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A cross-sectional study of cardiovascular disease risk clustering at different socio-geographic levels in India

Author

Listed:
  • Anne C. Bischops

    (Medical Faculty and University Hospital, Heidelberg University
    University Children’s Hospital)

  • Jan-Walter Neve

    (Medical Faculty and University Hospital, Heidelberg University)

  • Ashish Awasthi

    (Public Health Foundation of India)

  • Sebastian Vollmer

    (University of Goettingen)

  • Till Bärnighausen

    (Medical Faculty and University Hospital, Heidelberg University
    Harvard T.H. Chan School of Public Health
    Africa Health Research Institute, Somkhele)

  • Pascal Geldsetzer

    (Medical Faculty and University Hospital, Heidelberg University
    Stanford University)

Abstract

Despite its importance for the targeting of interventions, little is known about the degree to which cardiovascular disease (CVD) risk factors cluster within different socio-geographic levels in South Asia. Using two jointly nationally representative household surveys, which sampled 1,082,100 adults across India, we compute the intra-cluster correlation coefficients (ICCs) of five major CVD risk factors (raised blood glucose, raised blood pressure, smoking, overweight, and obesity) at the household, community, district, and state level. Here we show that except for smoking, the level of clustering is generally highest for households, followed by communities, districts, and then states. On average, more economically developed districts have a higher household ICC in rural areas. These findings provide critical information for sample size calculations of cluster-randomized trials and household surveys, and inform the targeting of policies and prevention programming aimed at reducing CVD in India.

Suggested Citation

  • Anne C. Bischops & Jan-Walter Neve & Ashish Awasthi & Sebastian Vollmer & Till Bärnighausen & Pascal Geldsetzer, 2020. "A cross-sectional study of cardiovascular disease risk clustering at different socio-geographic levels in India," Nature Communications, Nature, vol. 11(1), pages 1-7, December.
    • Handle: RePEc:nat:natcom:v:11:y:2020:i:1:d:10.1038_s41467-020-19647-3
    DOI: 10.1038/s41467-020-19647-3
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