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He provides us insights into Socioeconomic Gradients and Distribution of Diabetes, Hypertension, and Obesity in India, the latest paper he co-authored with Prof. Subu Subramanian from the T.H Chan Harvard School of Public Health, which has analysed the health environment of 800'000 people in India.
Swiss Re Institute: What are the 3 most important findings?
Daniel Corsi: The most important findings were that: 1. The majority of the burden of cardiovascular disease risk factors was found among those with higher levels of wealth, education, and social caste; 2. Increasing household wealth was associated with higher levels of obesity, diabetes, and hypertension; 3. These patterns were similar across states and regions in India.
Swiss Re Institute: Did these findings come as a surprise to you and, if yes, why?
Daniel Corsi: Although our previous research has given similar results, this was the first time we considered three risk factors (diabetes, hypertension, and obesity) simultaneously. We found that a majority of those with these conditions were in middle and upper social classes in India.
Swiss Re Institute: How did you manage surveying roughly 800'000 people?
Daniel Corsi: We are fortunate to work with the National Family Health Survey and the Demographic and Health Surveys Program which implement and manage the survey. The field work is carried out coordinated by multiple organizations in India. It relied on a high level of interviewer training and monitoring to ensure data quality. The survey also uses many technologies including computer based interviewing and data capture, field based measurements of blood pressure, blood glucose, and height and weight of respondents.
Swiss Re Institute: Which technologies are you using to process such large amounts of detailed data?
Daniel Corsi: We use statistical analysis software which has been designed for large data and for analysis of survey-specific data.
Swiss Re Institute: Will the findings communicated back to (some of the) surveyed people contain specific medical risk exposures?
Daniel Corsi: The findings will be communicated to various stakeholders in India including those in government, policy and planners, health care workers, the scientific community, and the public at large. Due to privacy and data integrity, the survey does not capture any personal identification information and it is not possible to communicate a specific result for example for high blood pressure back to an individual respondent.
Swiss Re Institute: What would be your health recommendations for these people?
Daniel Corsi: I think that it is important to consider that India is in a state of tremendous transition as an emerging economy. There is increased migration to cities and adoption of more ‘western’ lifestyles as a result including changes in diet and level of physical activity, and types of occupation. For an individual I think increased education and awareness about how these changes may affect one’s health and risk factors for cardiovascular disease would be important. Trying to maintain regular exercise, adequate diet, reduce smoking and alcohol can be important behaviour changes to promote a healthy lifestyle and reduce overweight, high blood pressure, and risk of diabetes.
Swiss Re Institute: Are you also in discussion with governmental or public health entities in India to make health policy recommendations?
Daniel Corsi: We plan to continue to work to communicate our findings to policy makers in India. We have made some suggestions for recommendations in our paper including to target health resources based on the burden of disease. In India there remains problems of poverty, economic inequality, and other health issues including undernutrition and maternal conditions which continue to put many lives at risk. We argue that while cardiovascular risk factors are a growing concern we have to be careful not to divert important resources away from other areas where they may still be needed.