Urban India Research Articles

Decomposing rural-urban differences in depression prevalence: a cross-sectional analysis of two community-based southern Indian cohorts

IntroductionDepression is a growing public health concern in India but its prevalence is uneven across the country, possibly influenced by several sociodemographic factors. We aimed to assess the rural-urban disparity...

Stigma and support: Infertility’s varied face across urban and rural India

Stigma and support: Infertility’s varied face across urban and rural India

An Overview of Accounting Reforms in Indian Urban Local Bodies

The Urban Local Bodies (ULBs) are considered as ‘Growth Engines’ for the development of the Nation. Different models have been adopted by ULBs in the rollout of accounting reforms, including centralized, decentralized, and independent approaches. In the case of ULBs that are independently managing their own accounts without any centralized supervision or monitoring by the department of urban affairs, there can be a risk of losing continuity with the transfer of staff, change in supervisor, etc. As ULBs are independent in their mode of self-governance, the methods adopted by the ULBs are bound to vary. Further, in the absence of a central monitoring body to supervise the accounting reform activities of the ULBs, there is lack of uniformity in the accounting modules being used and also in the reports created. The ultimate result is the absence of an efficient and sustainable effort to improve the financial performance of the ULBs. This leads to the conclusion that there is an urgent need to bring about greater uniformity and standardization in municipal accounting reforms at nationwide.

Exploring the Lived Experiences of LGBTQIA+ People in Diverse Fields: A Qualitative Study in Urban India

This article is based on a comprehensive investigation of the lived experiences of lesbian, gay, bisexual, transgender, queer, intersexual, and asexual plus (LGBTQIA+) individuals working in diverse fields within the urban Indian context. The study contributes to the mainstream discourse on diversity and inclusion (D&I) from the gender lens. It reveals how organizational policies, societal attitudes, and cultural norms in India influence the identity, family, and peer relationships, educational and workplace environments, support systems, and coping mechanisms of LGBTQIA+ professionals. Utilizing a qualitative research approach, data were obtained from interviews published on the “Feminism in India” website. Thematic analysis revealed seven themes, shedding light on the marginalization and challenges faced by LGBTQIA+ communities, including the exclusion of trans individuals within feminist spaces and inadequate representation in Pride events. This research investigates nascent experiences within social and professional contexts and narrows down the focus to the LGBTQIA+ community in India. In this study, intersectionality theory is integrated to explain how sexual orientation merges with gender, caste, class, and religion to establish workplace inclusion, equity, and belonging. The themes identified in the study reveal that it is the social, personal, and structural relationships that influence the lives of LGBTQIA+ persons in urban India. Organizations and policymakers can only minimize discrimination and support positive development upon understanding these experiences.

Protocol of the Nutritional, Psychosocial, and Environmental Determinants of Neurodevelopment and Child Mental Health (COINCIDE) study

Background Over 250 million children are developing sub-optimally due to their exposure to early life adversities. While previous studies have examined the independent effects of nutritional status, psychosocial adversities, and environmental pollutants on children’s outcomes, little is known about their interaction and cumulative effects. Objectives This study aims to investigate the independent, interaction, and cumulative effects of nutritional, psychosocial, and environmental factors on children’s cognitive development and mental health in urban and rural India. It also seeks to explain pathways leading to inequities in child outcomes at the individual, household, and neighbourhood levels. Methods A mixed-methods prospective cohort study will be conducted on 1600 caregiver-child dyads (child age 3–10 years) in urban and rural India. Nutritional status, psychosocial adversities, environmental pollutants, and child mental health outcomes will be assessed using parent-report questionnaires. Performance-based measures will be used to assess cognitive outcomes. Venous blood and urine samples will be used to measure nutritional and pesticide biomarkers in 500 children. Indoor air pollution will be monitored in 200 households twice, during two seasons. Multilevel regression, weighted quantile sum regression, and Bayesian kernel machine regression will assess the individual and combined effects of exposures on child outcomes. Thematic analysis of in-depth interviews and focus group discussions will explore pathways to middle-and late childhood development inequities. Discussion The data will be used to formulate a Theory of Change (ToC) to explain the biological, psychosocial, and environmental origins of children’s cognitive and mental health outcomes across the first decade of life in diverse Indian settings, which can inform interventions targets for promoting children’s outcomes beyond the first 1000 days, potentially generalizable to similar under-resourced global settings. The COINCIDE research infrastructure will comprise a valuable global health resource, including prospective cohort data, validated study tools, and stored biological and environmental samples for future studies.

Beyond Binary: Exploring the Dynamics of Bi-Curiosity Propulsion and Persistence Among Young Women

Sexual identity fails to adhere to the dichotomous models, transcending to a more fluid quality than normative compulsory heterosexuality. The present study investigates the experience of bi-curiosity, focusing on its initiation among young women residing in urban India. Bi-curiosity, a sexual orientation questioning marked by exploratory experiences, is a possible but not a necessary precursor to bisexuality. This qualitative study explores on the psychological and social factors contributing to a bi-curious orientation. It focuses on the subjective processes of development and maintenance of sexual identity questioning. Three organizing themes emerged from the Reflective Thematic Analysis: (a.) Affective Indicators, (b.) Social Experiences, and (c.) Intimacy in friendships. While sexual identity questioning was propelled by more psychological factors, like physical attraction, fantasy, experienced jealousy toward men, and comfort with the same sex, social and environmental factors contribute significantly. Individual experiences with patriarchy, social attitudes toward same-sex relationships, and their representation on media platforms often reinforce the process. Another important contributor was women’s close friendships with the same sex, which are sites for physical closeness, emotional intimacy, and personal growth, and share these characteristics with romantic relationships. These factors emerged as important reinforcers to the development and maintenance of sexual identity questioning.

Aging population in urban India: Challenges and insights from Kolkata

In Kolkata, the elderly people represent 11.76% of the total population. Here we present new data on the aging population of Kolkata, and address its causes, and consequences. We interviewed 110 elderly male and female who are living with their family members and in old age homes in Kolkata. The data was collected from low, medium, and high-income groups from three urban housing societies as well as five old age homes. It has been observed that the elderly male and female of the low-income group have no medical and life insurance, and many of them are suffering from health issues. Although females up to 60 years are part of Self-Help Group, males are suffering from Loneliness. The elderly male and female of the medium, and high-income group do not have financial issues, but most of them do not visit doctors and health care centers for regular health check-ups. Digital literacy has to be improved. Elderly people staying in old age homes are mentally and physically much better than their counterparts who live with family members. Analysis of existing government policies reveal scope for improvement of the elderly people. We propose social innovation for the elderly population in Kolkata.

Study on Impact of Neuroeconomics Tactics used by Streaming Services Companies (Eg. Netflix, Spotify) on Genz's Purchase Intentions in Ahmedabad City

This paper reflects on how the neuroeconomics strategies employed by streaming companies, like Netflix and Spotify, affect Generation Z's purchasing intentions in Ahmedabad City. Neuroeconomics endeavors to be an integrative science that explains how neuroscience and psychology will intervene in or complement economics to develop knowledge about understanding consumer decision-making processes and those factors that influence buying behavior. Having established such neuroeconomic theories, streaming service companies then hunt them under the guise of optimized user experience with visual and auditory stimuli and tailored recommendations to keep the user interested and waiting for another subscription or purchase. The effects of such strategies are pretty important to understand for the Gen Z audience - a bunch of kids known for their tech-savvy nature and instant gratification. This paper investigates how streaming applications make use of cognitive biases arising from loss aversion to dopamine-driven reward systems and social proof influencing the buying behavior of young consumers. A mixed method approach was used on a representative sample of Gen Z youths by surveys and interviews in Ahmedabad to collect the data. Overall, the findings from this study are expected to be very informative on how neuroeconomic strategies will or will not impact the consumption behavior of Gen Z in the streaming industry. This would be followed by actionable recommendations for companies about how they can maximize their marketing efforts to resonate more effectively with this emergent market going forward. As neuroeconomics and consumer behavior begin to intermix, streaming services stand to increase users' engagement, amplify sales, and cultivate long-term customer loyalty with Gen Z among urban India.

Incidence and Progression of Diabetic Retinopathy in Urban India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study, 15yr Follow up

ABSTRACT Purpose: To evaluate the 15 year incidence and progression of Diabetic Retinopathy (DR) and identify risk factors among Indian population. Methods: From a cross-sectional study of 1425 subjects, 911 participants took part in the 4-year follow-up. Out of these 911 participants, 140 returned for the 15-year follow-up, with baseline examinations conducted between 2003 and 2006, and subsequent follow-ups occurring from 2007 to 2011 and the current 15-year follow-up from 2018 to 2021. Of the 140 participants, 112 were eligible for analysis after excluding individuals with ungradable fundus photographs. Results: The 15-year incidence of any diabetic retinopathy (DR) was 5%, with mild NPDR and moderate NPDR at 1.57% and 2.7%, respectively. Proliferative DR was observed in 0.71% of cases, while diabetic macular edema (DME) and sight-threatening diabetic retinopathy (STDR) rates were 0.48% and 1.10%, respectively. Age-standardized rates revealed a significant association with increasing age and incident any DR and STDR. DR progression over 15 years included 7.5% one-step and 1.75% two-step progressions, while regression was limited to 1.75% one-step regression. Multiple logistic regression analyses revealed that baseline duration of diabetes, systolic blood pressure, HbA1c levels, and the presence of anemia influenced the incidence of any DR, DME, and STDR. Smoking and higher HbA1c were identified as risk factors for one-step progression of DR. Conclusion: This study provides crucial insights into the long-term incidence, progression, and regression of DR among individuals with Type 2 diabetes in India.

Sanitation ladder in rural and urban India: can subsidy from the Swachh Bharat Mission ensure transition to safely managed toilets?

ABSTRACT The Swachh Bharat Mission, globally the biggest public programme to support sanitation, has focused on subsidised construction of household toilets in rural areas, while aiming for solid waste disposal and behavioural changes in urban areas. In spite of that, India witnesses a huge gap from the SDGs related to usage of safely managed sanitation associated with more environment- responsive technology and hygiene management. The hierarchical sanitation ladder identifies fivecategories of toilets, namely, safely managed, basic, limited, unimproved, and open defecation. This study attempts to contribute to the existing literature by locating the empirical estimation of the sanitation ladder in India across both rural and urban settings, using nationally representative unit-level National Sample Survey data. Results find that only 38% of urban and 6% of rural households in India use safely managed toilets. Also, using logistic regression, the study posits that receiving subsidy for toilet construction can significantly improve usage of safely managed toilets along the ladder only among the poorest urbanclass and the factor is generally more potent in rural areas. The findings identify that there is hardly any benefit in subsidizing the middle-income class and hence highlight a need to redesign the subsidy-driven sanitation policy.

Urban Challenges Faced by the Hijra Community

This research focuses on the challenges faced by the hijra community in urban India, touching upon issues such as economic marginalization, discrimination, and the point of intersection between religion and caste, all within the LGBTQ+ context. Hijras are individuals who are born biologically male, and identify as trans women, and live in small, secretive communities across South Asia, forming a very distinctive cultural group. This study draws on in-depth interviews with two members of the hijra community in Mumbai, India, offering a first-hand account of their struggles. The findings of this research revealed that many members of the hijra community confine themselves to low-income hustles such as begging, or sex work, due to rampant discrimination that exists in the heteronormative post-colonial South-Asian societies. This also contributes to their lack of access to healthcare, safe housing, protection from hate crimes, and a declining mental health on a community-wide level. Despite legal progress, many challenges related to identity recognition and humanizing the community persist. This introductory article thus advocates for various empowerment initiatives to facilitate a more inclusive and equitable environment for hijra individuals in urban India.

Whose city is it anyway? Place, community and the fractured urban

ABSTRACT This paper examines the everyday processes of othering and exclusion of particular religious communities in expanding urbanscapes. It maps how deliberate contests are produced over cities’ histories, politico-cultural legacies and spatial arrangements, to isolate and displace communities. Specifically, it addresses how exclusion of Muslim residents is constructed in social and spatial terms in contemporary urban India. Focussing on the middle-sized central Indian city of Bhopal, I explore the emergent tensions that have steadily consolidated invisible, yet often impermeable, mental borders within that setting. In doing so, I highlight the disturbing implications of these processes of boundary making and solidification. I discuss what they mean for the everyday existence of people and communities, and how they produce fractured urbanisms. Drawing upon a mixed approach, I piece together archival records, press reports and a wide selection of other literature, as well as on-field conversations and observations, to examine how the city of Bhopal is sought to be reimaged as Hindu, and its socio-spatial character reconfigured, isolating and disenfranchising its Muslim residents. Finally, I reflect on the manner in which such shifts frame the exclusion of specific communities and produce a contested urban.

Comparison of fetal growth patterns from Western India with Intergrowth-21st.

To generate longitudinal fetal growth data in an Indian population and compare it with Intergrowth-21st. Fetal biometry data was collected in a prospective longitudinal observational study (REVAMP: Research Exploring Various Aspects and Mechanisms in Preeclampsia) from 2017 to 2022. Fetal crown-rump length (CRL) was measured at 11-14 weeks gestation, and biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) at 18-22 and 32-35 weeks, and converted into Z-scores using the Intergrowth standard. Generalized Additive Models for Location, Scale and Shape (GAMLSS) models were used to construct fetal growth centile curves compared against Intergrowth centiles. Out of 1096 singleton pregnancies in REVAMP, this analysis included 655 'healthy' pregnancies (uncomplicated by pre-eclampsia, diabetes, pre-term delivery or low birth weight) and a sub-set of 106 'low-risk' pregnancies defined using Intergrowth criteria. The 'healthy' study subjects showed lower mean CRL Z-score [-0.45 SD (95% CI:-0.54,-0.37)] at 11-14 weeks, and BPD Z-score [-1.2 SD (-1.28,-1.11) and -1.17 SD (-1.23,-1.1)] at 18-22 and 32-35 weeks respectively. Mean HC Z-score was comparable to the Intergrowth standard at 18-22 weeks [-0.08 SD (-0.16, 0.02)] but smaller at 32-35 weeks [-0.25 SD (-0.32,-0.19)]. Mean AC Z-score was lower at 18-22 weeks [-0.32 SD (-0.41,-0.23)] but comparable at 32-35 weeks [0.004 SD (-0.07, 0.07)]. FL was comparable to or larger than the Intergrowth standard at both time points [0.05 SD (-0.05, 0.14); 0.82 SD (0.75, 0.89), respectively]. These findings were similar, though measurements were slightly larger, in the 'low-risk' sample. This data from healthy and low-risk pregnant women in urban western India indicates that some fetal dimensions and growth trajectories differ significantly from the Intergrowth-21st. Our data suggest the need for a larger representative study to define a population-specific fetal growth reference for India, for identification of fetal growth restriction.

Examining the Impact of Socio-economic, Demographic and Policy Factors on Reverse Migration in India During COVID-19 Pandemic

This article examines the factors that determined ‘reverse migration’ of households from urban locations in India in the aftermath of a series of lockdowns that followed the coronavirus disease-2019 (COVID-19) pandemic. Positioning reverse migration as a coping strategy to ameliorate negative consequences of loss of livelihood, food shortages and loss of shelter in urban India, this article examines the factors that led to the utilization of this strategy in the aftermath of lockdown during the pandemic outbreak. The article also tests whether returning to hinterland persisted after the period of lockdowns. The lockdowns had exacerbated living conditions for urban poor. Migration to rural areas continued despite various policies and programmes that the national and state governments instituted to counter the negative impact of lockdowns, particularly on low-income households. Examining the socio-economic, demographic and policy factors, this article provides evidence that family support and rural social institutions such as self-help groups played a crucial role in providing support system during pandemic even to those who migrated back from urban areas. Government programmes such as Rural Employment Guarantee Scheme and access to public distribution system were also important for reverse migrants. An important result is that the first wave of reverse migration was due to family and emotional reasons that arose because of lockdowns, the second wave of migration was for economic reasons as households continued to struggle in urban areas, and the migration during the third wave was a usual seasonal migration.

Cross-sectional study of factors associated with caregiver's burden in patients diagnosed with psychotic disorders in urban India.

Pharmacotherapy has deinstitutionalized the patients with psychotic disorder. This has led to the transfer of the caregiving burden from hospitals to family members of the patients. This study aimed to assess the caregivers' burden and the factors associated with it objectively. This was a cross-sectional survey conducted amongst 143 caregivers of patients diagnosed with psychotic disorders reporting to a psychiatric outpatient department. The investigative tool used was a 12-item ZARIT Burden Interview (ZBI) questionnaire. The frequency of schizophrenia amongst patients with psychotic disorder was 68.5%. The median age of caregivers was 50 years in the "high burden" group, 40 years in the "moderate burden" group, and 34 years in the "no/mild burden" group. The mean score of burden experienced by the caregiver was 27.5 ± 9.7. The degree of burden was high in 66% of caregivers. The caregivers were generally more females, married, less educated, and mainly parents. A high degree of burden was associated with variables viz. female gender (OR 1.77 [0.88, 3.57], P = .043), low education status (OR 2.31 [1.09, 4.91] P = .002), unemployed status (OR 2.32 [1.12, 4.78] P = .027) and, increasing age of caregiver. No significant association was found between the degree of burden and variables, viz. marital status of caregivers, duration of caregiving, and duration of patient's illness. The current study identifies variables that can predict caregiver's burden. These results also suggest the implementation of psycho-educational, community-based programs which can address the core issues associated with caregiving.

Debating Citizenship and Seeking Political Solidarity in Mumbai’s Urban Margins

This article explores how the meaning of citizenship is articulated and debated in the aftermath of the legal prohibition of the slaughter of cow progeny and making the sale or possession of beef a punishable offense in the western Indian state of Maharashtra. The prohibition illuminated contradictions between the cultural roots of nationalism as opposed to democratic citizenship and how the two are increasingly in friction with the rising popularity of the Hindu right. Public action and debate in the aftermath of the beef ban (as it came to be popularly known) bestowed multiple conceptions of citizenship in the light of profound social divisions providing for the space to seek political solidarity with other marginalized groups. Here, I suggest that paying attention to the subtler nuances of political action through a framework of solidarity as opposed to that of resistance can bring to light ways in which citizenship is debated and shaped in urban India.

Health literacy and tobacco cessation among hypertensive individuals: A mixed method study

BACKGROUND: Hypertension and tobacco addiction are two major public health challenges in India that frequently coexist. About 30% of Indian adults have hypertension, while over one-fourth use some form of tobacco. So, the present study aimed to determine the prevalence and patterns of tobacco consumption and identify associated socio-demographic factors among hypertensive patients in urban India and also further explored patient perspectives regarding tobacco use through qualitative interviews. MATERIALS AND METHODS: This mixed-method study was conducted among 305 hypertensive adults recruited from an urban tertiary hospital using interviewer-administered questionnaires. Additionally, 15 tobacco-consuming patients were purposively sampled for in-depth interviews regarding perceptions and behaviors related to tobacco. Descriptive statistics and multi-variable logistic regression models were applied for quantitative analysis and thematic analysis for qualitative data. RESULTS: The prevalence of ever tobacco use among hypertensive patients was 21%. Smokeless tobacco was the predominant form used. Male gender, urban locality, illiteracy, and lack of knowledge about tobacco hazards had a higher likelihood of tobacco consumption. Qualitative interviews provided complementary insights into triggers like peer influences and stress, barriers to quitting including withdrawal effects and system gaps, and participant perspectives on facilitating cessation. CONCLUSION: Tobacco consumption among hypertensives is higher than national averages. Tailored educational, motivational, and policy-level interventions addressing gaps in knowledge, risk perceptions, addiction behaviors, and cessation support systems can enable the promotion of tobacco abstinence and hypertension control in this vulnerable sub-group. The multi-method data provide actionable inputs for planning targeted control and prevention strategies addressing this dual burden.

Changing preferences and societal dynamics: Analyzing public attitudes toward preferential discrimination policy in urban India

AbstractThis article analyzes public preferences toward affirmative action (reservation policy) designed for disadvantaged social groups in India by examining the co‐relational and causal relationship between the perceived fairness of the reservation policies and the citizens' preferences for reservation policies available in the political sphere, government jobs, and higher education institutions; and how urban India—particularly the metropolitan cities—utilizes better opportunities for socioeconomic mobility. I argue that there are opposing trends in discourse, primarily based on self‐interest or motivation‐based community interest. Examining citizens' preferences by adding more variables to the analysis and testing them with the data (N = 1800) is imperative since self‐motivation or community interest cannot be the sole factor. The findings allow us to represent potential interaction effects based on caste, education level, and place of birth. These are the primary reasons for citizens' choices, and they all have an additive effect rather than being present as an individual factor of analysis.Related ArticlesHarel‐Shalev, Ayelet. 2013. “Policy Analysis beyond Personal Law: Muslim Women's Rights in India.” Politics & Policy 41(3): 384–419. https://doi.org/10.1111/polp.12016.Harel‐Shalev, Ayelet. 2009. “Lingual and Educational Policy toward ‘Homeland Minorities’ in Deeply Divided Societies: India and Israel as Case Studies.” Politics & Policy 37(5): 951–70. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2009.00206.x/abstract.Pearson‐Merkowitz, Shanna. 2012. “Aqui no hay oportunidades: Latino Segregation and the Keys to Political Participation.” Politics & Policy 40(2): 258–95. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2012.00349.x/abstract.

Bargaining Freedoms: How Women in Urban India Experience a Sense of Agency

Bargaining Freedoms: How Women in Urban India Experience a Sense of Agency

‘Mostly women's issues’ – Gender differences in community responses to a large-scale NGO programme to prevent violence against women in urban India

Despite striking gender differences in men's and women's engagement in past prevention programmes to stop violence against women (VAW), few empirical studies have determined why such gender differences arise. We did a grounded theory study of a large-scale NGO programme in informal settlements in Mumbai, India, aiming to analyse how gender affects participation in community action to address VAW. We did 27 focus group discussions and 31 semi-structured interviews with 77 women and 36 men, as well as with 9 NGO staff. We supplemented qualitative data with quantitative monitoring data on referrals to NGO counselling centres. We found that male participants in the NGO programme not only reported violence to the NGO at lower rates but took less intensive action to support survivors. When they did engage, they more often defended perpetrators or asked survivors to accommodate them than female participants. These differences could be explained by a greater (1) affective response to VAW (2) perceived stake in addressing VAW (3) sense of empowerment from taking action, and (4) perceived NGO support for self among women compared to men. Differences were evident even between male and female participants who had taken part in NGO activities for years. We theorise that these differences ultimately stem from men and women's structurally different position in a gender unequal society. Our findings identify key motivational barriers to address to improve the effectiveness of programmes to prevent VAW. Given the greater barriers to men's community action compared to women's community action, it may be useful to recognize the value of prevention programmes with differing levels of male engagement, including women-only programmes and programmes in which male community participants play a secondary role and are not expected to be as active as female participants.