved control. Conclusion Significant socioeconomic and sex inequities persist in hypertension care among Odisha’s tribal populations, with better ATC outcomes for women and wealthier individuals. Targeted screening and gender-sensitive approaches are essential for equitable healthcare access.
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spelling doaj-art-bee633941d464c7ab169341b2ccc5afe2025-08-20T03:46:23ZengBMCBMC Public Health1471-24582025-07-0125111210.1186/s12889-025-23587-2Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23Tanveer Rehman0Chinmayee Sethy1Afeeq K.2Jaya Singh Kshatri3Manikandanesan Sakthivel4Kavitha A.K.5Ansuman Panigrahi6Mohan Kumar Raju7Archana Ramalingam8Sanghamitra Pati9ICMR-Regional Medical Research CentreICMR-Regional Medical Research CentreICMR-Regional Medical Research CentreICMR-Regional Medical Research CentreICMR-National Institute of EpidemiologyICMR-Regional Medical Research CentreICMR-Regional Medical Research CentreICMR-National Institute of EpidemiologyICMR-National Institute of EpidemiologyICMR-Regional Medical Research CentreAbstract Background We assessed sex and socioeconomic disparities in the care cascade, i.e., awareness, treatment, and control (ATC), for hypertension and diabetes among Odisha’s tribal communities. Methods We surveyed 14 tribal districts via multistage cluster sampling covering 10,090 households from 2022 to 23. Data from individuals aged > 18 years were analyzed for hypertension (BP > 140/90 mmHg) and diabetes (RBS > 200 mg/dL). The outcomes included (i) awareness (prior diagnosis or medication use), (ii) treatment (self-reported medication use), and (iii) control (BP < 140/90 mmHg for hypertension, RBS < 180 mg/dL for diabetes). Multivariable log-binomial regression was used to estimate adjusted prevalence ratios (aPRs with 95% CIs) for gender and wealth quintile associations with ATC stages. Results Of the 21,100 participants, 33.7% had hypertension and 9.7% had diabetes. Among the 6,620 hypertensive individuals, 19% were aware, 13·8% were on treatment, and 6·8% had controlled BP. Women with hypertension (N = 3,609) had significantly better outcomes than men did: awareness (aPR: 1·4;1·2–1·6), treatment (aPR: 1·5; 1·2–1·7), and control (aPR: 1·7; 1·4–2·2). Compared with those in the poorest quintile, hypertensive individuals from the richest quintile (N = 1,804) were more likely to be aware (aPR: 1·5; 1·2-1·9) and on treatment (aPR: 1·5; 1·2–2·7); however, BP control was not significantly different (aPR: 1·6; 0·9-2·8). Among the 1,883 individuals with diabetes, 49% were aware, 44·4% were on treatment, and 40·7% achieved control. Conclusion Significant socioeconomic and sex inequities persist in hypertension care among Odisha’s tribal populations, with better ATC outcomes for women and wealthier individuals. Targeted screening and gender-sensitive approaches are essential for equitable healthcare access.https://doi.org/10.1186/s12889-025-23587-2Care continuumDeterminants of healthHypertensionDiabetesTribal populationOdisha
spellingShingle Tanveer Rehman
Chinmayee Sethy
Afeeq K.
Jaya Singh Kshatri
Manikandanesan Sakthivel
Kavitha A.K.
Ansuman Panigrahi
Mohan Kumar Raju
Archana Ramalingam
Sanghamitra Pati
Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
BMC Public Health
Care continuum
Determinants of health
Hypertension
Diabetes
Tribal population
Odisha
title Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
title_full Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
title_fullStr Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
title_full_unstemmed Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
title_short Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022–23
title_sort socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in odisha india findings from the odisha tribal family health survey otfhs 2022 23
topic Care continuum
Determinants of health
Hypertension
Diabetes
Tribal population
Odisha
url https://doi.org/10.1186/s12889-025-23587-2
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