Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 16;25(1):2477.
doi: 10.1186/s12889-025-23587-2.

Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022-23

Tanveer Rehman  1 , Chinmayee Sethy  2 , Afeeq K  2 , Jaya Singh Kshatri  2 , Manikandanesan Sakthivel  3   4 , Kavitha A K  2 , Ansuman Panigrahi  2 , Mohan Kumar Raju  3   4 , Archana Ramalingam  3 , Sanghamitra Pati  5   6
Affiliations

Socioeconomic and sex disparities in hypertension and diabetes mellitus care cascade among tribal populations in Odisha, India: findings from the Odisha Tribal Family Health Survey (OTFHS), 2022-23

Tanveer Rehman et al. BMC Public Health. .

Abstract

Background: We assessed sex and socioeconomic disparities in the care cascade, i.e., awareness, treatment, and control (ATC), for hypertension and diabetes among Odisha's tribal communities.

Methods: We surveyed 14 tribal districts via multistage cluster sampling covering 10,090 households from 2022 to 23. Data from individuals aged > 18 years were analyzed for hypertension (BP > 140/90 mmHg) and diabetes (RBS > 200 mg/dL). The outcomes included (i) awareness (prior diagnosis or medication use), (ii) treatment (self-reported medication use), and (iii) control (BP < 140/90 mmHg for hypertension, RBS < 180 mg/dL for diabetes). Multivariable log-binomial regression was used to estimate adjusted prevalence ratios (aPRs with 95% CIs) for gender and wealth quintile associations with ATC stages.

Results: Of the 21,100 participants, 33.7% had hypertension and 9.7% had diabetes. Among the 6,620 hypertensive individuals, 19% were aware, 13·8% were on treatment, and 6·8% had controlled BP. Women with hypertension (N = 3,609) had significantly better outcomes than men did: awareness (aPR: 1·4;1·2-1·6), treatment (aPR: 1·5; 1·2-1·7), and control (aPR: 1·7; 1·4-2·2). Compared with those in the poorest quintile, hypertensive individuals from the richest quintile (N = 1,804) were more likely to be aware (aPR: 1·5; 1·2-1·9) and on treatment (aPR: 1·5; 1·2-2·7); however, BP control was not significantly different (aPR: 1·6; 0·9-2·8). Among the 1,883 individuals with diabetes, 49% were aware, 44·4% were on treatment, and 40·7% achieved control.

Conclusion: Significant socioeconomic and sex inequities persist in hypertension care among Odisha's tribal populations, with better ATC outcomes for women and wealthier individuals. Targeted screening and gender-sensitive approaches are essential for equitable healthcare access.

Keywords: Care continuum; Determinants of health; Diabetes; Hypertension; Odisha; Tribal population.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical statement: The Ethics approval was obtained from Institutional Human Ethics Committee IHEC of Indian Council of Medical Research– Regional Medical Research Centre, Bhubaneswar, Odisha. The approval was in consideration of the Helsinki Declaration. Informed consent was obtained from all the participants in written. Consent for publication: Not applicable. Conflict of interest: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Choropleth map showing the study districts of the Odisha Tribal Family Health Survey (OTFHS), 2022-23
Fig. 2
Fig. 2
Flowchart of participant selection in the OTFHS, 2022-23
See this image and copyright information in PMC

References

    1. Murray CJ, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396(10258):1223–49. - PMC - PubMed
    1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. - PMC - PubMed
    1. Lamloum D, Fassio F, Osetinsky B, Tediosi F. Care cascades for hypertension in low-income settings: a systematic review and Meta-analysis. Int J Public Health. 2023;68:1606428. - PMC - PubMed
    1. Schutte AE, Srinivasapura Venkateshmurthy N, Mohan S, Prabhakaran D. Hypertension in low-and middle-income countries. Circul Res. 2021;128(7):808–26. - PMC - PubMed
    1. Beaney T, Schutte AE, Stergiou GS, Borghi C, Burger D, Charchar F, et al. May measurement month 2019: the global blood pressure screening campaign of the international society of hypertension. Hypertension. 2020;76(2):333–41. - PubMed