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'Health divide' between indigenous and non-indigenous populations in Kerala, India: Population based study
- Source :
- BMC Public Health, BMC Public Health, Vol 12, Iss 1, p 390 (2012)
- Publication Year :
- 2012
- Publisher :
- BioMed Central, 2012.
-
Abstract
- Background The objective of this study is to investigate the magnitude and nature of health inequalities between indigenous (Scheduled Tribes) and non-indigenous populations, as well as between different indigenous groups, in a rural district of Kerala State, India. Methods A health survey was carried out in a rural community (N = 1660 men and women, 18–96 years). Age- and sex-standardised prevalence of underweight (BMI 2), anaemia, goitre, suspected tuberculosis and hypertension was compared across forward castes, other backward classes and tribal populations. Multi-level weighted logistic regression models were used to estimate the predicted prevalence of morbidity for each age and social group. A Blinder-Oaxaca decomposition was used to further explore the health gap between tribes and non-tribes, and between subgroups of tribes. Results Social stratification remains a strong determinant of health in the progressive social policy environment of Kerala. The tribal groups are bearing a higher burden of underweight (46.1 vs. 24.3%), anaemia (9.9 vs. 3.5%) and goitre (8.5 vs. 3.6%) compared to non-tribes, but have similar levels of tuberculosis (21.4 vs. 20.4%) and hypertension (23.5 vs. 20.1%). Significant health inequalities also exist within tribal populations; the Paniya have higher levels of underweight (54.8 vs. 40.7%) and anaemia (17.2 vs. 5.7%) than other Scheduled Tribes. The social gradient in health is evident in each age group, with the exception of hypertension. The predicted prevalence of underweight is 31 and 13 percentage points higher for Paniya and other Scheduled Tribe members, respectively, compared to Forward Caste members 18–30 y (27.1%). Higher hypertension is only evident among Paniya adults 18–30 y (10 percentage points higher than Forward Caste adults of the same age group (5.4%)). The decomposition analysis shows that poverty and other determinants of health only explain 51% and 42% of the health gap between tribes and non-tribes for underweight and goitre, respectively. Conclusions Policies and programmes designed to benefit the Scheduled Tribes need to promote their well-being in general but also target the specific needs of the most vulnerable indigenous groups. There is a need to enhance the capacity of the disadvantaged to equally take advantage of health opportunities.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
India
Rural Health
Indigenous
Young Adult
Population Groups
Environmental health
Epidemiology
Tribe
Medicine
Humans
Social determinants of health
Aged
Aged, 80 and over
business.industry
Rural health
Public health
lcsh:Public aspects of medicine
Caste
Public Health, Environmental and Occupational Health
lcsh:RA1-1270
Health Status Disparities
Middle Aged
Health Surveys
Socioeconomic Factors
population characteristics
Female
Underweight
medicine.symptom
business
geographic locations
Demography
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- BMC Public Health
- Accession number :
- edsair.doi.dedup.....c82de530b324b79444c6222aede98d06