Among the 266 subjects, a majority of the population fell in the 35–63 age range (59.8%), were females (75.6%), had less than high school level of education (71.4%), were unemployed (77.8%), spoke Hindi or Marathi (96.2%), were married (95.5%), sought care at government healthcare providers (61.7%), and had a toilet in their home (68.8%) (Table 2). Of the total population, 41.4% were illiterate and 37.9% could read and write (Table 2).
Of the screened population, 72.6% had elevated blood pressure, 9.0% had elevated blood glucose, 63.2% were obese, and 12.4% were overweight (Table 2). These rates of overweight and obesity, elevated blood pressure, and elevated blood glucose were 3.84, 2.81, and 1.04 times higher than the national average, respectively.25,11,10 Of the screened population, 26.7% only had one of the three conditions screened for, 53.4% had two, and 7.9% had all three.
Table 2
Description of the Sample
Characteristic
|
N = 266
|
Characteristic
|
N = 266
|
Age (years)
|
|
Place of Care
|
|
21–35
|
70 (26.32)
|
Missing
|
49(18.42)
|
35–49
|
84 (31.58)
|
Government
|
164 (61.65)
|
49–63
|
75 (28.20)
|
Private
|
53(19.92)
|
>= 63
|
37 (13.91)
|
Availability of Toilet
|
|
Sex
|
|
Community
|
83 (31.20)
|
Female
|
201(75.56)
|
In home
|
183 (68.80)
|
Male
|
65(24.44)
|
Blood Pressure
|
|
Literacy
|
|
Normal
|
73 (27.44)
|
Illiterate
|
110(41.35)
|
Prehypertension
|
13 (4.89)
|
Read
|
55(20.68)
|
Stage 1 Hypertension
|
94 (35.34)
|
Read and Write
|
101(37.97)
|
Stage 2 Hypertension
|
83 (31.20)
|
Educational level
|
|
Critical
|
3 (1.13)
|
Less than high school
|
190(71.43)
|
Blood Sugar
|
|
High school
|
51(19.17)
|
Normal
|
242 (90.98)
|
College plus
|
25(9.40)
|
Between 200–300 mg/dL
|
18 (6.77)
|
Employment
|
|
Above 300 mg/dL
|
6 (2.26)
|
Unemployed
|
207(77.82)
|
Obesity
|
|
Self-Employed
|
21(7.89)
|
Underweight
|
13(4.89)
|
Labor or Service Industry
|
18(6.77)
|
Normal
|
52(19.55)
|
Other
|
20(7.52)
|
Overweight
|
33(12.41)
|
Languages Spoken
|
|
Obese
|
168(63.16)
|
Hindi/Marathi
|
256 (96.24)
|
Comorbidity
|
|
Other
|
10 (3.76)
|
One condition
|
71 (26.69)
|
Marriage status
|
|
Two conditions
|
142 (53.38)
|
Married
|
254(95.49)
|
Three conditions
|
21 (7.89)
|
Unmarried/Separated/Widowed
|
12(4.51)
|
|
|
Elevated Blood Pressure
Age, sex, and availability of toilet had a statistically significant association with elevated blood pressure. Of those with elevated blood pressure, 65.8% were between 35–63 years of age. A majority of them were also female (70.0%) and had a toilet in their home (74.1%). Although diagnosis status was not statistically significant with this outcome, 91.2% of those with elevated blood pressure had never been diagnosed for this condition before (Table 3).
Table 3: Description of the sample according to elevated blood pressure, blood glucose, and overweight/obesity
|
Total (N = 266)
|
Elevated Blood Pressure (N = 193)
|
Elevated Blood Glucose (N = 24)
|
Obesity/Overweight (N=201)
|
Characteristic
|
N
|
N (Column %)
|
p-value
|
N (Column %)
|
p-value
|
N (Column %)
|
p-value
|
Age (years)
|
|
|
<0.001
|
|
0.003
|
|
<0.001
|
21-35
|
70
|
33 (17.10)
|
|
8 (33.33)
|
|
44 (21.89)
|
|
35-49
|
84
|
61 (31.61)
|
|
|
68 (33.83)
|
|
49-63
|
75
|
66 (34.20)
|
|
14 (58.33)
|
|
67 (33.33)
|
|
>= 63
|
37
|
33 (17.10)
|
|
2 (8.33)
|
|
22 (10.95)
|
|
Sex
|
|
|
<0.001
|
|
0.572
|
|
0.301
|
Female
|
201
|
135(69.95)
|
|
17(70.83)
|
|
155(77.11)
|
|
Male
|
65
|
58(30.05)
|
|
7(29.17)
|
|
46(22.89)
|
|
Literacy
|
|
|
0.606
|
|
0.390
|
|
0.230
|
Illiterate
|
110
|
83(43.01)
|
|
12(50.00)
|
|
89(44.28)
|
|
Read
|
55
|
40(20.73)
|
|
6(25.00)
|
|
40(19.90)
|
|
Read and Write
|
101
|
70(36.27)
|
|
6(25.00)
|
|
72(35.82)
|
|
Educational level
|
|
|
0.095
|
|
0.783*
|
|
0.230
|
Less than high school
|
190
|
142(73.58)
|
|
19(79.17)
|
|
149(74.13)
|
|
High school
|
51
|
31(16.06)
|
|
4(16.67)
|
|
35(17.41)
|
|
College plus
|
25
|
20(10.36)
|
|
1(4.17)
|
|
17(8.46)
|
|
Employment
|
|
|
0.109
|
|
0.253*
|
|
0.645*
|
Unemployed
|
207
|
143 (74.09)
|
|
16 (66.67)
|
|
156 (77.61)
|
|
Self-Employed
|
21
|
18 (9.33)
|
|
4 (16.67)
|
|
18 (8.96)
|
|
Labor or Service Industry
|
18
|
16 (8.29)
|
|
2 (8.33)
|
|
13 (6.47)
|
|
Other
|
20
|
16 (8.29)
|
|
2 (8.33)
|
|
14 (6.97)
|
|
Languages Spoken
|
|
|
0.294*
|
|
1.000*
|
|
0.710*
|
Hindi/Marathi
|
256
|
184 (95.34)
|
|
23 (95.83)
|
|
194 (96.52)
|
|
Other
|
10
|
9 (4.66)
|
|
1 (4.17)
|
|
7 (3.48)
|
|
Marriage status
|
|
|
0.521*
|
|
0.609*
|
|
0.495*
|
Married
|
254
|
183 (94.82)
|
|
24 (100.00)
|
|
193 (96.02)
|
|
Unmarried/Separated/Widowed
|
12
|
10 (5.18)
|
|
0 (0.00)
|
|
8 (3.98)
|
|
Place of Care
|
|
|
0.079
|
|
0.586*
|
|
0.698
|
Missing (49 missing)
|
49
|
|
|
|
|
|
|
Government
|
164
|
109 (72.19)
|
|
14 (70.00)
|
|
125 (76.22)
|
|
Private
|
53
|
42 (27.81)
|
|
6 (30.00)
|
|
39 (23.78)
|
|
Availability of Toilet
|
|
|
0.002
|
|
0.003
|
|
0.403
|
Community
|
83
|
50 (25.91)
|
|
1 (4.17)
|
|
60 (29.85)
|
|
In home
|
183
|
143 (74.09)
|
|
23 (95.83)
|
|
141 (70.15)
|
|
Diagnosis Status
|
--
|
|
0.369
|
|
<0.001*
|
--
|
--
|
Previously Not Diagnosed
|
--
|
176 (91.19)
|
|
5 (20.83)
|
|
--
|
--
|
Previously Diagnosed
|
--
|
17 (8.81)
|
|
19 (79.17)
|
|
--
|
--
|
Table Values are n (column %) and may not sum to 100% due to rounding *Indicates that P-value is for Fisher’s exact test, else it is for chi-squared
Upon adjusting for the other significant covariates, those who belonged to the 35–49 age category, the 49–63 age category, and the 63 or older age category had 3.03 times (95% CI 1.52–6.05), 7.22 times (95% CI 3.06–17.05), and 6.82 (95% CI 2.12-22.00) times higher odds of elevated blood pressure than those who belonged to the 21–35 age category, respectively (Table 4). Upon adjustment, males had 3.33 (95% CI 1.37–8.07) times higher odds of having elevated blood pressure than females (Table 4). Without adjusting for any covariates, those who used the community toilet had 0.42 (95% CI 0.24–0.74) times lower odds of having elevated blood pressure than those with a toilet in their homes (Table 4). However, upon adjustment, this significant association disappeared.
Table 4
Logistic Regression Results for Elevated Blood Pressure, Blood Glucose, and Overweight/Obesity
|
Total (N = 266)
|
Elevated Blood Pressure (N = 193)
|
Elevated Blood Glucose (N = 24)
|
Obesity/Overweight (N = 201)
|
Characteristic
|
N
|
N (Column %)
|
p-value
|
N (Column %)
|
p-value
|
N (Column %)
|
p-value
|
Age (years)
|
|
|
< 0.001
|
|
0.003
|
|
< 0.001
|
21–35
|
70
|
33 (17.10)
|
|
8 (33.33)
|
|
44 (21.89)
|
|
35–49
|
84
|
61 (31.61)
|
|
|
68 (33.83)
|
|
49–63
|
75
|
66 (34.20)
|
|
14 (58.33)
|
|
67 (33.33)
|
|
>= 63
|
37
|
33 (17.10)
|
|
2 (8.33)
|
|
22 (10.95)
|
|
Sex
|
|
|
< 0.001
|
|
0.572
|
|
0.301
|
Female
|
201
|
135(69.95)
|
|
17(70.83)
|
|
155(77.11)
|
|
Male
|
65
|
58(30.05)
|
|
7(29.17)
|
|
46(22.89)
|
|
Literacy
|
|
|
0.606
|
|
0.390
|
|
0.230
|
Illiterate
|
110
|
83(43.01)
|
|
12(50.00)
|
|
89(44.28)
|
|
Read
|
55
|
40(20.73)
|
|
6(25.00)
|
|
40(19.90)
|
|
Read and Write
|
101
|
70(36.27)
|
|
6(25.00)
|
|
72(35.82)
|
|
Educational level
|
|
|
0.095
|
|
0.783*
|
|
0.230
|
Less than high school
|
190
|
142(73.58)
|
|
19(79.17)
|
|
149(74.13)
|
|
High school
|
51
|
31(16.06)
|
|
4(16.67)
|
|
35(17.41)
|
|
College plus
|
25
|
20(10.36)
|
|
1(4.17)
|
|
17(8.46)
|
|
Employment
|
|
|
0.109
|
|
0.253*
|
|
0.645*
|
Unemployed
|
207
|
143 (74.09)
|
|
16 (66.67)
|
|
156 (77.61)
|
|
Self-Employed
|
21
|
18 (9.33)
|
|
4 (16.67)
|
|
18 (8.96)
|
|
Labor or Service Industry
|
18
|
16 (8.29)
|
|
2 (8.33)
|
|
13 (6.47)
|
|
Other
|
20
|
16 (8.29)
|
|
2 (8.33)
|
|
14 (6.97)
|
|
Languages Spoken
|
|
|
0.294*
|
|
1.000*
|
|
0.710*
|
Hindi/Marathi
|
256
|
184 (95.34)
|
|
23 (95.83)
|
|
194 (96.52)
|
|
Other
|
10
|
9 (4.66)
|
|
1 (4.17)
|
|
7 (3.48)
|
|
Marriage status
|
|
|
0.521*
|
|
0.609*
|
|
0.495*
|
Married
|
254
|
183 (94.82)
|
|
24 (100.00)
|
|
193 (96.02)
|
|
Unmarried/Separated/Widowed
|
12
|
10 (5.18)
|
|
0 (0.00)
|
|
8 (3.98)
|
|
Place of Care
|
|
|
0.079
|
|
0.586*
|
|
0.698
|
Missing (49 missing)
|
49
|
|
|
|
|
|
|
Government
|
164
|
109 (72.19)
|
|
14 (70.00)
|
|
125 (76.22)
|
|
Private
|
53
|
42 (27.81)
|
|
6 (30.00)
|
|
39 (23.78)
|
|
Availability of Toilet
|
|
|
0.002
|
|
0.003
|
|
0.403
|
Community
|
83
|
50 (25.91)
|
|
1 (4.17)
|
|
60 (29.85)
|
|
In home
|
183
|
143 (74.09)
|
|
23 (95.83)
|
|
141 (70.15)
|
|
Diagnosis Status
|
--
|
|
0.369
|
|
< 0.001*
|
--
|
--
|
Previously Not Diagnosed
|
--
|
176 (91.19)
|
|
5 (20.83)
|
|
--
|
--
|
Previously Diagnosed
|
--
|
17 (8.81)
|
|
19 (79.17)
|
|
--
|
--
|
Elevated Blood Glucose
Age, availability of toilet, and diagnosis status had a statistically significant association with the outcome of elevated blood glucose. Of those with this condition, 58.3% were between 49–63 years of age, 95.8% had a toilet in their home, and 20.8% had not been previously diagnosed (Table 3).
Without adjusting for any covariates, those between 49 to 63 years of age had 4.19 (95% CI 1.67–10.50) times higher odds of having elevated blood glucose than those in the 21–49 age category (Table 4). However, upon adjusting for other covariates, this association disappeared. Those who used the community toilet had 0.09 (95% CI 0.01–0.64) times lower odds of having elevated blood glucose than those who had a toilet in their home (Table 4). This association also disappeared upon adjusting for other covariates. Upon adjustment, those who had not been previously diagnosed had 0.04 (95% CI 0.01–0.13) times lower odds of having elevated blood glucose than those who had been previously diagnosed (Table 4).
Obesity
Age was statistically significantly associated with being over-weight or obese, where 67.2% of those between the ages of 35–63 were overweight or obese (Table 3).
Those between the ages of 35 and 49 and those between the ages of 49 and 63 had 2.51 times and 4.95 (95% CI 1.21–5.21, 95% CI 2.06–11.92) times higher odds of being overweight or obese than those between the ages of 21 and 35 (Table 4), respectively. This model was not adjusted for any covariates since the bivariate analysis did not show any other statistically significant variables.
(Insert Tables 3 and 4 here)
Comorbidity
There was a statistically significant association between age and availability of toilet and comorbidity. A majority of those with all three conditions were between 49–63 years of age (52.4%, P < 0.001) and had a toilet in their home (95.2%, P 0.033). 38.0% of those with one condition were between 21–35 years of age (Table 5). None of the other variables were significantly associated with comorbidity.
Table 5
Description of the sample according to comorbidity
Odds of Having Elevated Blood Pressure
|
Characteristic
|
Unadjusted OR (95% CI)
|
p-value
|
Adjusted OR (95% CI)
|
p-value
|
Age
|
|
|
|
|
21–35
|
Reference
|
Reference
|
Reference
|
Reference
|
35–49
|
2.97 (1.52, 5.82)
|
0.002
|
3.03 (1.52, 6.05)
|
0.002
|
49–63
|
8.22 (3.55, 19.04)
|
< 0.001
|
7.22 (3.06, 17.05)
|
< 0.001
|
>= 63
|
9.25 (2.96, 28.87)
|
< 0.001
|
6.82 (2.12, 22.00)
|
0.001
|
Sex
|
|
|
|
|
Female
|
Reference
|
Reference
|
Reference
|
Reference
|
Male
|
4.05 (1.75, 9.36)
|
0.001
|
3.33 (1.37, 8.07)
|
0.008
|
Availability of Toilet
|
|
|
|
|
Community
|
0.42 (0.24, 0.74)
|
0.003
|
0.60 (0.32, 1.12)
|
0.109
|
In home
|
Reference
|
Reference
|
Reference
|
Reference
|
Odds of Having Elevated Blood Sugar
|
Characteristic
|
Unadjusted OR (95% CI)
|
p-value
|
Adjusted OR (95% CI)
|
p-value
|
Age (years)
|
|
|
|
|
21–49
|
Reference
|
Reference
|
Reference
|
Reference
|
49–63
|
4.19 (1.67, 10.50)
|
0.002
|
1.55 (0.50, 4.76)
|
0.448
|
>= 63
|
1.04 (0.21, 5.13)
|
0.959
|
0.40 (0.07, 2.41)
|
0.320
|
Availability of Toilet
|
|
|
|
|
Community
|
0.09 (0.01, 0.64)
|
0.017
|
0.12 (0.02, 1.01)
|
0.051
|
In home
|
Reference
|
Reference
|
Reference
|
Reference
|
Diagnosis Status
|
|
|
|
|
Previously Not Diagnosed
|
0.03 (0.01, 0.10)
|
< 0.001
|
0.04 (0.01, 0.13)
|
< 0.001
|
Previously Diagnosed
|
Reference
|
Reference
|
Reference
|
Reference
|
Odds of Obesity/Overweight
|
Characteristic
|
Unadjusted OR (95% CI)
|
p-value
|
--
|
--
|
Age
|
|
|
--
|
--
|
21–35
|
Reference
|
Reference
|
--
|
--
|
35–49
|
2.51 (1.21, 5.21)
|
0.013
|
--
|
--
|
49–63
|
4.95 (2.06, 11.92)
|
< 0.001
|
--
|
--
|
>= 63
|
0.87 (0.38, 1.96)
|
0.731
|
--
|
--
|
|
Comorbidity
|
|
|
Characteristic
|
One (N = 71)
|
Two (N = 142)
|
Three (N = 21)
|
p-value
|
Age (years)
|
|
|
|
<0.001
|
21–35
|
27 (38.03)
|
25 (17.61)
|
0 (0.00)
|
|
35–49
|
17 (23.94)
|
48 (33.80)
|
8 (38.10)
|
|
49–63
|
10 (14.08)
|
52 (36.62)
|
11 (52.38)
|
|
>= 63
|
17 (23.94)
|
17 (11.97)
|
2 (9.52)
|
|
Sex
|
|
|
|
0.657
|
Female
|
55(77.46)
|
102(71.83)
|
16 (76.19)
|
|
Male
|
16(22.54)
|
40(28.17)
|
5 (23.81)
|
|
Literacy
|
|
|
|
0.559
|
Illiterate
|
27(38.03)
|
62(43.66)
|
11 (52.38)
|
|
Read
|
13(18.31)
|
29(20.42)
|
5 (23.81)
|
|
Read and Write
|
31(43.66)
|
51(35.92)
|
5 (23.81)
|
|
Educational level
|
|
|
|
0.577*
|
less than high school
|
47(66.20)
|
106(74.65)
|
17 (80.95)
|
|
high school
|
17(23.94)
|
22(15.49)
|
3 (14.29)
|
|
college plus
|
7(9.86)
|
14(9.86)
|
1 (4.76)
|
|
Employment
|
|
|
|
0.519*
|
Unemployed
|
58 (81.69)
|
106 (74.65)
|
15 (71.43)
|
|
Self-Employed
|
3 (4.23)
|
14 (9.86)
|
3 (14.29)
|
|
Labor or Service Industry
|
3 (4.23)
|
11 (7.75)
|
2 (9.52)
|
|
Other
|
7 (9.86)
|
11 (7.75)
|
1 (4.76)
|
|
Languages Spoken
|
|
|
|
0.890*
|
Hindi/Marathi
|
68 (95.77)
|
135 (95.07)
|
21(100.00)
|
|
Other
|
3 (4.23)
|
7 (4.93)
|
0 (0.00)
|
|
Marriage status
|
|
|
|
0.803*
|
Married
|
67 (94.37)
|
135 (95.07)
|
21 (100.00)
|
|
Unmarried/Separated/Widowed
|
4 (5.63)
|
7 (4.93)
|
0 (0.00)
|
|
Place of Care
|
|
|
0.114
|
Government
|
51 (85.00)
|
82 (73.21)
|
11 (64.71)
|
|
Private
|
9 (15.00)
|
30 (26.79)
|
6 (35.29)
|
|
Availability of Toilet
|
|
|
0.033
|
Community
|
24 (33.80)
|
42 (29.58)
|
1 (4.76)
|
|
In home
|
47 (66.20)
|
100 (70.42)
|
20 (95.24)
|
|
Table Values are n (column %) and may not sum to 100% due to rounding
*Indicates that P-value is for Fisher’s exact test, else it is for chi-squared
|