Temporal Dynamics, Patterns and Correlates of Single and Multi-morbidity in India, 1994–2018

Background: As a consequence of the epidemiological transition, multi-morbidity has been identified as a critical public health challenge in India. Majority of the studies in the domain are grounded on hospital-based data or are based on a small sample size, findings from which can only be generalized to a specific sub-group. These studies therefore recommend exploring multi-morbidity holistically in a community set-up to ensure adequate healthcare management in the country. Therefore, the present study examines the pattern and correlates of any one morbidity and multi-morbidity over the past two decades in India. Methods: The study utilized data on 397901, 257519 and 399705 individuals from 52nd (1994-95), 60th (2004-05) and 75th (2018) rounds of the National Sample Survey (NSS). Univariate, bivariate and multivariable statistical methods were applied to draw inferences from the data. The findings depict an increase in the level of any-one-and-multi-morbidity burden over individual's age and NSS rounds. Results: Chronic NCDs, e.g. hypertension, diabetes, and heart disease were the most commonly co-occurring morbidities in all the three time points of the study. Female sex, higher education, urban residence, and belonging to an affluent class were significantly associated with any-one-and-multi-morbidity occurrence over time. Conclusion: The burden of any-one and multi-morbidity is increasing over time, with the ascendency of non-communicable diseases among India's older adults. Therefore, there is an urgent need to recuperate chronic disease management strategies for older adults in the Indian healthcare infrastructure.