Abstract
BackgroundAsthma is one of the leading causes of disease burden when measured in terms of disability adjusted life years, despite low prevalence of self-reported cases among young women. This paper deals with the meso-scale correlates and spatial heterogeneity in the prevalence of self-reported Asthma across 640 districts in India, using a nationally representative sample of 699,686 women aged 15–49 years from all 36 States/UTs under NFHS-4 (2015–16).MethodsAnalytical methods used in this paper include multivariate logistic regression to examine the adjusted effects of various independent variables on self-reported Asthma and poor-rich ratios (PRR) and concentration index (CI) to understand the economic inequalities in the prevalence of Asthma. For the spatial analysis in the prevalence of Asthma, univariate and bivariate local Moran’s I statistic have been computed in addition to measure of spatial autocorrelation and auto regression using spatial error and spatial lag models.ResultsResults highlight that women’s education was an important marker to the prevalence of Asthma. Smoking tobacco in any form among women were significantly more likely to suffer from Asthma. The prevalence of Asthma was further aggravated among women from the households without a separate room for kitchen, as well as those using unclean fuel for cooking. The poor-rich ratio in the prevalence of Asthma across various States/UTs in India depict inherent inequality. An analysis of spatial clustering in the prevalence of Asthma based on spatial autocorrelation portrays that Moran’s I values were significant for improved source of drinking water, clean fuel used for cooking, and household environment. When spatial weights are taken into consideration, the autoregression model noticeably becomes stronger in predicting the prevalence of Asthma.ConclusionsAny programmatic effort to curb the prevalence of Asthma through vertical interventions may hinge around the use of clean fuel, poverty, and lifestyle of subjects, irrespective of urban-rural place of their residence, environmental and ecological factors.
Highlights
Asthma is one of the leading causes of disease burden when measured in terms of disability adjusted life years, despite low prevalence of self-reported cases among young women
Districts (30.0%) were having the prevalence of Asthma much above the national average (1.94%). It is clearly visible from the results presented in the table that women belonging to richest wealth quintile were more likely to suffer from Asthma than those from the poorest wealth quintiles (PRR = 0.93)
There is an evidence of better reporting of Asthma in certain group of women, especially those coming from economically better-off households and having better media exposure
Summary
Asthma is one of the leading causes of disease burden when measured in terms of disability adjusted life years, despite low prevalence of self-reported cases among young women. Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity from person to person [1]. It results from the chronic inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways, making them irritable and hyper-responsive to exposure of small quantity of allergens or irritants. Recurrent Asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels, and school and work absenteeism [2]. According to the GBD 2015, Asthma ranked among the top 20 conditions causing disability globally and ranked 23rd as causes of disease burden when measured by disability-adjusted life years [3]
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