Non-communicable disease risk factors: a cross-sectional study among the adult population of rural Patna, India

Dipti Das; Rathish Nair; Krishnaveni R.; Sampa Mondal; Girishkumar K

doi:10.18203/2394-6040.ijcmph20263639

Authors

Dipti Das College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India
Rathish Nair College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India
Krishnaveni R. College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India
Sampa Mondal College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India
Girishkumar K College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20263639

Keywords:

Central obesity, Non-communicable diseases, Prevalence, Risk factor clustering, WHO STEPS, Rural population

Abstract

Background: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality worldwide, primarily driven by cardiovascular diseases, diabetes, cancers and chronic respiratory conditions. This study aimed to assess the prevalence of NCD risk factors among adults in a rural area of Patna, Bihar.

Methods: A community-based cross-sectional study was conducted over two months (April–May 2024) among adults aged 18 years and above using convenience sampling. Data were collected using a modified WHO STEPS tool through face-to-face interviews, along with physical and biochemical measurements. Descriptive and inferential statistics, including chi-square tests, were applied for analysis.

Results: Among 211 participants (mean age: 47.05±16.63 years), tobacco use (31% smoking, 36.8% smokeless) and alcohol consumption (42.5%) were markedly higher among males, while inadequate fruit and vegetable intake was common in both sexes; physical activity was higher in males (64.4%) than females (53.2%). Hypertension was observed in 21.8% of males and 17.7% of females. Overweight was more prevalent in males (37.9%), whereas obesity was slightly higher in females (22.6%). Despite this, central obesity was notably high, affecting 85.1% of males and 76.6% of females, indicating increased metabolic risk even among individuals with normal or mildly elevated BMI. Overall, 74.88% of participants had three or more NCD risk factors, indicating a clustering of NCDs, with no significant association across socio-demographic variables.

Conclusions: A high burden of clustered NCD risk factors across all groups highlights the need for population-wide prevention and early screening strategies.

Metrics

Metrics Loading ...

References

Noncommunicable diseases. 2025. Available at: https://www.who.int/data/gho/data/themes/topics/noncommunicable-diseases-mortality. Accessed on 21 March 2026.

Noncommunicable diseases: Risk factors and conditions. 2025. Available at: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/ncd-risk-factors. Accessed on 21 February 2026.

Karan A, Hussain S, Jensen LX, Buhl A, Bearman M, Zodpey S. Non-communicable diseases, digital education and considerations for the Indian context–a scoping review. BMC Public Health. 2024;24:1280. DOI: https://doi.org/10.1186/s12889-024-18765-7

Tandon N, Anjana RM, Mohan V, Kaur T, Afshin A, Ong K, et al. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016. Lancet Glob Health. 2018;6(12):1352–62. DOI: https://doi.org/10.1016/S2214-109X(18)30387-5

Jung L, De Neve JW, Chen S, Manne-Goehler J, Jaacks LM, Corsi DJ, et al. The interaction between district-level development and individual-level socioeconomic gradients of cardiovascular disease risk factors in India: A cross-sectional study of 2.4 million adults. Soc Sci Med. 2019;239:112514. DOI: https://doi.org/10.1016/j.socscimed.2019.112514

Gupta R, Guptha S, Gupta VP, Agrawal A, Gaur K, Deedwania PC. Twenty-year trends in cardiovascular risk factors in India and influence of educational status. Eur J Prev Cardiol. 2012;19(6):1258–71. DOI: https://doi.org/10.1177/1741826711424567

Menon GR, Yadav J, John D. Burden of non-communicable diseases and its associated economic costs in India. Soc Sci Humanit Open. 2022;5(1):100256. DOI: https://doi.org/10.1016/j.ssaho.2022.100256

Joshi R, Cardona M, Iyengar S, Sukumar A, Raju CR, Raju KR, et al. Chronic diseases now a leading cause of death in rural India—mortality data from the Andhra Pradesh Rural Health Initiative. Int J Epidemiol. 2006;35(6):1522–9. DOI: https://doi.org/10.1093/ije/dyl168

Kumar R, Kumar D, Jagnoor J, Aggarwal AK, Lakshmi PVM. Epidemiological transition in a rural community of northern India: 18-year mortality surveillance using verbal autopsy. J Epidemiol Community Health. 2012;66(10):890–3. DOI: https://doi.org/10.1136/jech-2011-200336

Rai RK, Barik A, Mazumdar S, Chatterjee K, Kalkonde YV. Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012–2017. BMJ open. 2020;10(10):36578. DOI: https://doi.org/10.1136/bmjopen-2019-036578

Population Projection Report 2011-2036 - upload_compressed. 2025. Available at: https://mohfw.gov.in/sites/default/files. Accessed on 12 March 2026.

Dandona L, Dandona R, Kumar GA, Shukla DK, Paul VK, Balakrishnan K, et al. Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study. Lancet. 2017;390(10111):2437-60. DOI: https://doi.org/10.1016/S0140-6736(17)32804-0

Ross S, Chadha K, Mishra S, Lewington S, Shepperd S, Gathani T, et al. The burden of risk factors for non-communicable disease in rural Bihar, India: a comparative study with national health surveys. BMC Public Health. 2022;22(1):1538. DOI: https://doi.org/10.1186/s12889-022-13818-1

Raj S, Goel AD, Upadhyay V, Singh RK, Bhardwaj P. Strengthening of cancer care services in Bihar: A situational analysis. Cancer Research, Statistics, and Treatment. 2024;7(3):355-63. DOI: https://doi.org/10.4103/crst.crst_72_24

Karn D. Study of Stroke Due to Intra Cranial Atherosclerosis in Bihar Population. Indian J Public Health Res Dev. 2023;14(4):85–9. DOI: https://doi.org/10.37506/ijphrd.v14i4.19763

Metta E, Msambichaka B, Mwangome M, Nyato DJ, Dieleman M, Haisma H, et al. Public policy, health system and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review. Glob Health Action. 2014;4;56. DOI: https://doi.org/10.3402/gha.v7.23439

Kumar D, Kumari R, Anwar K, Singh R. Community-based assessment of risk factors for cardiovascular diseases in a tribal population of Tharus in Bihar, India. J Fam Med Prim Care. 2022;11(8):4404. DOI: https://doi.org/10.4103/jfmpc.jfmpc_55_22

Mahajan K, Batra A. Obesity in adult asian indians- the ideal BMI cut-off. Indian Heart J. 2018;70(1):195. DOI: https://doi.org/10.1016/j.ihj.2017.11.020

Instrument. Available at: https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/steps/instrument. Accessed on 21 March 2026.

Mathur P, Kulothungan V, Leburu S, Krishnan A, Chaturvedi HK, Salve HR, et al. National noncommunicable disease monitoring survey (NNMS) in India: Estimating risk factor prevalence in adult population. PLOS ONE. 2021;16(3):246712. DOI: https://doi.org/10.1371/journal.pone.0246712

Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Prasad R. Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey. BMC Public Health. 2016;16(1):816. DOI: https://doi.org/10.1186/s12889-016-3489-8

Geldsetzer P, Manne-Goehler J, Theilmann M, Davies JI, Awasthi A, Vollmer S, et al. Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults. JAMA Intern Med. 2018;78(3):363–72. DOI: https://doi.org/10.1001/jamainternmed.2017.8094

Ganju A, Goulart AC, Ray A, Majumdar A, Jeffers BW, Llamosa G, et al. Systemic Solutions for Addressing Non-Communicable Diseases in Low- and Middle-Income Countries. J Multidiscip Healthc. 2020;13:693–707. DOI: https://doi.org/10.2147/JMDH.S252300

Beura S, Patnaik L, Pattanaik S, Sahu T. Awareness about Behavioral Risk Factors of Noncommunicable Diseases and Practices Related to Healthy Lifestyle among Class IV Female Employees in a Tertiary Care Hospital of Eastern India. J Datta Meghe Inst Med Sci Univ. 2019;14(3):241. DOI: https://doi.org/10.4103/jdmimsu.jdmimsu_102_19

Singh PK, Singh N, Jain P, Sinha P, Kumar C, Singh L, et al. Mapping the triple burden of smoking, smokeless tobacco and alcohol consumption among adults in 28,521 communities across 640 districts of India: A sex-stratified multilevel cross-sectional study. Health Place. 2021;69:102565. DOI: https://doi.org/10.1016/j.healthplace.2021.102565

Rajpal S, Kumar A, Ronanki S, Sathesh N, Kim R, Subramanian SV. Changes in prevalence of alcohol and tobacco consumption across districts of India, 2016 and 2021. BMC Public Health. 2025;25(1):1962. DOI: https://doi.org/10.1186/s12889-025-23029-z

Ramamoorthy T, Kulothungan V, Mathur P. Prevalence and Correlates of Insufficient Physical Activity Among Adults Aged 18-69 Years in India: Findings From the National Noncommunicable Disease Monitoring Survey. J Phys Act Health. 2022;19(3):150–9. DOI: https://doi.org/10.1123/jpah.2021-0688

Strain T, Flaxman S, Guthold R, Semenova E, Cowan M, Riley LM, et al. National, regional and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants. Lancet Glob Health. 2024;12(8):1232–43. DOI: https://doi.org/10.1016/S2214-109X(24)00150-5

Ghosh S, Mukhopadhyay S, Barik A. Sex differences in the risk profile of hypertension: a cross-sectional study. BMJ Open. 2016;6(7):10085. DOI: https://doi.org/10.1136/bmjopen-2015-010085

Bade M, Saha C. Gender differences in the systolic blood pressure in young healthy adults. Physiol Soc. 2018;4:98.

Mohanty P, Patnaik L, Nayak G, Dutta A. Gender difference in prevalence of hypertension among Indians across various age-groups: a report from multiple nationally representative samples. BMC Public Health. 2022;22(1):1524. DOI: https://doi.org/10.1186/s12889-022-13949-5

Deepa M, Pradeepa R, Venkatesan U, Adhikari P, Das HK, Dash K, et al. High prevalence of metabolic obesity in India: The ICMR-INDIAB national study (ICMR-INDIAB-23). Indian J Med Res. 2025;161(5):461–72. DOI: https://doi.org/10.25259/IJMR_328_2025

Pradeepa R, Anjana RM, Joshi SR, Bhansali A, Deepa M, Joshi PP, et al. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) (ICMR - INDIAB-3). Indian J Med Res. 2015;142(2):139–50. DOI: https://doi.org/10.4103/0971-5916.164234

Flowers E, Molina C, Mathur A, Reaven GM. Adiposity and cardiovascular risk clustering in South Asians. Metab Syndr Relat Disord. 2013;11(6):434–40. DOI: https://doi.org/10.1089/met.2013.0081

Biradar RA, Singh DP, Thakur H, Halli SS. Gender differences in the risk factors for high and very high blood glucose levels: A study of Kerala. Diabetes Metab Syndr. 2020;14(4):627–36. DOI: https://doi.org/10.1016/j.dsx.2020.05.001

Pradeepa R, Shreya L, Anjana RM, Jebarani S, Venkatesan U, Kamal Raj N, et al. Sex-Based Differences in Clinical Profile and Complications among Individuals with Type 2 Diabetes Seen at a Private Tertiary Diabetes Care Centre in India. Healthcare. 2023;11(11):1634. DOI: https://doi.org/10.3390/healthcare11111634

Sarveswaran G, Kulothungan V, Mathur P. Clustering of noncommunicable disease risk factors among adults (18-69 years) in rural population, South-India. Diabetes Metab Syndr. 2020;14(5):1005–14. DOI: https://doi.org/10.1016/j.dsx.2020.05.042

Shaikh R, Khan J. Clustering of lifestyle risk factors among adult population in India: A cross-sectional analysis from 2005 to 2016. PloS One. 2021;16(1):244559. DOI: https://doi.org/10.1371/journal.pone.0244559

Sivanantham P, Sahoo JP, Lakshminarayanan S, Bobby Z, Anandraj J, Kar SS. Prevalence of clustering of non-communicable disease risk factors in a highly urbanized district of India: findings of a cross-sectional survey in Puducherry. J Diabetes Metab Disord. 2024;23(1):585–92. DOI: https://doi.org/10.1007/s40200-023-01318-x

Selvaraj K, Kar SS, Ramaswamy G, Premarajan KC, Saya GK, Kalidoss V. Clustering of cardiovascular disease risk factors - Syndemic approach: Is sit a time to shift toward integrated noncommunicable disease clinic. Indian J Public Health. 2019;63(3):186–93. DOI: https://doi.org/10.4103/ijph.IJPH_158_18