Epidemiological Transition in India and Determinants that Are Shifting Disease Burden: A Systematic Review

Abstract

India’s disease burden patterns are shifting towards increased morbidity and mortality from Non-communicable disease and chronic diseases. This is one of the first studies conducted using the PRISMA guidelines and checklist to understand the role played by various determinants of health in this epidemiological transition happening in India. The search on 9 reputed bibliographic databases yielded 459 articles and finally 58 articles were selected based on carefully curated selection criteria. The results confirm the relation between India's demographic transition and the increasing disease burden from Non-communicable diseases (NCDs). 21 studies significantly associated urban residential status, increasing income, better living conditions and education with increasing NCDs' prevalence. 12 studies found that NCDs were more prevalent among women than men. Increased physical activity, a healthy diet and a lower hipto-waist ratio were observed to protect against NCDs. While 9 studies found smoking tobacco and alcohol consumption were not significantly associated with the prevalence of NCDs. It is of foremost importance that India’s public health policy focus must shift towards inclusivity as there is an affluent gradient to the increased morbidity and mortality from NCDs.