A recent study conducted in rural India has revealed that three out of five people suffer from chronic health issues. The study by The George Institute of Global Health highlights the prevalence of multimorbidity (more than one health condition in an individual) in rural India and the urgent need for comprehensive healthcare solutions.

The authors of the report — Dr Balaji Gummidi, Vaishali Gautam, Dr Oommen John, Arpita Ghosh, and Dr Vivekanand Jha — analysed the self-reported health of individuals in a rural region of Andhra Pradesh to investigate the prevalence and causes of multimorbidity. The team studied non-communicable diseases, communicable diseases, and mental illnesses.

The findings showed that more than one-fourth (around 28 per cent) of the rural population suffered from a combination of diabetes and high blood pressure, while nearly 8 per cent dealt with diabetes, high blood pressure, and kidney disease. In the case of non-cardiometabolic diseases, about 44 per cent experienced two co-existing conditions: acid reflux and musculoskeletal diseases.

A key finding was that diabetes and high blood pressure were closely associated with chronic kidney disease rather than heart disease — highlighting a link that was not commonly known before. The study identified depression and anxiety as integral components of multimorbidity in rural India.

Dr Jha, Executive Director at George Institute, pointed out that multimorbidity in rural India was associated with advancing age, the feminine gender, and obesity. Gender-specific differences emerged, too, with a higher prevalence of stroke and heart failure seen in men, while more women reported suicidal thoughts. These differences may stem from a combination of biological and lifestyle factors.

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The study also highlighted the prevalence of multimorbidity among the younger working population, which throws up unique challenges. Unlike older individuals, younger people are less inclined to accept the need for multiple medications. Consequently, the concept of ‘multipills’ — combination pills that target multiple diseases — becomes crucial in managing multimorbidity, particularly among the youth. While multipills are already available for conditions such as musculoskeletal diseases and gastrointestinal ailments, more are needed to address other multimorbidities.

Another common problem in rural areas, Dr Gummidi pointed out, is that of ‘multi-pharmacy’. Patients often visit multiple doctors for various ailments, resulting in prescriptions of different medications for the same disease and the risk of overdose and associated complications.

A resilient healthcare system that addresses complex illnesses and their causes must grasp the implications of multimorbidity, shifting the focus from treating individual diseases to treating clusters of diseases. This holistic approach can improve patient outcomes and create a healthier future for all, he says.

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