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Mathur MR, Singh A, Mishra VK, Parmar P, Nagrath D, Watt RG, Tsakos G. Socioeconomic inequalities in clustering of health-compromising behaviours among Indian adolescents. Indian J Community Med 2020;45:139-44

Socioeconomic inequalities in clustering of health-compromising behaviours among Indian adolescents

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Author: Manu Raj, Mathur1; Singh, Ankur2; Mishra, Vijay Kumar1;
Organizations: 1Department of Non-Communicable Diseases and Health Policy, Public Health Foundation of India, Gurgaon, Haryana, India
2Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Melbourne, Adelaide, Australia
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Department of Epidemiology and Public Health, University College London, London, United Kingdom
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Medknow Publications, 2020
Publish Date: 2021-10-14


Background: The simultaneous occurrence of health-compromising behaviors can accentuate the risk of noncommunicable diseases (NCDs). This study aimed to examine the existence and patterns of clustering of four NCD risk behaviors among adolescents and its association with social position. In addition, socioeconomic inequalities in the occurrence of clustering of NCD risk behaviors were also assessed.

Methods: A cross-sectional study was undertaken among 1218 adolescents (14–19 years old) in the city of New Delhi, India. An interviewer-administered questionnaire was used to assess health-compromising behaviors (tobacco and alcohol use, fruit/vegetable intake, and physical inactivity). Clustering was assessed using pairwise correlations, counts of clustering of health-compromising behaviors, comparison of observed/expected ratios, and hierarchical agglomerative cluster analysis. Multivariable logistic regressions were used to test the associations of clustering with social position (education and wealth). The relative and slope indices of inequalities in the presence of clustering of behaviors according to education and wealth were estimated.

Results: Three major clusters of health behaviors emerged: (a) physical inactivity + lower fruit and vegetable intake, (b) tobacco + alcohol use, and (c) lower fruit and vegetable intake + tobacco + alcohol use. Pronounced clustering of health-compromising behaviors was observed with lower educational attainment and wealth.

Conclusions: The presence of clustering of health-compromising behaviors was considerably higher among adolescents with lower educational attainment and wealth. The area of residence has an important influence on socioeconomic inequalities in clustering of NCD risk factors.

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Series: Indian Journal of Community Medicine
ISSN: 0970-0218
ISSN-E: 1998-3581
ISSN-L: 0970-0218
Volume: 45
Issue: 2
Pages: 139 - 144
DOI: 10.4103/ijcm.IJCM_349_19
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was supported by the Wellcome Trust Capacity Strengthening Strategic Award to the Public Health Foundation of India and a consortium of UK universities.
Copyright information: © 2020 Indian Journal of Community Medicine. This article is available under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike License (CC BY-NC-SA), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.